AccountId: 011433970860
ContactId: 53498865-fd02-429a-8df1-5e31bc1cdef6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232750 ms
Total Talk Time (AGENT): 72983 ms
Total Talk Time (CUSTOMER): 93420 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/53498865-fd02-429a-8df1-5e31bc1cdef6_20250624T13:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning. My name is [PII] The last name initial is [PII]. Can you spell out your name, please?
[AGENT][NEUTRAL] My name is [PII]. It's spelled [PII] Last initial is [PII].
[CUSTOMER][NEUTRAL] OK, thank you much. Maybe, uh, I'm calling from West Buca Medical Center regarding the claim status for the patient. Can you help me with that?
[AGENT][NEUTRAL] I'm sure Said I can assist you with claim status. Um, first, I'll need a good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] Uh, the callback number is [PII]. My extension will be [PII].
[AGENT][NEUTRAL] And thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] Uh, the policy number is 01753781 M Mike Lima 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] The name is [PII]. I'm sorry, I pronounce it wrong.
[CUSTOMER][NEUTRAL] And the birth date is [PII].
[AGENT][NEUTRAL] Thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] The date of service is [PII]. And the total charge is $64,843 even.
[AGENT][NEUTRAL] OK. Let's see.
[AGENT][NEUTRAL] OK, yes, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 3,604,580 and I'm showing that this claim denied because according to the primary carrier EOB that was sent along with the claim, the primary insurance denied the um claim. So if the primary insurance denied the claim, we denied also as their secondary.
[CUSTOMER][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] Yeah, as, as I can check the primary insurance, Cigna and uh Cigna paid $124,800 and patient responsibility is $2,579.41 that goes to you uh as a secondary. So, uh, as I can check, Cigna paid the amount. So, uh you need the primary AOB?
[AGENT][NEUTRAL] Um, yes, the claim can be resubmitted, um, with that EOP. Yes, sir.
[CUSTOMER][NEUTRAL] OK. So, thank you very much. Uh, may I know the timely filing limit?
[AGENT][NEUTRAL] There's no timely filing limit?
[CUSTOMER][NEUTRAL] OK, thank you very much, Avi. Uh, please provide me the call reference.
[AGENT][NEUTRAL] So the reference number, you can use my name and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] Uh, that's all I need to know. Thank you very much, Avi. Thanks for the help. Have a nice day. Bye-bye.
[AGENT][NEUTRAL] You do the same to you. Thank you for calling ITL um bye.