AccountId: 011433970860
ContactId: 298bf357-8aa6-4308-824f-a6d5e73075c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 433619 ms
Total Talk Time (AGENT): 148219 ms
Total Talk Time (CUSTOMER): 104846 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/298bf357-8aa6-4308-824f-a6d5e73075c2_20250605T16:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] with Union Hospital, and I'm trying to get some information about a claim.
[AGENT][NEUTRAL] OK, yeah, I can get uh information on that claim for you. uh [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Um 01789595.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what was that bill amount please?
[CUSTOMER][NEUTRAL] $5,119.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, so we did receive this claim at [PII], uh, we paid a benefit of, let me check that.
[AGENT][NEUTRAL] $30.60 and that payment did meet their.
[AGENT][NEUTRAL] Payable benefit.
[AGENT][NEUTRAL] For the state of service.
[CUSTOMER][NEUTRAL] OK, so the balance goes to patient?
[AGENT][NEUTRAL] Oh, we don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] Oh OK, OK, was there any PPO adjustments?
[AGENT][NEUTRAL] No, so this is a limited indemnity medical plan.
[AGENT][NEUTRAL] So it just pays a set dollar amount per covered procedure or office visit.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] OK, is there any way to get a copy of the EOR EOB?
[AGENT][POSITIVE] Oh, absolutely. Yeah, definitely. Uh, do you have a fax number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, I will go ahead and get that sent now. Should get it within about 10 minutes or so. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was the claim number?
[AGENT][NEUTRAL] Oh yes, that is uh 35.
[AGENT][NEUTRAL] 50772.
[CUSTOMER][NEUTRAL] OK and um.
[CUSTOMER][NEUTRAL] Do I need to speak to somebody else about help with the website?
[AGENT][NEUTRAL] Um, what, what questions did you have?
[CUSTOMER][NEUTRAL] Because every time I try to.
[CUSTOMER][NEUTRAL] Well, I'm trying to.
[CUSTOMER][NEUTRAL] Yeah, sign up it says provide the following information for provider account tax ID when I do that it says error no user was found with the information that was entered. Please try again. If error persists, please contact customer service.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, yeah, OK, well I can verify the um tax ID that we have just so there's no um hiccup there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, the one tax ID we have is [PII].
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Correct, OK, um, when did you try doing this? I know when it first the website first launched, uh, there was quite a bit of um technical issues that have been resolved now.
[CUSTOMER][NEGATIVE] Well I'm trying to do it now and it won't let me.
[CUSTOMER][NEUTRAL] Well, maybe I don't know, it's thinking.
[CUSTOMER][POSITIVE] No error.
[AGENT][NEUTRAL] Are you using um
[AGENT][NEUTRAL] The uh claim number, are you able to enter that at all? Is it letting you do that?
[CUSTOMER][NEUTRAL] No, it, it creates your OSC account.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there somewhere else I need to go?
[AGENT][NEUTRAL] Alright, give me, let's see.
[AGENT][NEUTRAL] Now let me see what I can do to help. Hang on, um, I did just send that uh EOB to you give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this uh it launched just a couple of days ago and there's been and.
[AGENT][NEGATIVE] Quite a bit of confusion.
[CUSTOMER][NEUTRAL] Maybe I should.
[AGENT][NEUTRAL] Alright, bear with me just a moment.
[CUSTOMER][NEUTRAL] Uh, so there's a new website.
[AGENT][POSITIVE] Oh yes ma'am.
[CUSTOMER][NEUTRAL] Well maybe I'm on the old one.
[AGENT][NEUTRAL] Um, it should still be the same web address. It's just going to look a bit different than how it was.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, I see.
[AGENT][NEUTRAL] Let me go to the spot for providers, give me just a moment. I can try to walk you through all of.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] Well that's weird. I won't.