AccountId: 011433970860
ContactId: 272f68d9-9eaf-4c04-86d3-1fb24270e494
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 577859 ms
Total Talk Time (AGENT): 113730 ms
Total Talk Time (CUSTOMER): 152204 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/272f68d9-9eaf-4c04-86d3-1fb24270e494_20250513T14:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, this is uh and I'm calling you from the provider's office. How are you doing today?
[AGENT][POSITIVE] I'm doing well, sir. How are you doing today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I'm good thank you so much for asking um actually I'm just inquiring about the claim status.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I can help you with claim status. Can I please get your name, sir, again and the callback number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's I had AHAD.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] A hard, OK? And then
[CUSTOMER][NEUTRAL] And the call back, yeah.
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] Uh, and the callback number is [PII].
[AGENT][NEUTRAL] Thank you. Uh-huh. And what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] OK, it's uh [PII] and the date of birth is uh [PII].
[CUSTOMER][NEUTRAL] And the member ID is um [PII].
[AGENT][NEUTRAL] OK, let me pull up [PII]'s policy real quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and then may I please have the data service and the charge amount?
[CUSTOMER][NEUTRAL] they
[CUSTOMER][NEUTRAL] Yeah, sure, it's um 07-25 2024 and the charge amount is $225.
[AGENT][NEUTRAL] And then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I guess it's so.
[CUSTOMER][NEUTRAL] Just wait a minute, OK?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I guess it's uh $30.
[AGENT][NEUTRAL] OK, thank you and then what is the name of the facility you're calling from Aha?
[CUSTOMER][NEUTRAL] It's for union physicians for women.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim, and I'll be right back with you, sir.
[CUSTOMER][POSITIVE] Yeah, sure, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me. I had, I have the claim information for you. The claim number is 349-865-4.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the claim has been denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Office visits are not covered under, under patient's policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you still there?
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, I'm here.
[CUSTOMER][NEUTRAL] Yeah, so this is the only specific reason the claim denied due to office visits are not covered under the patient's policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And the claim number is 349-865-4.
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEUTRAL] OK just a moment.
[CUSTOMER][NEUTRAL] Uh there.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] OK, OK, what's the check number?
[AGENT][NEGATIVE] There is no check number. The claim was denied.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um, I just want to know about the process date and uh the denied date.
[AGENT][NEUTRAL] OK, let me get that for you real quick.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Bad
[AGENT][NEUTRAL] Call me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, the claim was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] [PII], right?
[CUSTOMER][NEUTRAL] That this was
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it's the process date and uh sorry what's the received date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Um, all right.
[CUSTOMER][POSITIVE] All right, thank you so much for today. And um can I have the call reference number and your name?
[AGENT][NEUTRAL] Yes, you can use um my name [PII] and today's date for your reference.
[CUSTOMER][NEUTRAL] Today's date only.
[AGENT][NEUTRAL] Yes, and my name.
[CUSTOMER][NEUTRAL] OK, OK, and uh can you spell your name again?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] And the initial to the last name?
[AGENT][NEUTRAL] That is A
[CUSTOMER][POSITIVE] OK [PII], thank you so much for today. Have a good day bye bye.
[AGENT][POSITIVE] You have a wonderful day too, and thank you for calling APL.
[CUSTOMER][NEUTRAL] Alright bye.
[AGENT][NEUTRAL] Bye-bye, sir.