AccountId: 011433970860
ContactId: 49acdeb1-8f7e-4ed3-99df-197dcbd032b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 229759 ms
Total Talk Time (AGENT): 89323 ms
Total Talk Time (CUSTOMER): 85158 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/49acdeb1-8f7e-4ed3-99df-197dcbd032b3_20250602T16:17_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], my name is [PII], and I'd like to check on the claim, please, please.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um first, could I get a callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] 1261895 M for Mary L for Larry 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] 3574.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] 3 14 20251876.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thanks for your patience. Um, I'm not showing that claim on file, but he does have a new policy number that the claim would need to be resubmitted under.
[CUSTOMER][NEUTRAL] OK, what's that number E?
[AGENT][NEUTRAL] Um, it is 02589447.
[CUSTOMER][NEUTRAL] Let me repeat 025894447.
[AGENT][NEUTRAL] Yes, ma'am. That's correct. And that's his new policy number as of [PII].
[CUSTOMER][NEUTRAL] [PII], OK, and you don't have a claim yet on file because it was forwarded back in April.
[AGENT][NEUTRAL] OK. No, ma'am. I'm not showing that claim on file. Um, would you like to verify how the claim was submitted?
[CUSTOMER][NEUTRAL] It says forwarded, so I'm assuming it went electronically. It's because he has Amed as his primary.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It doesn't say papers. It must have been done electronically.
[AGENT][NEUTRAL] OK. Yeah, normally, we don't receive them directly from the primary carrier. We'll receive them from um the provider or the member themselves would submit it.
[CUSTOMER][NEUTRAL] OK this is coming from the sleep study, so normally you said you don't, you don't receive it from home.
[AGENT][NEUTRAL] We don't receive it from the primary insurance carrier. We'll receive the claims from the provider or the member could submit the claim themselves.
[CUSTOMER][NEUTRAL] OK, all right, well, we're the sleep study center and we sent it, we forwarded, forwarded the uh claim information to you from.
[CUSTOMER][NEUTRAL] After we got back to primary with the EOB, so normally I know that's how we would do it.
[AGENT][NEUTRAL] OK. Yes, ma'am. Well, the claim can be
[CUSTOMER][NEGATIVE] It wasn't forwarded from admin sorry.
[AGENT][NEUTRAL] OK. Yes, ma'am. Well, the claim could be resubmitted under the correct policy number.
[CUSTOMER][POSITIVE] OK, alright, I'll go ahead and resubmit the claim on that new number you gave me. I appreciate your help, and may I have a reference number to speak with you, please, [PII]?
[AGENT][NEUTRAL] Um, yes, ma'am. For the reference number, you can use my name and today's date. Um my name is spelled [PII] and today's date. Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That's it. I appreciate your help.
[AGENT][POSITIVE] OK, thank you, [PII] for calling ATL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.