AccountId: 011433970860
ContactId: 46629cc7-c7e0-411f-a85d-9606d0d76617
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 235479 ms
Total Talk Time (AGENT): 80508 ms
Total Talk Time (CUSTOMER): 122188 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/46629cc7-c7e0-411f-a85d-9606d0d76617_20250609T19:52_UTC.wav
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[AGENT][POSITIVE] And thank you for calling API. This is Easy. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I was calling. I had a couple of questions. Um, do you need my group number and policy number?
[AGENT][NEUTRAL] Well, first I'll need your name and a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] OK, my name is [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need your policy number.
[CUSTOMER][NEUTRAL] OK, um, it's 238-9019.
[CUSTOMER][NEUTRAL] And it's, it's not an active policy. This was, um, I'm calling about a claim from about a year ago so I we because my husband changed jobs, so this is kind of a it's not gonna show active right now.
[AGENT][NEUTRAL] OK. Yes, ma'am. I found the policy in our system. Um, please verify your date of birth.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and the date of service and bill charges on the claim you're calling about?
[CUSTOMER][NEUTRAL] Um, it was the day of service was [PII], and it's a claim uh for my daughter [PII].
[CUSTOMER][NEUTRAL] And I don't know that it got filed that's why I'm trying to just see if it didn't get filed. I was gonna try to file it with you guys.
[AGENT][NEUTRAL] Right, I'm not showing it on file.
[CUSTOMER][NEUTRAL] OK, so what would you need from me to file the claim?
[AGENT][NEUTRAL] Um, we'll need the EOB from the primary insurance company for the date of service. And we will also need the, the diagnosis code and you can get the diagnosis code um from the provider. We would need documentation um from the provider's office with a diagnosis code on it. And you can either fax us the information or you can mail it to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what is your fax number?
[AGENT][NEUTRAL] Um, the fax number is [PII].
[AGENT][NEUTRAL] And make sure that you attention it to the claims department and reference your policy number.
[CUSTOMER][NEUTRAL] Claims department and then the policy number, OK.
[CUSTOMER][NEUTRAL] Um, and you said [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] So, OK, OK, um, and the what is the, um, since this, this happened like it was an ER visit from a year ago and they just now finally sent her a bill so uh how long do we have to to get this followed up with? I mean, I don't know what the time frame is.
[AGENT][NEUTRAL] Yeah, there's no timely filing limit as long as you had coverage on the date of service, um, we'll get the claim processed.
[CUSTOMER][NEUTRAL] OK, does it take, how long does it usually take once you receive it?
[AGENT][NEUTRAL] Um, once we receive it, um, we ask that you allow, let's see, 7 to 10 business days.
[CUSTOMER][NEUTRAL] 7 to 10 business days. OK, and you said you need the EOB from the primary and then you need diagnosis code um and that has to come from the.
[CUSTOMER][NEUTRAL] Uh, the person that build the services are from the ER.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and would it is it acceptable if they on the if they send it on the bill and it shows the diagnosis code on the bill they send?
[AGENT][NEUTRAL] Um, yes, ma'am. We'll take that.
[CUSTOMER][POSITIVE] OK, OK, perfect, thank you so much for your help I appreciate it.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, not today. Thank you.
[AGENT][POSITIVE] OK, thank you again, [PII] for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.