AccountId: 011433970860
ContactId: 45d4f16e-105b-4124-b855-454580b54151
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531020 ms
Total Talk Time (AGENT): 232310 ms
Total Talk Time (CUSTOMER): 172448 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/45d4f16e-105b-4124-b855-454580b54151_20250610T15:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from Northern Oral Surgeons and I just wanna follow up on a pre-estimate that we have sent out.
[AGENT][NEUTRAL] OK, you submitted a pre-treat. I'm sorry.
[CUSTOMER][NEUTRAL] Yeah pretreatment estimate.
[AGENT][NEUTRAL] OK, yeah, I can check on that for you um what was your name? I'm sorry?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, thank you. Uh, do you have that policy number?
[CUSTOMER][NEUTRAL] Um, yeah, one second here.
[CUSTOMER][NEUTRAL] Um, I have 1580719.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] date of birth is [PII].
[AGENT][POSITIVE] OK perfect thank you for vering that give me just a moment here um do you know when that was submitted to us?
[CUSTOMER][NEUTRAL] Well, OK, I've been kind of back and forth with you guys for a while now because the total amount has been submitted for $8,137. We sent out that preestimate, um, prior to patient having surgery done, and it came back with only the 1st 15 minutes of IV and Decadron on there, so I sent it back for reprocessing, and the same thing happened again.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So then I tried sending it back out because I talked to multiple people, asked for them to fax over the correct information or email it over, and I haven't received anything and we just got a third one now and it's the same thing. It says that the total amount billed was the uh the total charges submitted for was $8,137 but it's only showing two lines of services, and I don't know what's happening with the rest of the pre-estimate.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, OK, when you're saying, um, just so that I understand correctly, when you say, uh, two lines of service, you mean it's just showing the two procedures, is that right?
[CUSTOMER][NEUTRAL] Correct. It's only showing the two things like they're taking the whole treatment plan and it's only putting those two things on there, the 1st 15 minutes of IV and then the Decadron.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] OK, so I do see one.
[AGENT][NEUTRAL] Let's see, I'm just gonna look at the most recent, uh, this looks like it was [PII] that we received this one. give me just a moment. I'm getting this information pulled up.
[AGENT][NEUTRAL] Bear with me just a moment, it's thinking about it.
[CUSTOMER][POSITIVE] No, you're good.
[AGENT][NEUTRAL] OK, so it looks like it is just finishing up because I'm not able to access just everything, um, so I would check back.
[AGENT][NEUTRAL] Either later today or tomorrow.
[AGENT][NEUTRAL] I'm so sorry it's been taking so long. Um, I'm not, I haven't.
[AGENT][NEUTRAL] Known about any of this, but I am so sorry that sounds so frustrating. Let's see.
[AGENT][NEUTRAL] Within.
[CUSTOMER][NEUTRAL] Because it looks like the last time I resent it was [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me verify, um, is this, I'm sorry, I know you said the name of the facility that's uh Northern Oral and oh goodness.
[AGENT][NEUTRAL] Maxio could you repeat the name of the provider?
[CUSTOMER][NEUTRAL] Yeah, yeah, the Northern oral maxificial surgical, um, so.
[AGENT][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, with Doctor [PII] here on there. So it's, you have it on your end and it's just waiting to be sent?
[AGENT][NEUTRAL] Um, no, no, no, so I'm showing that we, we have received it. It looks like we have, um, let me go back here.
[AGENT][NEUTRAL] Let's see, um, [PII] was when I'm showing it was received, so that would make sense um I'm going to, if you wouldn't mind bearing with me just a moment, I'm gonna take a look at.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All of these and then see if I'm able to, I may not be able to send you anything right away but I'm gonna see if I can find any notes regarding each code.
[AGENT][NEUTRAL] Because I am showing multiple codes that we've received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, it's like the 1st 15 minutes of IV there should be 3 additional a Decadron, multiple. There's like 4 surgical extractions.
[AGENT][NEUTRAL] 234.
[AGENT][NEUTRAL] 789 11.
[AGENT][NEUTRAL] I've got 11. I, I think that's 11.
[AGENT][NEUTRAL] Yeah, I'm showing 11 procedures, is that right?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] That's correct, yeah.
[AGENT][POSITIVE] OK, OK, so we're on the right track here.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Now let me ask you um when you did receive um.
[AGENT][NEUTRAL] The response back from us um how many pages did you receive?
[CUSTOMER][NEUTRAL] So I have a copy. The first time I got it was there's two pages. One was, it was they were separated, so the Decadron was on one page and then I had IV on the other and then this time around.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There should
[CUSTOMER][NEGATIVE] I think it was the last time too it was separated. This is the 3rd 1 we've received and they're on 1.
[AGENT][NEUTRAL] OK, so there should be um 4 pages, so that might be the issue there, um, let's see.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] This one's showing uh.
[AGENT][NEUTRAL] ECR and how much would be covered. OK, yeah, so it looks like I have that um let me go ahead and send this. Do you have a fax number?
[CUSTOMER][NEUTRAL] I have a fax number, yes.
[AGENT][NEUTRAL] OK, what was that fax number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Uh-huh.
[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][POSITIVE] That's correct.
[AGENT][POSITIVE] OK, so I'm going to go ahead and send this to you again. You should receive 4 pages, um, and you shouldn't, it shouldn't take too long. I would say maybe about within 10 minutes, uh, you should receive this so if for some reason, um.
[AGENT][NEUTRAL] You don't uh receive all of them, uh, give us a call back and then maybe we can just send the specific ones that you're missing.
[CUSTOMER][NEUTRAL] OK, sounds good and then can I get a reference number for this call?
[AGENT][NEUTRAL] Yes, uh, it would be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][NEUTRAL] All right, and then today's date?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK perfect sounds good.
[CUSTOMER][NEUTRAL] Um, I'll just wait for that fax and then if I don't see that I'll give you guys a call back.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Sounds good, yes, give us a call back if you need anything else. Hopefully this is everything though.
[CUSTOMER][POSITIVE] All right, thank you so much for your help have a great rest of your day.
[AGENT][POSITIVE] Alright, thanks [PII] of course have a great rest of your day thank you bye bye.
[CUSTOMER][POSITIVE] Thanks you too bye bye.