AccountId: 011433970860
ContactId: 01288907-3153-4221-8937-3292afb3747e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399859 ms
Total Talk Time (AGENT): 143968 ms
Total Talk Time (CUSTOMER): 82150 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/01288907-3153-4221-8937-3292afb3747e_20250404T19:58_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I have 2 claims to check on calling from a provider's office.
[AGENT][NEUTRAL] I can help with claims and with whom am I speaking, please?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Thank you, [PII], what's the policy number that we're looking at today?
[CUSTOMER][NEUTRAL] ID 02212928 ML 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is that data of service?
[AGENT][NEUTRAL] For her?
[CUSTOMER][NEUTRAL] 1122 24, and total charge 5,615.
[AGENT][NEUTRAL] OK, is that a facility bill, perhaps?
[CUSTOMER][NEUTRAL] Yes, we're about to sleep center.
[AGENT][NEUTRAL] OK, thank you. Let's see here.
[AGENT][NEUTRAL] OK. The claim number on this.
[AGENT][NEUTRAL] It's 354-895-6.
[AGENT][NEUTRAL] And it looks like we received that.
[AGENT][NEUTRAL] Looks like we received that claim.
[AGENT][NEUTRAL] On the [PII] and we processed it on, it was processed on the [PII]. Now a check.
[AGENT][NEUTRAL] And the amount of $384.84 dollars 44 cents was sent out at that time. Uh, the check number is 2021838.
[AGENT][NEUTRAL] And it went to [PII] now.
[AGENT][NEUTRAL] I can have this, if you haven't received this, I can have it reissued.
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let me verify that, hold on.
[CUSTOMER][NEUTRAL] Yeah, that is the correct address. Has it been cast?
[AGENT][NEUTRAL] Uh, no, no, it has not been cast. So what I can do is I can have another one reissued.
[CUSTOMER][POSITIVE] Yes, that would be great.
[AGENT][NEUTRAL] OK, and you said that there was uh another um data service that we could look at?
[CUSTOMER][NEUTRAL] Yes, it's a different patient though.
[AGENT][NEUTRAL] OK. And what is that policy number?
[CUSTOMER][NEUTRAL] Policy number is 02212928ML8. Oh wait, is it the same person? Oh, it is. Hold on a 2nd. [PII]. I'm sorry, same person, different date of service.
[AGENT][NEUTRAL] OK, what is the date of service?
[CUSTOMER][NEUTRAL] [PII] total charge 780.
[AGENT][NEUTRAL] OK, let me just check.
[AGENT][NEUTRAL] OK, it looks like uh the claim number for this is 352-2401.
[AGENT][NEUTRAL] And uh
[AGENT][NEUTRAL] It looks like we processed this.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Looks like we processed this on [PII] or we received it on [PII] and we processed it on [PII].
[AGENT][NEUTRAL] Uh, [PII]. Um, it's showing that it was denied. Uh, I don't, it's uh not being a, a covered place of service. Um, so, uh, I can have that reviewed. I'm not really sure whether that.
[AGENT][NEGATIVE] Um, but that's, uh, that was, looks like that was a denial, so I will.
[AGENT][NEUTRAL] I can see if that uh can be reprocessed. Um, but this was in the hospital, is that?
[CUSTOMER][NEUTRAL] Yeah, see, that can be reprocessed.
[CUSTOMER][NEUTRAL] Well, um, no, it's a sleep center. This was a, a sleep study, but it was applied to the patient deductible.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. But was it in an outpatient hospital setting or what was the setting, uh, that this was?
[CUSTOMER][NEUTRAL] Let me check
[CUSTOMER][NEUTRAL] I'm gonna have to pull up the claim. Bear with me.
[CUSTOMER][NEUTRAL] It's loading. One moment.
[CUSTOMER][NEUTRAL] OK. So this is a home sleep study and what we're billing for is uh
[CUSTOMER][NEUTRAL] The technical component.
[AGENT][NEGATIVE] OK, OK. Well then that wouldn't be covered under this policy. So that's not, um, so that's uh that was uh not gonna be covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. I'll go ahead and bill the patient. Can you give me a, oh no, you did give me the claim number. OK. Thank you so much. That's all for today.
[AGENT][POSITIVE] OK, well, thank you for contacting ATL Marla. Have a very good day.