AccountId: 011433970860
ContactId: 0f4d6cdc-3462-4855-a214-ca9fd16e8fba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 942969 ms
Total Talk Time (AGENT): 155648 ms
Total Talk Time (CUSTOMER): 347994 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/0f4d6cdc-3462-4855-a214-ca9fd16e8fba_20250331T19:52_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]. Uh, this is [PII] and I'm calling for the provider, [PII], for a payment clarification. Please be informed this call has been recorded and monitored for training and quality purposes. May I know if I can help you with the patient's information and the provider's information?
[AGENT][NEUTRAL] OK, I can help you with claim status. Do you have a policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So I have the member ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is 253.
[CUSTOMER][NEUTRAL] 62667
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] February, I'm sorry, [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] $150 even.
[AGENT][NEUTRAL] And do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII]. It's a direct line extension.
[AGENT][NEUTRAL] And you needed the claim status, is that correct?
[CUSTOMER][NEUTRAL] Ma'am, uh, I have all the information. Uh, this claim is paid. So I just, uh, want the duplicate copy of EOB.
[AGENT][NEUTRAL] OK, do you have a fax number?
[CUSTOMER][NEUTRAL] Sure. One moment. Before that, so, uh, just need to verify the
[CUSTOMER][NEUTRAL] The claim was received on [PII].
[CUSTOMER][NEGATIVE] And the allowed unpaid amount is $75 even. No patient responsibility. It was a single check.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The check number is 2015194 and they cleared on [PII] and issued on [PII]. And the remaining balance is provided right off, right?
[AGENT][NEUTRAL] Uh, we can't determine patient responsibility, but everything you said was correct besides that.
[CUSTOMER][NEUTRAL] All right. And uh the payment mailing address is [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And could you please verify the patient account number?
[AGENT][NEUTRAL] Uh, the patient account number.
[CUSTOMER][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, hold on one moment. I'm gonna pull up the claim that was submitted by the provider.
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][POSITIVE] OK, yes, that's correct.
[CUSTOMER][NEUTRAL] All right. And the claim number is 3532836, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Alright, uh, sure, the fax number.
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 825
[CUSTOMER][NEUTRAL] 486 9 and it would be uh attention to the patient account number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] No, what will you give me that one more time?
[CUSTOMER][NEUTRAL] The fax number?
[AGENT][NEUTRAL] No, the patient account number?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And then I clicked on that.
[CUSTOMER][NEUTRAL] Sure. The
[CUSTOMER][NEUTRAL] All right, one moment.
[CUSTOMER][NEUTRAL] The patient account number is 3563.
[CUSTOMER][NEUTRAL] I'm sorry, 3763.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 4 V as in Victor.
[CUSTOMER][NEUTRAL] 25542.
[AGENT][NEUTRAL] OK, alright, I will get that faxed over there.
[CUSTOMER][NEUTRAL] And may I know how much time it will take?
[AGENT][NEUTRAL] Uh, it'll be today, about 10 minutes.
[CUSTOMER][NEUTRAL] 10 minutes.
[AGENT][NEUTRAL] Huh.
[CUSTOMER][POSITIVE] Alright, thank you so much. Could you help me with the call reference number for this claim?
[AGENT][NEUTRAL] Uh, it's my first name is [PII], last [PII] [PII], and today's date.
[CUSTOMER][NEUTRAL] Alright, one moment.
[CUSTOMER][NEUTRAL] [PII]. All right. I have one more claim, so uh could you help me with that also?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] So for the same patient or a different patient?
[CUSTOMER][NEUTRAL] Uh, it's for a different patient.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And the patient policy number?
[CUSTOMER][NEUTRAL] Uh, uh, the member ID, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, sure, one moment.
[CUSTOMER][NEUTRAL] It's uh 134.
[CUSTOMER][NEUTRAL] 889
[CUSTOMER][NEUTRAL] 5 M as in Mike, L as in Lima, then number 8.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So, uh, the patient's name is [PII]. Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, I don't have a claim on file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The claim is not on file?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] All right. Thank you so much. One moment.
[CUSTOMER][NEUTRAL] All right, thank you for holding the line. So is the patient active on the data service?
[AGENT][NEUTRAL] Um, let me see
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, this policy terminated [PII]. Let me see if there's a different policy.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Uh, no, the policy is terminated. That is correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the patient is not active, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And the, the policy, uh, could you help me with the policy effective date, the term date?
[AGENT][NEUTRAL] It was.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII] effective terminated [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII] and [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And are you a primary or secondary insurance?
[AGENT][NEUTRAL] This is a secondary policy.
[CUSTOMER][NEUTRAL] Uh mhm. One moment.
[CUSTOMER][NEUTRAL] And may I know when was the last coordination of benefit updated?
[AGENT][NEUTRAL] I can't give you that information at just we can give you claim status for claims that have been submitted.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right. And may I know what is the preferred mode of submission?
[AGENT][NEUTRAL] The what?
[CUSTOMER][NEUTRAL] May I know the preferred mode of submission?
[AGENT][NEUTRAL] Uh, we have a payer ID, a claims mailing address, and a fax number.
[CUSTOMER][NEUTRAL] All right, one moment.
[CUSTOMER][NEUTRAL] All right. May I know the claim submission timely filing limit?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] No timely filing limit?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] All right. May I have the claim submission, mailing address and the payer ID?
[AGENT][NEUTRAL] Payer ID is 60801.
[AGENT][NEUTRAL] And the mailing address is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] 773124-8950.
[AGENT][NEUTRAL] 24
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] All right, one moment.
[CUSTOMER][NEUTRAL] And the call reference number will be the same, right? Your name and today's date.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] All right. Uh, so,
[CUSTOMER][NEUTRAL] Could you help me with the, the, with the last claim for today? It's, it's the last.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You know the policy number?
[CUSTOMER][NEUTRAL] Member ID 2, I'm sorry, 025.
[CUSTOMER][POSITIVE] I am good man.
[CUSTOMER][NEUTRAL] 19056
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] Yes, one moment.
[CUSTOMER][NEUTRAL] Rail service is [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the build out?
[CUSTOMER][NEUTRAL] $530 even.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I have you know my.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And who is the provider on that?
[CUSTOMER][NEUTRAL] The provider's name is [PII].
[AGENT][NEUTRAL] Um, I don't have a claim on file for that date.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] With that amount?
[CUSTOMER][NEUTRAL] This one as well?
[AGENT][NEUTRAL] Uh, no claim on file.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And is the patient active on the data service?
[AGENT][NEUTRAL] Yes they are.
[CUSTOMER][NEUTRAL] All right. May I know the policy effective date and the term date?
[AGENT][NEUTRAL] Policy effective date is [PII] and the policy is active, so there's there's no term date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Still active.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And are you a primary or secondary?
[AGENT][NEUTRAL] This is a secondary policy.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And may I know when was the last coordination of benefit updated?
[AGENT][NEUTRAL] We don't provide that information.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right. And the preferred mode of submission?
[AGENT][NEUTRAL] Um, all of the ones that we went over on the last one, payer ID, claims address, fax.
[CUSTOMER][NEUTRAL] All right. And the claims, no, no claim submission timely filing, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] All right. Could you help me with the caller reference number. The caller reference number is same, right? uh, your name and today's date.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] All right, Ms. [PII], uh, really, thank you for your assistance. Have a nice day.
[AGENT][POSITIVE] OK. Thank you for calling ATL. Have a good day.