AccountId: 011433970860
ContactId: 3e2b2984-bdef-4a98-9e7c-c7e555cef75b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 505679 ms
Total Talk Time (AGENT): 179607 ms
Total Talk Time (CUSTOMER): 176219 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/3e2b2984-bdef-4a98-9e7c-c7e555cef75b_20250410T19:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting ATO, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. Um, I was calling to get some information on a few claims of mine.
[AGENT][NEUTRAL] OK, I can certainly help with that. And this is for your policy, [PII]? Is it?
[CUSTOMER][NEUTRAL] No, I'm, I'm a provider. I am calling from the.
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] The facility, the UC Health.
[AGENT][NEUTRAL] OK, yes. That's fine. Yes, I can certainly help with that. And what is that, um, what is that policy number that we're looking at today?
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Yeah, so my subscriber ID for the first patient is 02150702.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] I have [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my direct number to work from home is gonna be [PII].
[CUSTOMER][NEUTRAL] [PII] that'll be my direct number.
[AGENT][NEUTRAL] Thank you. And what date of service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] Yeah, $122 2025 looks say was a bill amount of $2,206.
[AGENT][NEUTRAL] OK, thank you. Is this a facility bill that we're looking at?
[CUSTOMER][NEUTRAL] Um, yeah, looks like it was an outpatient.
[AGENT][NEUTRAL] OK, let me check. I'll be right back. Excuse me just one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you so much for holding. Your claim number is 35.
[AGENT][NEUTRAL] 65.
[AGENT][NEUTRAL] 629. Now,
[AGENT][NEUTRAL] It looks like we uh received.
[AGENT][NEUTRAL] That claim, let's see.
[AGENT][NEUTRAL] On the [PII].
[AGENT][NEUTRAL] We process it on the [PII].
[AGENT][NEUTRAL] Um, a check for 154, yes, yeah, um, yeah, we, that's [PII].
[CUSTOMER][NEUTRAL] It's the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 20
[AGENT][NEUTRAL] Uh, 25, um, a check in the amount of $154.
[AGENT][NEUTRAL] And 57 cents was issued. Now, these policies have a $100 deductible. It must be met for the calendar year prior to any sort of uh payment going out.
[AGENT][NEUTRAL] And that is what has happened here is that um.
[CUSTOMER][NEUTRAL] OK, so,
[AGENT][NEUTRAL] And so that is what that is.
[CUSTOMER][NEUTRAL] OK, they had a how, how much was the deductible?
[AGENT][NEUTRAL] It's $100. Excuse me. I, I think it's more than that. Oh, forgive me. Um, I'm sorry, it's 100, yeah, it's $100.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] $100 deductible. Was there any co-insurance?
[AGENT][NEUTRAL] Uh, no, it doesn't look like it.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, was this sent in a bulk check?
[AGENT][NEUTRAL] Yes, it was a uh the uh check was um a single paper check. That check number is 202.
[AGENT][NEUTRAL] 8722.
[CUSTOMER][NEUTRAL] You said 202-8722?
[AGENT][NEUTRAL] It's uh 202. Let me do it, let me do it again, actually. I'm sorry, um 202.
[AGENT][NEUTRAL] 8722.
[CUSTOMER][POSITIVE] Yeah, cool, I have that, um.
[CUSTOMER][NEUTRAL] And then you said this was a bulk check?
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] It's it, excuse me, I'm sorry, no, it's, I'm sorry, it's not a bulk check actually, it's a single paper check. That was the check. This is that one check number would have been just that one check.
[CUSTOMER][NEUTRAL] For how much is the bulk check for?
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Can you tell me if it's been cleared or received?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] It looks like it was cashed on [PII].
[CUSTOMER][POSITIVE] That's OK, cool, thank you. Um, is there any way you can fax me an EOB?
[AGENT][NEUTRAL] Sure. What would you like that faxed to?
[CUSTOMER][NEUTRAL] Yeah it's gonna be 970.
[CUSTOMER][NEUTRAL] 4904391 if you want attention [PII], that's just my department. We have two [PII], so they get mixed up a little bit.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, so [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, great. And you said that there was another, um, is there another day of service for [PII] or?
[CUSTOMER][NEUTRAL] Yeah, it's not this data service that I have a different patient. I have a few patients that I was checking on. It looks like I have about a total.
[CUSTOMER][NEUTRAL] 5 patients that I wanted to check claims on.
[AGENT][NEUTRAL] OK, and the next policy?
[CUSTOMER][NEUTRAL] Yeah, my next policy number is 002.
[CUSTOMER][NEUTRAL] 353-773
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] That's gonna be [PII] [PII].
[AGENT][NEUTRAL] And how do you spell her last name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Her first name is [PII].
[AGENT][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] [PII], I'm sorry.
[AGENT][NEUTRAL] [PII], I'm sorry, um, she's not coming up in our system. Um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm not sure that this is one of our policies. Uh, is there, do you have a social security number or?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, hold on a second.
[CUSTOMER][NEUTRAL] Yeah, one second, let me view her ID card.
[CUSTOMER][NEUTRAL] Sometimes they'll list them in here and say that they're that and then I'll be on the phone and just kind of see and be like is this maybe you guys because they'll have a registered wrong.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So I just kind of wanted to let me see.
[CUSTOMER][NEUTRAL] I have a social for her.
[CUSTOMER][NEUTRAL] I have a social [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let's see what we've got with this.
[AGENT][NEUTRAL] [PII].
[AGENT][NEGATIVE] I don't think she's one of our patients or one of our clients. She's still not coming up in our system.
[CUSTOMER][NEUTRAL] OK, new to American public life, correct?
[AGENT][POSITIVE] Uh, no, we're yes, American Public Life, that's correct.
[CUSTOMER][NEUTRAL] OK, that's probably why. 00 my God, I completely looked over that. There was another American plan and it was just right above there. So no worries, can I just get a call reference number? My apologies on that.
[AGENT][NEUTRAL] Oh, no, that's fine. Um, my name is [PII], and the first letter of my last name is [PII], and we'll use that today's date as a reference. Is there anything else at all that I may help with?
[CUSTOMER][POSITIVE] Cool.
[CUSTOMER][POSITIVE] No, that's it, [PII]. Thanks so much. I hope you have a great rest of your week and have a great weekend.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Mhm thanks for contacting AT have a