AccountId: 011433970860
ContactId: 5588613e-4abe-42f6-b8a9-e08bc97b1918
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 405279 ms
Total Talk Time (AGENT): 128721 ms
Total Talk Time (CUSTOMER): 82624 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/5588613e-4abe-42f6-b8a9-e08bc97b1918_20250121T19:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, this is [PII] and I'm calling from provider office. I'm looking for the claim status.
[AGENT][NEUTRAL] OK, I can check on a claim for you, [PII]. Uh, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for that. And then do you have the policy number?
[CUSTOMER][NEUTRAL] 022
[CUSTOMER][NEUTRAL] 781-99 M as in Mike, L as in Lima, and then number 7.
[AGENT][NEUTRAL] All right, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] The insured name, uh, the patient name?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] So this 1 [PII] with the amount of $3,428.
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And $3,428.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] I'm sorry, [PII], what was the name of the provider's office?
[CUSTOMER][NEUTRAL] West Boca Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Bear with me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and that amount, the $3,428 was that the amount before major medical paid?
[CUSTOMER][NEUTRAL] No, that's the
[CUSTOMER][NEUTRAL] build out.
[AGENT][NEUTRAL] OK, is that before or after major medical paid though?
[CUSTOMER][NEUTRAL] Before
[AGENT][NEUTRAL] It is before, OK.
[AGENT][NEUTRAL] Bear with me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I did find the claim that y'all submitted um and I can absolutely send you a copy of this uh EOB so it looks like for this member they had already filed the claim previously and the benefit had been paid to them.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, all right. Can I have the receive all the information, the general information?
[AGENT][NEUTRAL] Yes, give me just a moment. Yes.
[CUSTOMER][POSITIVE] Sure. Take your time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this claim was received [PII].
[AGENT][NEUTRAL] And then it was processed [PII].
[AGENT][NEUTRAL] And then I've got that claim number for you as well whenever you're ready.
[CUSTOMER][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] OK, claim number is 345-0284.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And did you want me to send you a copy of this EOB Sam?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have a fax number?
[CUSTOMER][NEUTRAL] One moment. The fax number is [PII].
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back, make sure I heard that correctly. That was [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Alright, and when I just put this to your attention?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right, I will get that sent to you now. Uh, you should get it here maybe 10-15 minutes depending on how busy your machine is. Uh, did you have any other questions for me?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, just, can you please.
[CUSTOMER][NEUTRAL] Spell out your name.
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] And the reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date so my last initial is A.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much for assisting me. Have a wonderful day.
[AGENT][NEUTRAL] All right, yeah.
[AGENT][POSITIVE] Of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye