AccountId: 011433970860
ContactId: 3437f676-a1c3-4c3b-b28f-94d4cc341452
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 534460 ms
Total Talk Time (AGENT): 165551 ms
Total Talk Time (CUSTOMER): 136823 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/3437f676-a1c3-4c3b-b28f-94d4cc341452_20250325T17:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm sorry, what's your name again?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh hi [PII], this is [PII] with SAHMC physician Services calling in regarding a claim.
[AGENT][NEUTRAL] OK, spell your first name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], thank you. And what's the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Policy number is 02492388. Phone number [PII].
[AGENT][NEUTRAL] Thank you for that information and what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that information. Uh, we're checking claim status for what data service?
[CUSTOMER][NEUTRAL] Uh, data service is 52024. Billed amount is $219.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, so I'm showing that a payment was not made on this claim. It looks like the maximum benefit for the outpatient sickness writer um is exhausted.
[AGENT][NEUTRAL] Um, I show that the claim was processed under claim number 352.
[AGENT][NEUTRAL] 396 7.
[AGENT][NEUTRAL] On [PII] and the explanation of benefits was mailed to the claim, the address on the claim form on the claim.
[CUSTOMER][NEUTRAL] OK, I'm not.
[CUSTOMER][NEUTRAL] Is it possible to get a copy of that claim of of that ELB faxed over to me?
[AGENT][NEUTRAL] It's now available to download online. um, I can give you the web address and then help you create an account if one has not been created.
[CUSTOMER][NEUTRAL] OK, what is that?
[AGENT][NEUTRAL] It's secured [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], the word [PII]. So it's secured. [PII].
[CUSTOMER][NEUTRAL] New user.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Medical provider.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so the security screen of course would be the tax identification.
[CUSTOMER][NEUTRAL] This account number.
[AGENT][NEUTRAL] The tax ID number and then the account number is uh at the bottom I think it gives instructions um if you're filing the CMS 1500, which is his office, I think that patient account number is in box number 26.
[AGENT][NEUTRAL] Do you see the patient account number on that in that box?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK, I was just asking and to make sure that it's there, the instructions are there.
[CUSTOMER][NEUTRAL] Oh, on, on the claim form. Oh yeah, the instructions are here. Is that the patient account number?
[AGENT][NEUTRAL] Yeah, that's located on the CMS 1500 form in box 26. That's the patient account number, not our policy number, but the patient account number assigned to that claim by the office.
[CUSTOMER][NEUTRAL] Oh, our account number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] No user was found.
[AGENT][NEUTRAL] So what tax ID number did you enter?
[CUSTOMER][NEUTRAL] The [PII]?
[AGENT][NEUTRAL] And the patient account number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm showing a different. It looks like were there letters in front of that number?
[AGENT][NEUTRAL] Let me pull up the CMS 1500 and see what we have.
[CUSTOMER][NEGATIVE] When I pull up the CMS 1500, it doesn't have box numbers on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, let's see.
[CUSTOMER][NEUTRAL] It's just a blank form.
[AGENT][NEUTRAL] Yeah, at the bottom it's the CMS 1500 form um in box number 26 I see A as in apple, Z as in zebra.
[AGENT][NEUTRAL] 19854.
[AGENT][NEUTRAL] 047-3.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, can I use your name?
[AGENT][NEUTRAL] And then there's two ways that you can search the quick search, um, I think it requires the patient's first name, date of birth, and then the claim number.
[CUSTOMER][POSITIVE] It's submitting right now for the information using my email and username and password and all that fun stuff.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] It's submitting right now because it needs a username and password.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So your account has been successfully created login.
[CUSTOMER][NEUTRAL] Go log in submit submitting.
[CUSTOMER][NEUTRAL] Quick claim APR claim number.
[CUSTOMER][NEUTRAL] OK, so that was the same number you gave me.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Do the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][MIXED] OK 0 outpatient fitness benefit, it really doesn't say that benefits have been exhausted.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It just says outpatient fitness benefit.
[CUSTOMER][NEUTRAL] Ah, there it is, right, it's been exhausted for the calendar year. Got it. All right, perfect. And I'm sorry, what was your name again? [PII], right? And is there
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, you're, uh-huh, and you'll use.
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call.
[CUSTOMER][NEUTRAL] That's what I was about to ask.
[AGENT][NEUTRAL] I know
[CUSTOMER][POSITIVE] All right, you have a wonderful day, [PII].
[AGENT][POSITIVE] Alright, it's [PII], [PII], and you do the same, [PII]. Have a good day. Thanks for calling APL uh huh bye bye.
[CUSTOMER][NEUTRAL] You too, bye bye. Bye bye.