AccountId: 011433970860
ContactId: 21628109-a9fd-45a5-b6b3-895c62580a94
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204970 ms
Total Talk Time (AGENT): 86550 ms
Total Talk Time (CUSTOMER): 74615 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/21628109-a9fd-45a5-b6b3-895c62580a94_20250501T18:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. How are you?
[AGENT][NEUTRAL] Doing well, [PII], how are you?
[CUSTOMER][NEUTRAL] I'm doing good. Um, wasn't quite sure what department I have. Um, is this the provider line department?
[AGENT][NEUTRAL] Um, the technically this is the care team, um, but I can, I've talked to providers. What can we do for you? Are we need to check on a claim eligibility?
[CUSTOMER][NEUTRAL] Yeah, I need to check on the claim.
[AGENT][NEUTRAL] Yeah, I can check that for you. Um, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am, give me just a second to pull that back up.
[AGENT][NEUTRAL] Sure. Uh-huh.
[CUSTOMER][NEUTRAL] Alright, so the policy number that I have is 247-4401.
[AGENT][NEUTRAL] OK, and what was the name?
[CUSTOMER][NEUTRAL] And could you spell your name for me?
[AGENT][NEUTRAL] Oh, sure, it's [PII]
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] That's OK. uh, what was the name and date of birth for this member, please?
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Um, [PII], [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] Uh, $19,477.86.
[AGENT][NEUTRAL] OK, now is that the amount before or after major medical paid Crystal?
[CUSTOMER][NEUTRAL] Um, that's before, that's the total charge.
[AGENT][POSITIVE] OK, got it. OK, thank you one moment.
[AGENT][NEUTRAL] This was Emry Saint Joseph's Hospital.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Got it. OK, so we did receive this claim and we are missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK, hold on just a second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Cause I think we faxed that, yeah, we faxed that on 32525.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Um, the fax number we have is [PII]. Was that a good one?
[AGENT][NEUTRAL] That's correct. That's correct, yes. I've also got, um, well I've got a mailing address. I would say fax would probably be the most reliable method, but it does not look like that has been received.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. Um, I can try to refax that, um.
[AGENT][NEUTRAL] OK. Yeah, as long as it shows um the amounts paid towards uh co-pay, deductible or co-insurance, that's all we really need.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and um do you have a call reference number?
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial, and today's date. Uh, so my last initial is [PII], was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that was all. Thank you so much.
[AGENT][POSITIVE] Alright, yeah, thanks for calling uh APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.