AccountId: 011433970860
ContactId: 016e0b1a-8547-4f39-8679-146ebcd537f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557619 ms
Total Talk Time (AGENT): 198654 ms
Total Talk Time (CUSTOMER): 190221 ms
Interruptions: 9
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/016e0b1a-8547-4f39-8679-146ebcd537f1_20250213T13:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm calling to check on some claims for a newborn.
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you're calling on behalf of a provider's office?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] That is 01661549.
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and how many claims do you have for her?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] 6.
[AGENT][NEUTRAL] OK, you know that you can also check your status online at secured.
[CUSTOMER][NEUTRAL] Oh my word.
[AGENT][NEUTRAL] [PII] as well.
[CUSTOMER][NEUTRAL] [PII] as well. Mhm.
[AGENT][NEUTRAL] And go ahead and give me each date of service and the charge for each date.
[CUSTOMER][NEUTRAL] OK, it's 12124 build amount $2,943.
[CUSTOMER][NEUTRAL] Um, 122 24 build out 2,943.
[CUSTOMER][NEUTRAL] 12 3 24 for 2,943, 124 24 for 1,0021.
[CUSTOMER][NEUTRAL] 12524 for 1,021.
[CUSTOMER][NEUTRAL] And for $493.
[AGENT][NEUTRAL] I missed the last one. What's the date of service?
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $493.
[AGENT][NEUTRAL] OK, are these facility or professional fees?
[CUSTOMER][POSITIVE] Professional.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name of the provider?
[CUSTOMER][NEUTRAL] Provider
[CUSTOMER][NEUTRAL] On-site neonatal.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just gonna look all them up at one time and then I'll come back to you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There was a benefit paid on each of these uh claims, so the [PII], the claim number is 3558321.
[CUSTOMER][NEUTRAL] 1st 24, the claim number is 358321. Mhm.
[AGENT][NEUTRAL] Uh, processed on [PII].
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] The payment amount is $467.83.
[CUSTOMER][NEUTRAL] The payment of $47.06.
[AGENT][NEUTRAL] And then I'll give you the other ones in that order, is that OK?
[CUSTOMER][NEUTRAL] the other ones in that is that OK yeah.
[AGENT][NEUTRAL] So the next one is for data service 12224. The claim number is 3558329.
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] 9
[AGENT][NEUTRAL] Process the same date.
[CUSTOMER][NEUTRAL] same date.
[AGENT][NEUTRAL] Issuing a payment of 467.83.
[CUSTOMER][NEUTRAL] a of
[CUSTOMER][NEUTRAL] Break in
[AGENT][NEUTRAL] Uh, date of service [PII].
[CUSTOMER][NEUTRAL] OK your service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That claim number is 3,558,310.
[CUSTOMER][NEUTRAL] Is that OK, but you
[AGENT][NEUTRAL] Processed on the same date issuing a payment of $108.42.
[AGENT][NEUTRAL] Uh, data service 124, the claim number is 3558319.
[AGENT][NEUTRAL] Processed on the same date, issuing a payment of $140.59.
[AGENT][NEUTRAL] 125 date of service claim number is 3558307 processed on the same date.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On this one.
[AGENT][NEUTRAL] I'm gonna skip to 12 6 24. I'll come back to 125, 12 6 24.
[CUSTOMER][NEUTRAL] 24. Mhm.
[AGENT][NEUTRAL] Uh, this claim processed on the [PII] issuing a payment of $124.81.
[CUSTOMER][NEUTRAL] This claim processed on the [PII].
[CUSTOMER][NEUTRAL] a payment of $124.81 under claim number 3558332.
[AGENT][NEUTRAL] Under claim number 3558332.
[AGENT][NEUTRAL] And were these inpatient services?
[CUSTOMER][NEUTRAL] And these inpatient services? Yes.
[AGENT][NEUTRAL] OK, so on the 125 data service it looks like a payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] data services like a payment.
[AGENT][NEGATIVE] Now it looks like this is applying towards a deductible, which I don't think is correct.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Red.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] No, there is an inpatient deductible.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And how much was the flight? OK.
[AGENT][NEUTRAL] Yeah, let's see, so on the.
[CUSTOMER][NEUTRAL] Yeah, let's see.
[AGENT][NEUTRAL] [PII] date of service it looks like.
[CUSTOMER][NEUTRAL] On the
[CUSTOMER][NEUTRAL] Like.
[AGENT][NEUTRAL] The $140.59 was applied towards the inpatient deductible.
[CUSTOMER][NEUTRAL] 159 cents on the flight.
[CUSTOMER][NEUTRAL] Deductible. OK, and on all the other claims there was no.
[AGENT][NEUTRAL] And that claim number is.
[CUSTOMER][NEUTRAL] I'm sorry, you gave me the claim number for the uh 125 um on all the other claims there was no patient responsibility, right?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] We do not determine patients responsibility, so you can do your check and balances by looking at the primary EOB that'll say what they're responsible for.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And our payment should should match that.
[CUSTOMER][NEUTRAL] OK, so there was no like um.
[CUSTOMER][NEUTRAL] Should match that. Right, but there was no um like uh additional deductible applied, right? Because the only one that I still have besides the 125, which is fine because that's you said deductible was the 123 data service that only paid.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That pay 1084
[CUSTOMER][NEUTRAL] To that was being applied to deduct the balance of that was being applied to deductible as well.
[AGENT][NEUTRAL] Yeah, on the explanation of benefit that was sent attached to the check, there is a remark code on that one and it says.
[CUSTOMER][NEUTRAL] You know, on
[CUSTOMER][NEUTRAL] One and it says.
[AGENT][NEUTRAL] You know, part of it was applied towards that $500 inpatient deductible, so.
[CUSTOMER][NEUTRAL] You know, part of it was like that $500 inpatient deductible, um.
[AGENT][NEUTRAL] Benefit payment of 108.42359.45 41% deductible.
[CUSTOMER][NEUTRAL] 134259.4541 deductible. OK, all right, great. That takes care of all of them that's and do you have reference numbers?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You'll use my name in today's state as your reference. [PII], and did you have any other questions I can help out with today?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] We
[CUSTOMER][POSITIVE] No, that'll be it for today. Thank you very much.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.