AccountId: 011433970860
ContactId: 06575f03-c324-4ad5-9ef4-5d2690614de8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451459 ms
Total Talk Time (AGENT): 206934 ms
Total Talk Time (CUSTOMER): 153379 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/06575f03-c324-4ad5-9ef4-5d2690614de8_20250319T13:44_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Baptist Memorial Hospitals, and I'm looking for a claim status.
[AGENT][NEUTRAL] I can help with claim status, [PII]. What's the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, just a moment. The policy number is 793215.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry, [PII] and the date of birth is [PII].
[AGENT][POSITIVE] OK, I appreciate that. Is there a callback number, please, in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] OK, I appreciate that. What date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, that's too old.
[AGENT][NEUTRAL] Thank you. Is there a build amount that I should look for?
[CUSTOMER][NEUTRAL] Yeah, just a moment. It's $4,064 even.
[AGENT][POSITIVE] 64. OK, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, it looks like the claim, um,
[AGENT][NEUTRAL] Uh, for this.
[AGENT][NEUTRAL] Is 2
[AGENT][NEUTRAL] 325209. So that's 2325209.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like, it looks like we.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Process that
[AGENT][NEUTRAL] 9
[AGENT][NEUTRAL] We received it on the [PII]. We processed it on [PII]. Now, [PII], this policy has a $1000 deductible that must be met prior to
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Any benefits being paid out?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so all of the benefits went towards that, uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] towards that um deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So total $178.20 was applied to our patient deductible.
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] OK. So actually, we don't have an EOB, so can you, it is possible to send an EOB through fax. I will send my fax number.
[AGENT][NEUTRAL] Yes, what is your fax number, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and attention to my name, [PII].
[AGENT][POSITIVE] Yes, I can certainly do that. Is there anything else I can help with?
[CUSTOMER][POSITIVE] Yeah, actually, I have 2 claims remaining, so if you could help me with 2 also, it would be great.
[AGENT][NEUTRAL] OK, and what's the next policy number, please?
[CUSTOMER][NEUTRAL] Yeah, just a moment. The policy number is 02274763.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] OK, I appreciate that. And what date of service we're looking for for uh [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there a particular bill amount?
[CUSTOMER][NEUTRAL] $584 even.
[AGENT][NEUTRAL] It looks like your claim number is 32.
[AGENT][NEUTRAL] 58078. So that's 3258078.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like we received the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On the [PII], and we process it on [PII].
[AGENT][NEUTRAL] Now this is a hospital indemnity policy at uh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] pays a limited benefit for certain services, um, in this particular case.
[AGENT][NEUTRAL] Let's see, it looks like the uh claim.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] It looks like uh the the uh
[AGENT][NEUTRAL] Patient wasn't active.
[AGENT][NEUTRAL] On this data service, so they would need to be active. The policy would need to be active for that date of service for the uh for the claim to be paid out.
[AGENT][NEGATIVE] So in this case, it doesn't look like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Thank you for the information, [PII]. So, do you have, what is the effective date and termination date of the patient?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] So it looks like the uh effective date for the policy was uh [PII], and it was active until [PII].
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][POSITIVE] OK. Thank you for the information, [PII]. So,
[CUSTOMER][NEUTRAL] Yeah, so we can move with other patients.
[AGENT][NEUTRAL] OK, I can do one more. And what is that policy number, please?
[CUSTOMER][NEUTRAL] Yeah, just a moment. The policy 967957.
[AGENT][NEUTRAL] 967-537. Is that correct?
[CUSTOMER][NEUTRAL] 967957.
[AGENT][NEUTRAL] 957. OK, thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. And what date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And is there a particular build amount?
[CUSTOMER][NEUTRAL] Just a moment. Yes, $647 even.
[AGENT][NEUTRAL] OK, thank you. It looks like that claim number is 333.
[AGENT][NEUTRAL] 4400.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, uh, it looks like the patient wasn't active on that day of service.
[CUSTOMER][POSITIVE] OK. Yeah, go on, sorry for that.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Uh, so, um, so it looks like he was, uh, active, uh, um, let me check and see when he was when he.
[AGENT][NEUTRAL] Taking off the policy. So it looks like he was dropped on on [PII], excuse me, [PII].
[AGENT][NEUTRAL] So any claim after that date.
[AGENT][NEUTRAL] Excuse me, any claim after that date would not be payable, so on the date of service, he was no longer active on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do you have any call reference numbers? So can you spell your name for the documen[PII] purpose.
[AGENT][NEUTRAL] Yes, it's [PII], yes, it's [PII]
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And we're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][POSITIVE] No, sir. Thank you for the information. That's all I have for you today.
[AGENT][POSITIVE] OK, thank you for contacting ATL [PII]. Have a good day.