AccountId: 011433970860
ContactId: 129e8497-3abb-4830-a2c6-14263a9046e0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 296410 ms
Total Talk Time (AGENT): 76009 ms
Total Talk Time (CUSTOMER): 205155 ms
Interruptions: 7
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/129e8497-3abb-4830-a2c6-14263a9046e0_20250226T15:04_UTC.wav
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[AGENT][NEUTRAL] Calling ATM. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from the office to check on a claim status.
[AGENT][NEUTRAL] You said I'm sorry, spell your first name for me?
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] It's [PII], and I'm calling from the department's office.
[AGENT][NEUTRAL] OK, and [PII], if I can get a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] with the extension.
[CUSTOMER][NEUTRAL] Should I repeat?
[AGENT][NEUTRAL] OK, um, I'm fine. Um, what is your, um, what is the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The policy number?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] 022.
[CUSTOMER][NEUTRAL] 55673 M as in Mike L as in Lima 8.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] The first name is [PII] and the last name is [PII].
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] The date of service will be [PII].
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] And your tax ID?
[CUSTOMER][NEUTRAL] You need the date of birth?
[CUSTOMER][NEUTRAL] OK, the tax ID it's 2048.
[CUSTOMER][NEUTRAL] 59734.
[AGENT][NEUTRAL] I'm sorry, what was that date of birth?
[CUSTOMER][NEUTRAL] The date of birth was [PII].
[AGENT][NEUTRAL] Thank you for that information. Now I'm not showing that we have a claim on file from your tax ID for that data service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Ma'am, I just thought about, but.
[CUSTOMER][NEUTRAL] No claim on file, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So, do you have
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you please check if the it got rejected or anything with your site.
[AGENT][NEUTRAL] I don't have that we don't have that capability.
[AGENT][NEUTRAL] To see
[AGENT][NEUTRAL] If it was rejected.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I'm just not sure we received it.
[CUSTOMER][NEUTRAL] So you found the member, right?
[AGENT][NEUTRAL] I found the member
[CUSTOMER][NEUTRAL] family.
[AGENT][NEUTRAL] But I'm not showing that we have a claim from your tax ID for that data service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] So, can you please check the mailing address and the payer ID for me?
[CUSTOMER][POSITIVE] Good.
[AGENT][NEUTRAL] Our mailing address is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And the pay ID?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, I do have the same.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Would you like the fax number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I just want to know the member's eligibility and the term date.
[CUSTOMER][NEUTRAL] If it is possible.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Patient was eligible. policy effective date was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And policy termed on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII], right? OK, so.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] So what will be the time if I to resubmit this claim again.
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] When Cigna did not opted any claim to you, right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so can I get the reference number?
[AGENT][NEUTRAL] Reference is just my name, [PII]. Last initial [PII], and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] Thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][NEUTRAL] Bye.