AccountId: 011433970860
ContactId: 4ea72317-0e5f-4a77-8388-5fe0ab8bfb42
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331820 ms
Total Talk Time (AGENT): 102409 ms
Total Talk Time (CUSTOMER): 89924 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/4ea72317-0e5f-4a77-8388-5fe0ab8bfb42_20250521T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check on claim status. And can you please spell me your name for our records?
[AGENT][NEUTRAL] Um, sure, [PII], I can assist you with claim status, and my name is [PII]. Um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] OK. And [PII], could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. The callback number, it's start with 4.
[CUSTOMER][NEUTRAL] [PII] with an extension of 4.
[AGENT][NEUTRAL] OK, thank you. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Yes, sir. The policy number it starts it.
[CUSTOMER][NEUTRAL] 020.
[CUSTOMER][NEUTRAL] 326.
[CUSTOMER][NEUTRAL] 06 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the patient name, it's [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Yeah, sure. The data so [PII].
[CUSTOMER][NEUTRAL] And the total charge amount it's $790 790.
[AGENT][NEUTRAL] OK, one moment, I'm waiting on my system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes. Um, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 359-5440.
[AGENT][NEUTRAL] And it paid it paid out for $97.54.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it was a single check for $97.54.
[AGENT][NEUTRAL] And the check number is
[AGENT][NEUTRAL] 204-1559.
[CUSTOMER][NEUTRAL] OK. And is there any member responsible?
[AGENT][NEUTRAL] No, I'm not showing any.
[CUSTOMER][NEUTRAL] OK. And the $97.54 it's paid for the procedure code 99204 or for the other procedure codes?
[AGENT][NEUTRAL] The other procedure codes.
[CUSTOMER][NEUTRAL] OK. And may I know the status of the postal code [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, office visits are not covered under this policy, so that would be members responsibility.
[CUSTOMER][NEUTRAL] Uh, just one.
[CUSTOMER][NEUTRAL] You know the patient plan name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Uh, may I know uh when was this claim received and processed?
[AGENT][NEUTRAL] We received the claim on [PII], and it was processed on [PII].
[CUSTOMER][NEUTRAL] OK. It's under the same claim number ends with 5440.
[AGENT][NEUTRAL] Yes, sir. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, no, that's it for this call and the call reference number, please.
[AGENT][NEUTRAL] Um, for the reference number, you can use my name and today's date and my name is [PII], um spelled [PII] Last initial is [PII], and today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much. Thanks for the information you have provided. Have a great day and bye for now.
[AGENT][POSITIVE] Yeah, thank you, [PII], for calling APL. You have a great day as well. Mm, bye.