AccountId: 011433970860
ContactId: f6cb8e5d-d6f3-41a7-94d0-16c33c4757ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 695020 ms
Total Talk Time (AGENT): 205033 ms
Total Talk Time (CUSTOMER): 132990 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/f6cb8e5d-d6f3-41a7-94d0-16c33c4757ac_20250131T19:40_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to follow up on a claim.
[AGENT][NEUTRAL] OK, you're needing claim status, is that correct? Yes, I can help you with that and who am I speaking with?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling with Baptist Medical Center.
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have 01546668 ML 8.
[AGENT][POSITIVE] OK, thank you, [PII]. Give me a couple of moments to get all the information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, OK, so I have
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh [PII] is a long name. Uh looks like [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount please?
[CUSTOMER][NEUTRAL] [PII] 2024.
[CUSTOMER][NEUTRAL] And I have 2,232 and 15 cents.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, so I do show that this claim was received. It was received on [PII] and processed on [PII].
[AGENT][NEUTRAL] And what is, well, first off, what is the name of the facility?
[AGENT][NEUTRAL] For this claim?
[CUSTOMER][NEUTRAL] Baptist mother.
[CUSTOMER][NEUTRAL] Baptist Medical Center.
[AGENT][NEUTRAL] OK, so I'm sorry then we do not have a claim on file for that provider for this data service. What I was about to give you was something different.
[CUSTOMER][NEUTRAL] It could be under the um it's Wolfson's Children's Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so just one moment there.
[AGENT][NEUTRAL] And then you just say the total bill amount is 22, 32, and 15 cents. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so yes, that initial information that I gave you on this claim is correct.
[AGENT][NEUTRAL] The claim number is 3465927.
[AGENT][NEUTRAL] There was a benefit paid in the amount of 200. Let me look at the remarks, just one second.
[AGENT][NEUTRAL] I'm sorry, I'm having trouble with one of my screens.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So yes, I do show that there was a benefit paid in the amount of $250.
[CUSTOMER][NEUTRAL] OK, does it show when it was paid?
[AGENT][NEUTRAL] It was paid the date, the same date as the process date that I provided for you.
[CUSTOMER][NEUTRAL] OK, so the 67.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, did you guys process as primary?
[AGENT][NEUTRAL] Uh, no, ma'am. We are not a major medical insurance. This is a supplemental policy.
[AGENT][NEUTRAL] That helps with co-pays, deductibles and co-insurance amounts.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is there, um, do you have any of the check information? It looks like they're just missing the payment then.
[AGENT][NEUTRAL] What is the address?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have, let me just check.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Where
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Alright, awesome. What is that?
[CUSTOMER][NEUTRAL] I'm not sure. I don't wanna give the wrong address because I'm not sure if it's a different address for the payments. I don't, I can't find me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's the address that I would need to verify before requesting.
[AGENT][NEUTRAL] Making any further requests on it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I can provide you the check number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That it was issued on?
[AGENT][NEUTRAL] And that's 1856477, and that is a single check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it was issued 67.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright perfect and then are you, are you able to tell if it was cashed?
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] It's showing as outstanding, but before I could send a request, I would need to be able to verify the, you know, the address.
[AGENT][NEUTRAL] That we received before we resend it again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you hold on just one second? Let me see if there's anyone that could just confirm.
[CUSTOMER][NEUTRAL] Alright let me so this is.
[CUSTOMER][NEUTRAL] Is it the [PII]?
[AGENT][NEUTRAL] That is correct, yes, ma'am. That is what was on the claim and that is where the check was issued to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I thought it was on the W-9, but I haven't done it in a really long time, so.
[CUSTOMER][NEUTRAL] Wasn't sure. I was like let me.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So I can have the I'll just send this back and then see if they can check into this first and then maybe I can give you a call back if um.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK. All right, perfect.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] And if you need a copy of the explanation of benefits, [PII] for this number you can go to our portal website to print that now that you have the claim number and our portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] Yes ma'am, uh huh.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And so you're just gonna, you did say that you're gonna research it on that end and then you all will call us back if it, if you're not able to locate it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's fine and then is there a um reference number for the call?
[AGENT][NEUTRAL] Yes, ma'am. You're just gonna use my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome. And can I help you with anything else?
[CUSTOMER][POSITIVE] No, that's it have a great weekend.
[AGENT][POSITIVE] OK. I hope you have a great weekend too, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] You too. Bye