AccountId: 011433970860
ContactId: 476f3240-b474-4b42-b6a1-58152f6e8427
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240690 ms
Total Talk Time (AGENT): 87765 ms
Total Talk Time (CUSTOMER): 99854 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/476f3240-b474-4b42-b6a1-58152f6e8427_20250505T15:17_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]. Uh, I would like to check status of a claim, please.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. uh, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, I, can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yeah, that would be [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Policy number would be 01682909M for Mama L for Lima 7.
[AGENT][NEUTRAL] Got it. And what was the name and date of birth for this member, please?
[CUSTOMER][NEUTRAL] Yeah, that would be [PII].
[AGENT][NEUTRAL] OK and then uh what was the name for the member?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and then what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] This is for [PII].
[AGENT][NEUTRAL] OK, do you have that bill amount?
[CUSTOMER][NEUTRAL] Uh, amounting $366.16.
[AGENT][POSITIVE] Got it, thank you for that one moment please.
[AGENT][NEUTRAL] And do you have the tax ID for this uh provider?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you for that. One moment please.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Oh, I see. Can I have the claim number instead?
[AGENT][NEUTRAL] Of course that claim number is 3585.
[AGENT][NEUTRAL] 853.
[CUSTOMER][NEUTRAL] I'm sorry, that's 358-585-3?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Um, can you happen to send to me the EOB for this one?
[AGENT][NEUTRAL] Yeah, of course, uh, do you have a fax number?
[CUSTOMER][NEUTRAL] Yeah, uh, that would be [PII].
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That's [PII].
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] OK, I will go ahead and get that sent now. Should get it within about 10 minutes or so. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, uh, so office business is not covered. Also the, um, the procedure that was done, the CPT code 97593. I'm sorry 597.
[AGENT][NEUTRAL] But
[AGENT][NEGATIVE] Yes, that is not.
[AGENT][NEUTRAL] that's not going to be covered at an office setting.
[CUSTOMER][NEUTRAL] Oh, I see. OK. Thank you very much for this one, [PII]. And can I have your last name's initial and uh reference number for the call?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date, and some, uh, my name is spelled [PII]
[CUSTOMER][POSITIVE] OK. Thank you very much for this one, [PII], and have a, have a great day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely thanks for giving us a call you too bye bye.
[CUSTOMER][NEUTRAL] Bye.