AccountId: 011433970860
ContactId: f8334a3a-f5b0-4786-9144-9ff9dbb87efd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358290 ms
Total Talk Time (AGENT): 90115 ms
Total Talk Time (CUSTOMER): 189142 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/f8334a3a-f5b0-4786-9144-9ff9dbb87efd_20250507T14:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm hoping you can help me. Um, I just received a call from [PII], but I'm not sure. She gave me a different phone number. It's about a member if you can verify for me that you have the member on your listed. I'm calling from Palm Beach Urology, the doctor's office.
[AGENT][NEUTRAL] OK. Uh, just check, you're checking eligibility. Is that right?
[CUSTOMER][NEUTRAL] No, not really. I'm actually checking on a claim. She called us because they said they paid the claim, but they kept getting rejected from the US Postal Service for their check because they're sending it to the lockbox, so I need to check which address they're mailing the check to. Can you check the claim for the member as well?
[AGENT][NEUTRAL] Uh, sure. Do you have your, the policy number?
[CUSTOMER][NEUTRAL] Yeah, ID is W281127184.
[AGENT][NEUTRAL] And that's not one of our policy numbers. Um.
[CUSTOMER][NEUTRAL] OK, uh, American Public Life secondary APL maybe, yeah, right? APL, OK, so employee, um, hold on, let me see where it's out in the card, um, I have a name insured coverage and group number. There's no it says Medi link select group med sub.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, certification number benefit, which number do you need?
[AGENT][NEUTRAL] Certification number.
[CUSTOMER][NEUTRAL] Out outpatient benefit certification number maybe?
[AGENT][NEUTRAL] Yeah, that'd be fine.
[CUSTOMER][NEUTRAL] 01568605 M for Mary L for Larry, number 8.
[AGENT][NEUTRAL] And do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII] actually. I'm sorry. [PII] is the one that called me from APL I guess it's one, it's OK. Our area code is [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] [PII] I'm sorry [PII].
[CUSTOMER][NEUTRAL] And my extension is [PII].
[CUSTOMER][NEUTRAL] Is it the one that was in the.
[AGENT][NEUTRAL] OK, [PII], and do you have a patient name and date of birth?
[CUSTOMER][NEUTRAL] Yes. Patient name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And what was that?
[CUSTOMER][NEUTRAL] I just need to know.
[CUSTOMER][NEUTRAL] The date of service.
[AGENT][NEUTRAL] You the
[CUSTOMER][NEUTRAL] I have on file I have two dates of services from last year [PII] and also [PII].
[AGENT][NEUTRAL] OK, and this is for physician services?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Let me pull that up. One moment.
[CUSTOMER][POSITIVE] Thank you for holding.
[AGENT][NEUTRAL] OK, let me see what this says.
[AGENT][NEUTRAL] OK, let me read the notes here.
[CUSTOMER][NEUTRAL] Their insurance stated their copay.
[CUSTOMER][NEUTRAL] Maybe it went up
[CUSTOMER][NEUTRAL] they have to call their insurance.
[AGENT][NEUTRAL] OK, so let me see where we're sending this. Did she verify the lockbox?
[CUSTOMER][NEUTRAL] No, she did not. She actually said that it was uh they were trying to mail the check, but it would the postal service kept rejecting. I, I meant to ask her and I didn't get that information, but I was gonna confirm with our corporate office to see what they have on file.
[AGENT][NEUTRAL] OK. Let me get that pulled up.
[CUSTOMER][NEUTRAL] I'm wondering if you guys got a paper claim? Was it you received a paper claim is that what it was?
[AGENT][NEUTRAL] Uh, probably, yeah, let me get that pulled up. Hold on one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well,
[AGENT][NEUTRAL] to find the original claim so I can see what what we received.
[AGENT][NEUTRAL] Yeah, so we're sending it to.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, that's what we have on file 30394, so you guys are getting a rejection.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3038.
[CUSTOMER][NEGATIVE] It's being returned
[CUSTOMER][NEUTRAL] OK, hold on, I have Genesis Care USA of Florida [PII] 30394-7152.
[AGENT][NEUTRAL] OK, we have 303-84. OK, so should it.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] No, it's 94. That's what it is.
[AGENT][NEUTRAL] 94.
[CUSTOMER][NEUTRAL] OK, just wanna make sure you guys get it proper.
[AGENT][NEUTRAL] OK, so 38
[CUSTOMER][NEUTRAL] Before I sent out an email to corporate.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, 303-94. OK, I will um send a request back with this information that you've provided, the 30394, um, and then we.
[CUSTOMER][NEUTRAL] 7152 just to make sure it's complete that way doesn't return.
[AGENT][NEUTRAL] Uh-huh, yes, 7152.
[CUSTOMER][NEUTRAL] And do you have our NPI on file as well?
[AGENT][NEUTRAL] Um, I, I'm not sure. We don't use, it's a secondary policy, so we don't use those.
[CUSTOMER][NEUTRAL] OK, don't worry, that's fine. OK, just making sure you got the proper address.
[AGENT][NEUTRAL] OK, I will get this information relayed to that team and then we will work on getting that sent back.
[CUSTOMER][POSITIVE] Thank you so much I appreciate it.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] Alright bye bye you too.