AccountId: 011433970860
ContactId: 19e5856a-1406-4a35-a19c-970699352fa7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284119 ms
Total Talk Time (AGENT): 116202 ms
Total Talk Time (CUSTOMER): 97526 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/19e5856a-1406-4a35-a19c-970699352fa7_20250527T15:19_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider office. To check on the status for claim, could you assist me further?
[AGENT][NEUTRAL] Yes, I can help with the claim status. [PII], what's that policy number that we're looking at today?
[CUSTOMER][NEUTRAL] Sorry, my policy number is
[CUSTOMER][NEUTRAL] 0245 0555
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] So, the patient's first name would be [PII] and the last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][POSITIVE] I do appreciate that. If I could just have a callback number, please, in the event that we're disconnected.
[CUSTOMER][NEUTRAL] Uh, sure. Uh, that is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. What date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] Uh, that is
[CUSTOMER][NEUTRAL] [PII], the total charge is $690 even.
[AGENT][POSITIVE] I appreciate that. Thank you. I'm just looking that up now.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Your claim number on this.
[AGENT][NEUTRAL] It's 352.
[AGENT][NEUTRAL] 2196.
[AGENT][NEUTRAL] So again, that's 352.
[AGENT][NEUTRAL] 2196.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we received the
[CUSTOMER][NEUTRAL] 352
[AGENT][NEUTRAL] Uh yes, it's 352.
[AGENT][NEUTRAL] 21
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 96
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we received your place.
[CUSTOMER][NEUTRAL] 2196, right, ending with?
[AGENT][POSITIVE] That that's correct, yeah, that's right, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm just looking this up and I apologize my computer is very slow today, so uh we received the claim.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, let's see, we, we received the claim on, um, [PII]. We processed it on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] It looks like they were saying that they're, I'm just gonna check here just to see why this is.
[AGENT][NEGATIVE] So it looks like the policy wasn't paid for that week of service, um, and it actually ended up uh lapsing, yes.
[CUSTOMER][NEUTRAL] Uh, so
[CUSTOMER][NEUTRAL] OK. May I know the recent uh COB?
[CUSTOMER][NEUTRAL] Letters sent for your site. May I know the date?
[AGENT][NEUTRAL] The date that the BOB was submitted or or sent out was [PII].
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] No, no, no. No. May I know the recent uh CUD letter sent to the patient?
[AGENT][NEUTRAL] The reason that
[CUSTOMER][NEUTRAL] I mean letter
[CUSTOMER][NEUTRAL] Letter, letter. May I know the date when you send the letter to the patient?
[AGENT][NEUTRAL] We sent the letter on [PII].
[AGENT][NEUTRAL] That's that.
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] That is processed it. May I know that, uh,
[CUSTOMER][NEUTRAL] You know, you this, so the claim got denied for uh coordination of benefit, right?
[AGENT][NEUTRAL] That's, that's right, on [PII]. So that's when it, that's when the, the EOB, the letter went out.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK. That's why I'm asked when you send the letter to the patient. May I know the date?
[AGENT][NEUTRAL] Well, that is the date, um, [PII], that's, that was the date that we sent it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm. So once premium payment got processed means you will pay this claim. Is it correct?
[AGENT][NEUTRAL] Uh, yes, for this date of service, that's correct, yeah.
[CUSTOMER][NEUTRAL] OK, gotcha. And uh may I, could you please spell out your name for documentation purposes?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] And the last indig is [PII]?
[AGENT][NEUTRAL] With keys and kites.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I get the call reference number.
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as our reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, that's it. Bye now.
[AGENT][POSITIVE] OK, well, thank you very much for contacting ATL. Hope you have a very good day. Thank you.