AccountId: 011433970860
ContactId: 17a2b423-e836-4864-9a1a-1953c2c44ce7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 556229 ms
Total Talk Time (AGENT): 133351 ms
Total Talk Time (CUSTOMER): 155655 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/17a2b423-e836-4864-9a1a-1953c2c44ce7_20250417T18:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII]. This is [PII]. I'm calling from provider's office to check the claim status. How are you doing today?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][POSITIVE] Yeah, I'm doing great. Thank you for asking. Um, and if you don't mind, could you spell your name for me? Yeah.
[AGENT][NEUTRAL] OK. Can you
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII], yes, uh.
[CUSTOMER][NEUTRAL] Yeah, I'm calling from provider's office to check the claim status on you.
[AGENT][NEUTRAL] OK, spell your first name for me.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Oh, OK. And um.
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is 01545923 M as in Mike L as in Lima 1.
[AGENT][NEUTRAL] And the phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You got it?
[AGENT][NEUTRAL] I have it one moment I'm pulling up the file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] I think I'm missing a digit in the policy number. I have 0154923. There's one more number.
[CUSTOMER][NEUTRAL] Yeah, it's after 4, there is 5, 45923, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Or OK.
[AGENT][NEUTRAL] I missed the 5, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see 154.
[AGENT][NEUTRAL] 923.
[AGENT][NEUTRAL] And you said the patient's first name is [PII]? And what's her date of birth?
[CUSTOMER][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you for that and uh you said that you're checking claim status can I get the date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes. Yeah. It's [PII] for the total charges, $29,559 even.
[AGENT][NEUTRAL] So that's [PII] for $29,559 even, OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] And this is a hospital claim?
[AGENT][NEUTRAL] Or an emergency room claim?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] So we originally denied it for a copy of the primary explanation of benefits, uh, received it again.
[CUSTOMER][NEUTRAL] Primary UOB.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, and it denied as a duplicate, so give me one second to take a look at that.
[CUSTOMER][NEUTRAL] Yeah, may I know the general claim status?
[AGENT][NEUTRAL] I'm checking, give me a moment to look at it, OK?
[CUSTOMER][POSITIVE] Sure, [PII]. Take your time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Few more minutes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I am pulling up the last document that we received.
[AGENT][NEUTRAL] To see what information is attached.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] OK, and all they all was submitted was the, the hospital UBO4 form, the itemized bill, the primary explanation of benefits was not attached.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So we still need a copy of the major medical explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So you, you need a primary UB?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Sure, and we
[CUSTOMER][NEUTRAL] May I know when was this received on and denied on?
[AGENT][NEUTRAL] The initial claim or the second claim, or both?
[CUSTOMER][NEUTRAL] Uh, the, the one which you needed now, uh, which you need the primary UOB.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it was received [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Processed [PII].
[CUSTOMER][NEUTRAL] [PII] forri will be and uh can we send through fax and the fax number would be?
[AGENT][NEUTRAL] 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 877
[CUSTOMER][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942 3.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][POSITIVE] Great
[CUSTOMER][NEUTRAL] Attention to claims and the claim number would be?
[AGENT][NEUTRAL] 343.
[AGENT][NEUTRAL] 83
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 343-834-0.
[CUSTOMER][NEUTRAL] That's it?
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The call reference.
[AGENT][NEUTRAL] Is my name in today's date, [PII]
[AGENT][NEUTRAL] And first initial of my last name is [PII].
[CUSTOMER][NEUTRAL] Shoot on you.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] Anything else I can help out with today?
[AGENT][NEUTRAL] Uh uh. Anything else I can help out with today?
[CUSTOMER][POSITIVE] Uh yeah, that's it for today. Yeah, that's it for today, [PII]. You've been a great assistance and great help. You have a nice day. Bye-bye.
[AGENT][POSITIVE] Uh huh thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.