AccountId: 011433970860
ContactId: 10d344a9-5993-45c9-8bab-21a78e02131b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179690 ms
Total Talk Time (AGENT): 61906 ms
Total Talk Time (CUSTOMER): 81071 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/10d344a9-5993-45c9-8bab-21a78e02131b_20250304T14:17_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Atlanta Heart Associates in the billing department. How are you doing today?
[AGENT][NEUTRAL] I'm doing fine. How are you?
[CUSTOMER][NEUTRAL] Good, I'm doing fine, thank you. Uh, the reason I'm calling, [PII], um, our patient [PII], we submitted a claim back on [PII], uh, and we have not received anything back, no ERP nothing from me from your insurance.
[AGENT][NEUTRAL] OK, well, I can definitely look into the claim for you. Um, for, for my notes, can you spell your first name for me please and provide a good contact number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right. And may I have a good contact number in case we're disconnected and the member's policy number?
[CUSTOMER][NEUTRAL] Sure, 7,706,924,000 [PII] 128.
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is 2541929.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bill?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It was on [PII].
[CUSTOMER][NEUTRAL] Hold on one second. OK, [PII] and it was for $80.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so I'm showing to received the claim on December, I'm sorry, on [PII].
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] And that claim number is 353.
[AGENT][NEUTRAL] 7752.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] And on [PII], we denied the claim.
[AGENT][NEUTRAL] Because the benefit
[CUSTOMER][NEUTRAL] Why?
[AGENT][NEUTRAL] The benefit maximum for the data service has been met?
[CUSTOMER][NEUTRAL] Oh, it's maxed out.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][POSITIVE] Yes, the, the max has been met, yes.
[CUSTOMER][POSITIVE] OK, OK, alrighty, so then that's patients responsibility $80. OK, very good, that's all I need to know. I thank you for your time and you have a good one, OK?
[AGENT][POSITIVE] You're also and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.