AccountId: 011433970860
ContactId: 2f40982a-538f-42f1-8d46-bd50e4f5f045
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 976179 ms
Total Talk Time (AGENT): 223519 ms
Total Talk Time (CUSTOMER): 351822 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/2f40982a-538f-42f1-8d46-bd50e4f5f045_20250609T21:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from the provider office to check on the claim status.
[AGENT][NEUTRAL] I can help you with claim status. [PII], can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yep, once again.
[CUSTOMER][NEUTRAL] Um 01530909.
[CUSTOMER][NEUTRAL] M for [PII] and L for Lima, 8.
[AGENT][NEUTRAL] One moment while I look that up.
[AGENT][NEUTRAL] Can I get you to verify the patient's name and date of birth for me please?
[CUSTOMER][NEUTRAL] Yeah, sure. The last name is [PII] and the first name is [PII].
[CUSTOMER][NEUTRAL] And the due is [PII].
[AGENT][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yeah, the data services um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, give me one moment to look that up.
[AGENT][NEUTRAL] And what is the provider's name?
[CUSTOMER][NEUTRAL] Yeah, one second
[CUSTOMER][NEUTRAL] The provider's name is uh [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] It was processed.
[CUSTOMER][NEUTRAL] One second please hold on a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I'm, yeah, once again, please hold on a moment, uh.
[CUSTOMER][NEUTRAL] Actually, one second.
[CUSTOMER][NEUTRAL] Yup. I just need to know about the CPT of [PII] and [PII].
[AGENT][NEUTRAL] You said
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] It looks like those were paid. Uh, we paid the amount of $119.52.
[CUSTOMER][NEUTRAL] One second. Can I have the claim number?
[AGENT][NEUTRAL] 359-683-4.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, for CPT [PII].
[AGENT][NEUTRAL] Yes, what about it?
[CUSTOMER][NEUTRAL] Yeah. Can I have the uh uh allowed amount that paid amount for CPT [PII]?
[AGENT][NEUTRAL] Yes ma'am, it was $98.07.
[CUSTOMER][NEUTRAL] Mhm. What is the paid month?
[AGENT][NEUTRAL] $98.07.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh what about the CP of [PII]?
[AGENT][NEUTRAL] $21.45.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please hold on. Yeah, please hold on a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. 21.45. And uh
[CUSTOMER][NEUTRAL] Yup. Uh, I'll repeat the claim number. The claim number is 359-6834. Am I right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh-huh. OK. Uh, can I have the issue and process it?
[CUSTOMER][NEUTRAL] And received and processed it.
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we process the claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, can I have the EFD number?
[AGENT][NEUTRAL] I'm sorry, what?
[CUSTOMER][NEUTRAL] Can I have the EFD number?
[AGENT][NEUTRAL] The claim number?
[CUSTOMER][NEUTRAL] EFT number.
[AGENT][NEUTRAL] 35.
[CUSTOMER][NEUTRAL] Electronic, mhm.
[AGENT][NEUTRAL] 96834.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 34. Can I have the issued uncle date?
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're wanting the check information?
[CUSTOMER][NEUTRAL] Yeah, what is the, what is the issue and uh clear date? This is the EFT, right? EFT or uh check payment?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the check number, I'm so sorry, the check number is 20.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 42594.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what about that 359-683-4?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] That was the claim number I'm.
[CUSTOMER][NEUTRAL] Beside that is an EFT number.
[AGENT][NEUTRAL] Yeah, that was the claim number. I'm sorry I mis I misheard you.
[CUSTOMER][NEUTRAL] Oh, yeah OK.
[CUSTOMER][NEUTRAL] It's OK. It's OK. No issues. Uh, can I have the check number again?
[AGENT][NEUTRAL] Uh, sure, it's 20.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 42
[AGENT][NEUTRAL] 594.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yup, got it. And uh.
[CUSTOMER][NEUTRAL] Um, can I have the issued and uh clear date?
[AGENT][NEUTRAL] It looks like we issued the check on [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the check cleared on [PII].
[CUSTOMER][NEUTRAL] Yeah, cleared on [PII], OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, OK. Um.
[CUSTOMER][NEUTRAL] One second. Can I have the pay to address?
[AGENT][NEUTRAL] Uh, it was sent to the provider.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Once people for.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] OK. One second. OK. And is this a bulk check or a single, bulk payment or a single payment?
[AGENT][NEUTRAL] It was a single payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what about the uh.
[CUSTOMER][NEUTRAL] Provider, uh, is belong to an in network or out of network provider.
[AGENT][NEUTRAL] I'm sorry, can you repeat that, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Can you confirm that the providers belong to in-network or out of network?
[AGENT][NEUTRAL] Uh, this policy doesn't have in and out of network. It's secondary gap insurance.
[AGENT][NEUTRAL] So we don't participate in networks.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, is this a part be provider?
[AGENT][NEUTRAL] Yes, we don't participate in networks, um, as long as it's a covered service and their primary insurance pays partial coverage, we'll help pay that as well.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, so participant provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 1 2nd.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um, yeah. Is it possible? Can you, uh, send me the copy of your bill?
[AGENT][NEUTRAL] Give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one more moment please.
[CUSTOMER][POSITIVE] Yeah, sure. No issues.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] Who would you like the attention to go to? Would it be you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, you told me.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And what is the fax number?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] All right, and to confirm, I have [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 395.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, no, [PII].
[AGENT][NEUTRAL] [PII]. So [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. Yeah, of course.
[AGENT][NEUTRAL] 08213. OK.
[CUSTOMER][NEUTRAL] Fact
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 12, yeah.
[AGENT][NEUTRAL] All right, I just sent that fax over.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. And uh once again, before that, can I have your name and call reference number?
[AGENT][NEUTRAL] So we don't have call reference numbers so you can use my name and last initial in today's date so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know your name, please?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh-huh, sorry. Yeah. Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm. Yes, yeah.
[AGENT][NEUTRAL] Last initial is [PII]
[CUSTOMER][NEUTRAL] Yes. OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I just need to check on the another claim. I just need uh one the um
[CUSTOMER][NEUTRAL] Copy of EO be alone.
[AGENT][NEUTRAL] OK, I just sent that through a fax. Um, you should get it here soon.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No, no, I just need to check on the another.
[CUSTOMER][NEUTRAL] And for that number, the claim got paid. I just need to, uh, I just need a one day copy of your.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I like uh
[CUSTOMER][NEUTRAL] Shall I move on to the next number ID?
[AGENT][NEUTRAL] OK, um, give me just one moment. Uh, let me finish up my notes with this one and then we can move on to the next one, OK?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm mhm OK.
[AGENT][NEUTRAL] And this is for a different patient, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] It belonged to the same provider. Yeah.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And what is the next, um, policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 023.
[CUSTOMER][NEUTRAL] 173.
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] Uh, M for Michael, L for Lima, and 8.
[AGENT][NEUTRAL] And can I get the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah. The last name is [PII], and the first name is [PII]. And the date is uh [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Mhm. You come.
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] One second, yeah, one second.
[CUSTOMER][NEUTRAL] Uh, the claim number is 359-0583.
[AGENT][NEUTRAL] OK. It looks like
[AGENT][NEUTRAL] We received that claim on [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, yes, once again, sorry to interrupt actually. Yeah, I have the, uh, claim status actually. Uh, I just need one copy of your.
[AGENT][NEUTRAL] You just need a copy of the EOB for this one?
[CUSTOMER][NEUTRAL] Uh, yep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK, I just sent that EOB to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] And thank you so much for your assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling ATL. Have a great day.
[CUSTOMER][POSITIVE] Yeah, thank you.