AccountId: 011433970860
ContactId: 1988c8cb-872c-4b3d-8093-f89eaa46b712
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372899 ms
Total Talk Time (AGENT): 143851 ms
Total Talk Time (CUSTOMER): 75928 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/1988c8cb-872c-4b3d-8093-f89eaa46b712_20250418T14:03_UTC.wav
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[AGENT][NEUTRAL] contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] If, if I can help with the claim status. What's that policy number, please?
[CUSTOMER][NEUTRAL] Yeah, uh
[CUSTOMER][NEUTRAL] The policy number is 2312224.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yes, uh, the patient name is uh [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. What's the data service that we're looking for, please?
[CUSTOMER][NEUTRAL] It's for [PII].
[AGENT][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] It's $32,480 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Because it's not showing up on my files, um, you know where it was sent to?
[CUSTOMER][NEUTRAL] Yes, uh, it was sent through mailing address.
[CUSTOMER][NEUTRAL] Uh, to [PII].
[AGENT][NEUTRAL] OK, um, our mailing address has actually changed since then, so whenever you're ready, I, I can give you our current, uh, mailing address so you can get that claim.
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, before that, uh, can you please verify with uh the claim number because I have the claim number on my file.
[AGENT][NEUTRAL] OK, and what is that claim number, please?
[CUSTOMER][NEUTRAL] It's 343-815-2.
[AGENT][NEUTRAL] 152. OK, let's just see what, and it's for [PII] you're saying? OK, let's see.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 343-8152.
[AGENT][NEUTRAL] OK, it's, it's under a different policy, so let's just see what we have here.
[AGENT][NEUTRAL] Just a second here.
[AGENT][NEUTRAL] OK. Was this for physical therapy or for a facility that
[AGENT][NEUTRAL] This is for?
[CUSTOMER][NEUTRAL] Uh, the facility name is HCF Florida University Hospital. Just a moment, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the
[CUSTOMER][NEUTRAL] Yes, it's for therapy.
[AGENT][NEUTRAL] OK, great. Um, there is a, there is a different, it's a different policy number that's on there, but it's also a different claim. Um, the claim number, uh, that this is processed under was 35.
[AGENT][NEUTRAL] 60
[AGENT][NEUTRAL] 647
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] It looks like that claim was uh received.
[AGENT][NEUTRAL] On the, uh, excuse me, [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Now the policy does not cover speech, kinesiology or occupational therapy. So the claim was was denied because the the services were not covered.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] Again, the, the claim number.
[AGENT][NEUTRAL] And this is 356-0647. It was processed on the [PII].
[AGENT][NEGATIVE] Um, but it's not covered.
[AGENT][NEUTRAL] Uh, [PII], because those types of services are not, are not covered by this policy.
[CUSTOMER][NEUTRAL] Yeah, OK. And can you please provide me the patient plan type?
[AGENT][NEUTRAL] This is a secondary or gap insurance.
[AGENT][NEUTRAL] And it's uh meant to pick up the deductible, co-payment or co-insurance from the major medical for covered places of service.
[CUSTOMER][NEUTRAL] Yeah. Uh, now, what is the patient responsibility?
[AGENT][NEUTRAL] Well, that, you know, I can't really tell you that. The only thing I can say is that, is that it's not covered by our, by our policy. That's really the only thing I can tell you.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Yeah, OK. Thank you for those information. And can you please provide me the call reference number for this call?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We'll use that today's date as our reference.
[CUSTOMER][POSITIVE] Yeah, OK. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] Alright, thanks for contacting