AccountId: 011433970860
ContactId: 4c02545b-b5e5-4d1b-b861-581395ac772f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419769 ms
Total Talk Time (AGENT): 190666 ms
Total Talk Time (CUSTOMER): 95630 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/4c02545b-b5e5-4d1b-b861-581395ac772f_20250512T13:22_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. I was calling to see if a, if a claim is on file.
[AGENT][NEUTRAL] OK, so you're wanting to see if we've received a claim for a member, is that correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII], last [PII]
[AGENT][NEUTRAL] I'm so sorry. Did you say [PII] or [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Alright, thank you, [PII]. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is the member's policy number?
[CUSTOMER][NEUTRAL] And the policy number is 023.
[CUSTOMER][NEUTRAL] 893-874 Mad and [PII].
[AGENT][NEUTRAL] OK. Did you say 023893874?
[CUSTOMER][NEUTRAL] No, just at 87.
[AGENT][NEUTRAL] OK. All right. Thank you. One moment.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name again and their date of birth?
[CUSTOMER][NEUTRAL] Madam [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him, please?
[CUSTOMER][NEUTRAL] [PII] and the total bill amount.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Total bill amount was $435.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, so I see this claim has been received more than once. The most recent one was denied as a duplicate.
[AGENT][NEUTRAL] But let me pull that information up. OK, give me one second to get that pulled up.
[CUSTOMER][NEUTRAL] OK, and what
[AGENT][NEUTRAL] OK, so actually part of it was denied as a duplicate. So do you need the receipt date and the process date or just the claim status on it?
[CUSTOMER][NEUTRAL] OK, you said that the most recent one was a duplicate. What was the original filing um.
[AGENT][NEUTRAL] Well, the most recent, the most recent one was not a complete duplicate. The most recent one was received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Uh, EOB
[AGENT][NEUTRAL] That claim was 3595518.
[AGENT][NEUTRAL] And on there the offices.
[AGENT][NEGATIVE] Had initially been denied as not being covered under this policy. And then the other code 96,160.
[AGENT][NEUTRAL] States that benefits are payable only if your major medical insurance provider provides benefits. If this claim is later paid by your major medical insurance, please send the explanation of benefits showing benefits were paid.
[AGENT][NEUTRAL] That's the remark on code 96,160.
[CUSTOMER][NEUTRAL] OK. Let me pay if major medical provides benefits.
[AGENT][NEUTRAL] Mhm. And if you need a copy of this EOB with those remarks, it it is being mailed, but you can also or should be able to print it, Bora from our portal if you go to [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] Yes, ma'am. Sure.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] He says secure.
[AGENT][POSITIVE] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh oh, I can't. Give it to me. I'm so sorry. Give it, hold on, let's see, secure it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Within the
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I don't know. I can't get to the website.
[AGENT][NEUTRAL] OK, and you're spelling, you're just typing in [PII].
[AGENT][NEUTRAL] That's all you're typing in, right?
[CUSTOMER][NEUTRAL] OK, OK, I got it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, and
[CUSTOMER][NEUTRAL] Hey, OK, now I'll try to receive that EOB and thank you so much for what, what was the claim number again? Did you give me the claim number?
[AGENT][NEUTRAL] I did. 359-5518.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, and thank you so much for your help this morning.
[AGENT][POSITIVE] Well, you are certainly very welcome. Is there anything else, [PII], that I can help you with today?
[CUSTOMER][NEUTRAL] That's all. I call reference.
[AGENT][POSITIVE] Yes ma'am, you're gonna use my name along with today's date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I see. All right, thank you.
[AGENT][POSITIVE] Uh-huh. Well, you're welcome. So again, if that is all I can help you with, thank you for calling APL Laundro, and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.