AccountId: 011433970860
ContactId: 269e2b7d-41a7-4deb-8a78-1a322caaa8db
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 162259 ms
Total Talk Time (AGENT): 72678 ms
Total Talk Time (CUSTOMER): 69037 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/269e2b7d-41a7-4deb-8a78-1a322caaa8db_20250312T21:19_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] and I'm calling with the provider's office. I'm meaning to get some information about a claim that we sent to you guys.
[AGENT][NEUTRAL] Yes, I can help with the claim status. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Um, the policy number is 02571425.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Looks like [PII] date of birth is.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a particular bill amount that I need to look at?
[CUSTOMER][NEUTRAL] Um, the total bill amount was $533.
[AGENT][NEUTRAL] OK, thank you. It looks like your claim number is 357.
[AGENT][NEUTRAL] 1059.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And uh
[CUSTOMER][NEGATIVE] I have, yeah, I have the check that's paid for $75 and I have the explanation of benefits and I got on the website as well. My question is, is that basically it just, I'm not sure how this insurance works because generally you know I have like a a write off and then what is patient responsibility and this doesn't tell me any of that. It just says $75.00 pay to the other lines which is OK, but then are you guys saying that she's responsible for the rest of the bill? You just pay $75 towards the visit.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEGATIVE] Uh, no.
[AGENT][NEUTRAL] Right, well, what we're, we can't really tell you that whether uh [PII] is, um, responsible for the rest of the bill. She may have a different insurance, so this is uh a limited liability, or excuse me, a limited benefit policy. What it does is it pays a very specific amount for the services that are covered. And with that claim, that is the, that is the extent of our contractual obligation for that date of service.
[AGENT][NEUTRAL] Um, so if she does have another, uh, policy, if she does have major medical, uh, if she does have other, uh, other insurance, uh, cards or, or policies, we don't know that. Um, the only thing that I can tell you is that that's the most that we will pay.
[CUSTOMER][NEUTRAL] OK, yeah, it doesn't look like she provided any others. OK, well I will send the rest to her and then if she does have one she can call and give it to me.
[AGENT][NEUTRAL] OK. Is there anything else that I can help with?
[CUSTOMER][POSITIVE] Nope, I believe that's all thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting ATL. Have a good day.