AccountId: 011433970860
ContactId: 1938329e-fe7d-4b15-b365-b22a075e1cbb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 728059 ms
Total Talk Time (AGENT): 211448 ms
Total Talk Time (CUSTOMER): 169049 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/1938329e-fe7d-4b15-b365-b22a075e1cbb_20250212T15:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. Uh, I'm calling from Care Resource Community Health for claim status.
[AGENT][NEUTRAL] OK Ms. [PII], I can help you.
[AGENT][NEUTRAL] Can I get the, um, first name of your community health center again, please, ma'am? I missed that.
[CUSTOMER][NEUTRAL] Care resource.
[AGENT][NEUTRAL] OK, thank you so much. And then what is your um callback number, Ms. [PII], [PII], did I say it right, [PII]?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 33.
[CUSTOMER][POSITIVE] Yes, [PII], correct.
[AGENT][POSITIVE] Thank you. Oh, that's OK, and your call back number?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][POSITIVE] Thank you very much. And then what's the patient's name?
[CUSTOMER][NEUTRAL] Patient's name is [PII].
[AGENT][NEUTRAL] OK, and what is the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the patient's policy number, please?
[CUSTOMER][NEUTRAL] OK. It's 02455519.
[CUSTOMER][NEUTRAL] M as in mother. L as in Lima. S as in Sierra.
[CUSTOMER][NEUTRAL] Oh no, I'm sorry. The, the M as in mother, L as in Lima, and the number 8.
[AGENT][POSITIVE] OK, thank you so much and then what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then what is the uh charge amount?
[CUSTOMER][NEUTRAL] 260 or 200? Let me see.
[CUSTOMER][NEUTRAL] 200
[AGENT][NEUTRAL] 200 even? OK, and then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK, $25.
[AGENT][NEUTRAL] OK thank you so much alright I'm gonna put you on a brief hold while I look up this claim and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you very much. I appreciate it.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi [PII], this is [PII] back with you again. So I have the claim number for you. It is 351-285-0.
[CUSTOMER][NEUTRAL] Hi, I'm sorry. Can you repeat it for me?
[AGENT][NEUTRAL] And the claim was denied.
[AGENT][NEUTRAL] Sure, yes ma'am, it's 351-285-0.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim was denied these office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, and I have another date of service. I, I think it's the same, but maybe you can give me the, the claim number.
[AGENT][NEUTRAL] Yes ma'am, and what is that it's for the same insured, is that correct? same patient?
[CUSTOMER][NEUTRAL] Yes, correct. Yes, it's the same insured and the, the date of service is [PII].
[AGENT][NEUTRAL] OK, yes, what's that date service?
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] Yes ma'am, you're correct, it was denied for the same reason office visits covered by the policy.
[CUSTOMER][NEUTRAL] OK, so I.
[AGENT][NEUTRAL] And the claim number is.
[AGENT][NEUTRAL] The claim number is 351.
[AGENT][NEUTRAL] 2850.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, it's the same number?
[CUSTOMER][NEUTRAL] Oh, maybe we will.
[AGENT][NEUTRAL] Oh, wait, wait, wait, wait, hold on, let me keep looking.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's the same.
[AGENT][NEUTRAL] Yeah, it's the same 351-285-1.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Maybe we've been together? Probably.
[AGENT][NEUTRAL] Uh, I'm sorry, the first.
[AGENT][NEUTRAL] No, the first one was 351-285-0.
[CUSTOMER][NEUTRAL] 351-285-0
[AGENT][NEUTRAL] Yes, yes, that was the 1st 1. The 2nd claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] is 351-285-1.
[CUSTOMER][NEUTRAL] Uh 51, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you very much. And I have one more patient to check.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] What's the next patient's name?
[CUSTOMER][NEUTRAL] Um, hold on please.
[CUSTOMER][NEUTRAL] Patient's name is uh [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And his policy number, please?
[CUSTOMER][NEUTRAL] Um, just one moment, please.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And mm policy number is.
[CUSTOMER][NEUTRAL] OK. 024969.
[CUSTOMER][NEUTRAL] 08.
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, and then what is his date of service?
[CUSTOMER][NEUTRAL] Day of service.
[CUSTOMER][NEUTRAL] Its data services [PII].
[AGENT][NEUTRAL] OK, and the charge amount?
[CUSTOMER][NEUTRAL] And charge amount.
[CUSTOMER][NEUTRAL] $50
[AGENT][NEUTRAL] OK, is and the charge that's the charge after primary paid?
[CUSTOMER][NEUTRAL] After primary, yes.
[AGENT][NEUTRAL] OK, what was the charge before primary paid?
[CUSTOMER][NEUTRAL] Let me see, I think it's 200, let me see.
[CUSTOMER][NEUTRAL] Uh, 200.
[AGENT][NEUTRAL] 200 even, OK, in the same facility?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, so.
[AGENT][NEUTRAL] OK. All right. I'm gonna put you on a brief hold. I'm gonna look that up. I'll be right back.
[CUSTOMER][NEUTRAL] Thanks. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh well.
[AGENT][NEUTRAL] OK, are you there, Ms. [PII]?
[CUSTOMER][NEUTRAL] The type of yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Looking at [PII], his claim number is 352.
[AGENT][NEUTRAL] 6778.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim was paid $16.15.
[AGENT][NEUTRAL] With check number 2012356.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me look at the remarks.
[AGENT][NEGATIVE] The office visit was not covered.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] And that check did clear.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] And and can you have the clear date?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The check cleared on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you very much. May I have a reference number for the call?
[AGENT][NEUTRAL] Yes ma'am, you can use my name. It's [PII] and today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. I appreciate your help.
[AGENT][POSITIVE] Well, we appreciate you, Ms. [PII]. I hope you have a blessed rest of your day and thanks so much for calling APL.
[CUSTOMER][POSITIVE] Thank you, same to you, bye bye.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Bye-bye, ma'am.