AccountId: 011433970860
ContactId: 495b9757-2320-42fc-8aeb-babbedc3f708
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379920 ms
Total Talk Time (AGENT): 152574 ms
Total Talk Time (CUSTOMER): 167227 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/495b9757-2320-42fc-8aeb-babbedc3f708_20250206T16:11_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so how are you today?
[AGENT][POSITIVE] I'm good, thank you. How about you?
[CUSTOMER][NEUTRAL] I'm OK, thank you. My name is [PII] and I'm calling from Lexington Medical on behalf of Lexington ENT. Just calling to see if you could provide claim status for a member.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims and may I have a callback number just in case we get disconnected, Mr. [PII].
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] All right, thank you. And may I have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, it's 02498766.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] OK, may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Day service in question is [PII]. The total bill amount is $274.
[AGENT][NEUTRAL] All right, let me see if I can find this claim.
[CUSTOMER][NEUTRAL] that.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me look at this claim really quick. And for future, you can check claim status online through our website at [PII] and that's just optional and.
[CUSTOMER][NEUTRAL] What can we get
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Hey, what is it? A, what is it? Secure.
[AGENT][NEUTRAL] Am [PII].
[CUSTOMER][NEUTRAL] [PII] is it self registered? OK.
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] All right, so let's see. hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me, this one they have the total charges. Let me see if this is you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm.
[CUSTOMER][NEUTRAL] When you started doing the thing.
[AGENT][NEUTRAL] Mm nope and.
[AGENT][NEUTRAL] I have several claims for that day. Do you know the procedure code? Maybe I can locate it faster like that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I have 99243.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You're looking at.
[CUSTOMER][NEUTRAL] 45.
[CUSTOMER][NEUTRAL] I need to try to access your website while I'm on with you.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Am told.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Mm. Any other procedures besides that one?
[CUSTOMER][NEUTRAL] Um, we have, well, it's zero charge for them, but it's 3008F 3079F.
[CUSTOMER][NEUTRAL] 3075 FF um 4010 excuse me 4010. Well those are hard road charges.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me try it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me try this uh a claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] This is good to know. OK, let me try to register. Do I have this right?
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] I have a different amount for those charges and then the charge for the office visit is different so it's probably not even this one. No, I don't think it's this one I don't see that one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's the only one.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so it's
[AGENT][NEUTRAL] I don't see that amount listed on the claims.
[CUSTOMER][NEUTRAL] Let's see what
[CUSTOMER][NEUTRAL] You said you can?
[AGENT][NEUTRAL] Mm mm, no, I don't see one for that amount. Uh, and the first code you gave me for the office visit, I don't see it either.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I guess I'll I'll.
[CUSTOMER][NEGATIVE] Send another send the claim again.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] What's the um mailing address if you don't mind.
[AGENT][NEUTRAL] OK, let me check and see where this one goes to.
[CUSTOMER][NEUTRAL] And what's your name, right? It's the old airline so.
[AGENT][NEUTRAL] Yes. So, yes, [PII] last initial [PII]
[CUSTOMER][POSITIVE] OK, let's make sure right.
[AGENT][NEUTRAL] OK, and the address, sure, no problem. The address to submit claims is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, got it. OK, so we'll get it. I'll, I'll mail it to you guys. It's probably what's going on here.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][POSITIVE] No problem. Um, is there, you're welcome. Is there anything else I may help you with today? Any other questions? Any other concerns?
[CUSTOMER][POSITIVE] Ma'am, OK, thank you.
[CUSTOMER][NEUTRAL] do you have a reference number for me?
[AGENT][NEUTRAL] We don't, we don't use reference numbers, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, thank you so I appreciate your time.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] Yes ma'am you too bye bye.
[AGENT][POSITIVE] Thank you, bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye