AccountId: 011433970860
ContactId: f316a863-93fd-418d-8fc1-2c80f6ee459f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1212670 ms
Total Talk Time (AGENT): 192058 ms
Total Talk Time (CUSTOMER): 125297 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/f316a863-93fd-418d-8fc1-2c80f6ee459f_20250109T15:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from our office, checking on a claim.
[AGENT][NEUTRAL] Sure, I can assist you with claims and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the spelling of your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have uh the patient's policy number, mister?
[CUSTOMER][NEUTRAL] Patient policy. Before that, I would like to inform you that this call is being recorded for quality and training purpose. Policy ID is 02419434 M as Mike L as Lima number 8.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. May I have the date of service and the amount of the claims?
[CUSTOMER][NEUTRAL] Data service is [PII]. Bill amount is $500.
[AGENT][NEUTRAL] Thank you. So that's [PII]. And for future, you can check claim status online through our website at [PII]. That's just optional.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Alright, let me pull this ERP one moment.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, I'm still waiting on the EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] You said it was $500. Is it $500 even?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] 76641.
[AGENT][NEUTRAL] 16.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, just one.
[AGENT][NEUTRAL] And what's the name of the provider?
[CUSTOMER][NEUTRAL] Diagnostic Center of Miami for Women.
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] OK, here it is. All right, so it looks like we processed the claim on [PII] and we send a benefit amount of $417.95 to the provider.
[CUSTOMER][NEUTRAL] Uh, can you help me with the payment details?
[AGENT][NEUTRAL] Yes, um, that is a paper check and single check.
[AGENT][NEUTRAL] The check number is 2004884.
[AGENT][NEUTRAL] And let me see if I can get a cash date. One moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Can you verify the address where the payment needs to go to?
[CUSTOMER][NEUTRAL] Uh, just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can I place your call on hold because I need to check this information at my end.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Just bear with me one more moment.
[AGENT][POSITIVE] Mhm. Sure. Thank you.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And that is um where the check needed to go to.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Is that the, where the check um supposed to go to? That's the address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the check is still outstanding, but that is not the address that we send the check to.
[CUSTOMER][NEUTRAL] Uh, can you help me with the address on which the check has been sent?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, this is a single, uh, single payment check, right?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, just give me one moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, do you have the clear date for this uh check number?
[AGENT][POSITIVE] Again, it has not cleared. It's, it's outstanding.
[CUSTOMER][NEUTRAL] Uh, why so? Do you have any reason for that?
[AGENT][NEGATIVE] It's just not clear
[CUSTOMER][NEUTRAL] Is it received by the provider?
[AGENT][NEUTRAL] If it's not clear, that means that it's uncertain if they received the check or not.
[AGENT][NEUTRAL] Now, the address that is on the 1500 form is the one that I just mentioned. So if we uh cancel and reissue, it's gonna go to the same address unless we receive a W-9. So you want me to send the request for the check to be canceled and reissued?
[CUSTOMER][NEUTRAL] Uh, just give me a moment. Let me recheck with with my supervisor.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please be on hold.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Uh yes, please. Go ahead and uh cancel the check and reissue the check.
[CUSTOMER][NEUTRAL] So that we can receive that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, um, do you mind holding for me so I can process this?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Mr. [PII]. OK, I went ahead and send that request over so they should be working on it within 24 to 48 business hours, OK?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, please uh.
[CUSTOMER][NEUTRAL] Can you please spell out your name for my records?
[AGENT][NEUTRAL] Sure, that's [PII]. Last initial is [PII].
[CUSTOMER][NEUTRAL] Also, please help me with the call reference number.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in the state if you like.
[CUSTOMER][POSITIVE] Thank you so much for your assistance. Have a great day.
[AGENT][POSITIVE] You as well thank you for calling APL. Have a good day.