AccountId: 011433970860
ContactId: 008e9b20-a955-4995-99d6-a7241c23f192
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 548010 ms
Total Talk Time (AGENT): 138469 ms
Total Talk Time (CUSTOMER): 116570 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/008e9b20-a955-4995-99d6-a7241c23f192_20250204T18:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office to check on a claim status. And before we proceed, I would like to inform you that this call is being recorded for quality and training purposes. Is that OK with you?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the name of the patient?
[CUSTOMER][NEUTRAL] Member's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and what's the patient's policy number?
[CUSTOMER][NEUTRAL] That is 02212315 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what is the date of service?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII], total bill amount, $405 even 405.
[AGENT][NEUTRAL] OK, thank you and then what is the um charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] OK. And what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Diagnostic Center of Women.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for you and I'll be right back.
[CUSTOMER][POSITIVE] No problem. Take your time.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Thank you for holding for me, [PII]. Yes, ma'am, thank you for holding. I do have the claim. The claim number is 355-4162.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was received on [PII].
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEGATIVE] And it was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Provide me the fax number.
[AGENT][NEUTRAL] Yes, ma'am. That's [PII].
[CUSTOMER][NEUTRAL] And before the reference number, ma'am, actually I have uh one more claim to check on after this one. So can you help me with that also?
[AGENT][NEUTRAL] Yes, and you can use my name and today's date it's [PII] for all of your reference numbers.
[CUSTOMER][POSITIVE] OK, thank you so much for that one. Just a moment.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Uh, I'll provide you the next number I, OK, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So for the next number, the member ID is 600974347.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] That's not a one of our policy numbers.
[CUSTOMER][NEUTRAL] Uh, just a moment, let me check once.
[CUSTOMER][NEUTRAL] OK, so can you check the member ID 00974347?
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] OK, what is the patient's name?
[CUSTOMER][NEUTRAL] That's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK and then what is the date of service?
[CUSTOMER][NEUTRAL] [PII] total bill amount $1,872.47.
[AGENT][NEUTRAL] OK, and then what is the charges after the primary paid their part?
[CUSTOMER][NEUTRAL] $646.35.
[AGENT][NEUTRAL] OK and the name of the facility please?
[CUSTOMER][NEUTRAL] It is diagnostic center for women.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold again so I can look this claim up for you and I'll be right back.
[CUSTOMER][POSITIVE] No problem. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, [PII], this is [PII] back with you again.
[AGENT][NEUTRAL] So I found the claim. The claim number is 3551217.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was received on [PII]. It was processed on [PII].
[AGENT][NEGATIVE] And it was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][POSITIVE] OK, no problem. Thank you so much, [PII], for your assistance and you were really helpful. Have a great day ahead. Bye-bye. Take care.
[AGENT][POSITIVE] You too, Ms. [PII]. You have a great day also. Thanks for calling APL.