AccountId: 011433970860
ContactId: 290a18e6-dde8-45a1-91e3-ab7548f98d67
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 327700 ms
Total Talk Time (AGENT): 147173 ms
Total Talk Time (CUSTOMER): 79633 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/290a18e6-dde8-45a1-91e3-ab7548f98d67_20250603T12:59_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check claim status.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Yes, I can help you with that and what is your callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you and [PII], how many claims do you have to check status on today?
[CUSTOMER][NEUTRAL] Only one
[AGENT][NEUTRAL] OK, um, I, yes, ma'am, I can help you with that. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] 02443498. I'm sorry, could you please spell out your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And then the information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] The number's name is [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the total bill amount is $299,785 even.
[AGENT][NEUTRAL] OK, 299785. Is that correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so I do see that this claim was received on [PII].
[AGENT][NEUTRAL] Processed and denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number, [PII] is 356-6108.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the reason for the denial is that we need a copy of the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] Actually, we have sent it already. Could you please verify that?
[AGENT][NEGATIVE] We do not, we have not received that. Yes, ma'am, as of now, we have not received that.
[CUSTOMER][NEUTRAL] Yeah, and
[CUSTOMER][NEUTRAL] OK. Can you submit the TB along with your claim form? You have sent more than 2 times at TUB.
[AGENT][NEUTRAL] OK, we only need the primary insurance company's explanation of benefits for this data service, but as to date, that has not been received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You have to submit the DB with the contact, ma'am?
[AGENT][NEUTRAL] We do not need the claim, we only need the primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, can I get your fax number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. For verification, it's [PII], right?
[AGENT][NEUTRAL] Yes ma'am attention claims department.
[CUSTOMER][NEUTRAL] OK. And what's the time phone number to submit that?
[AGENT][NEGATIVE] There is no timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the call reference?
[AGENT][NEUTRAL] Yes ma'am, you would use my name along with today's date and then also [PII], if you do not already have our portal website, we do have a portal in which you should be able to obtain this explanation of benefits if you need a copy of it, and that website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Uh verification, your name is spelled as [PII], right?
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] No, but that is not correct. It's [PII]
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Thank you. Thank you so much for your time and assistance. Have a wonderful day.
[AGENT][NEUTRAL] I thought you
[AGENT][POSITIVE] Yes, ma'am. I hope you have a wonderful day too, and if that's all I can help you with, [PII], and thank you again for calling ATL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye-bye.