AccountId: 011433970860
ContactId: 18c4a9ac-c00b-4bc7-a76b-4ede51bc8322
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258480 ms
Total Talk Time (AGENT): 85188 ms
Total Talk Time (CUSTOMER): 120836 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/18c4a9ac-c00b-4bc7-a76b-4ede51bc8322_20250623T19:07_UTC.wav
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[AGENT][NEUTRAL] For contacting ATO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. Uh, my name is [PII] calling from a provider's office and I needed assistance, um, with, um.
[CUSTOMER][NEUTRAL] Information for uh patient please.
[AGENT][NEUTRAL] Yes, I can help with um patient information, uh, [PII]. What is the policy number, please?
[CUSTOMER][NEUTRAL] Oh sorry, let me see.
[AGENT][NEUTRAL] It might begin with a 01 or 02.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] I'm not too sure if this is some um old card or not, but it has 2230085.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um, this would be for [PII] and his date of birth.
[CUSTOMER][NEUTRAL] Yeah, let's see, um.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 99 of 78.
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That's my number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No, I'm about ready to give you another insurance card.
[CUSTOMER][NEUTRAL] It's been a long day. Area code [PII]. I'm so sorry.
[AGENT][NEUTRAL] OK, thank you. The policy went into effect on [PII]. It is active. This is the secondary or gap insurance that's meant to pick up the deductible, co-payment or co-insurance from the major medical. Is there anything in particular I could tell you about the secondary or gap insurance?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Actually it's for a claim that we have uh submitted for this patient. Let me get to that date of service.
[CUSTOMER][NEUTRAL] Hold on, let's see.
[CUSTOMER][NEUTRAL] It was for um him for date of service uh excuse me, [PII].
[AGENT][NEUTRAL] Yes, is there a particular build amount?
[CUSTOMER][NEUTRAL] Um, let's see, um.
[CUSTOMER][NEUTRAL] Well, the total charges, he did have a primary and they paid a portion and left the balance of $115.32 applied to the copay to co-insurance. The total bill submitted to the primary was $576.60.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] Let me just see what we have here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And and what was the name of the provider?
[CUSTOMER][NEUTRAL] I'm calling from Allergy Asthma East Clinic, I mean Clinic [PII].
[AGENT][NEUTRAL] OK, thank you. Um, it looks like your claim number is 361.
[AGENT][NEUTRAL] 3950. Now there's going to be, there's a check in the amount of $115.32 that has been issued.
[AGENT][NEUTRAL] This is a single paper check, [PII], and that check number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 20.
[AGENT][NEUTRAL] 50
[AGENT][NEUTRAL] 305. That was for $115.32 and it looks like it was sent out on the [PII] of this month.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that means that last Tuesday yeah we sent out to you.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] It's probably still in transit. Yes ma'am, yeah, it's still in transit.
[CUSTOMER][NEUTRAL] It's in the mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what's your name again?
[AGENT][NEUTRAL] My name is [PII], and the first letter of my last name is [PII]. We use that today's date as a reference. Is there something else I can help with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, and again my name is [PII] and first initial of my last name is [PII]. Um, thank you, [PII]. I appreciate your assistance on this information and we'll go ahead and notate notate the account. You take care. Thank you for your call.
[AGENT][NEUTRAL] Certainly.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Thanks for contacting ATO have a good day.