AccountId: 011433970860
ContactId: 565f2ebc-20a5-4b09-9269-181aa74a3e1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 304859 ms
Total Talk Time (AGENT): 105383 ms
Total Talk Time (CUSTOMER): 96435 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/565f2ebc-20a5-4b09-9269-181aa74a3e1f_20250321T18:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good morning. My name is [PII]. It's [PII] and the last initial is [PII]. [PII], what's your last initial?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Perfect. And actually I'm calling from the provider office from Piedmont Athens Regional Medical Center and I'm looking for a medical claim status of a patient. Can you please assist me with the claim?
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, and may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's, it's [PII].
[AGENT][NEUTRAL] Thank you, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] Yes, the member ID is 01640969.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes. [PII], with the date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yes, total bill is $4,706 even, whereas the rate of service [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what's the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] It's Piedmont Athens Regional Medical Center.
[AGENT][NEUTRAL] OK, here we go hold on one moment.
[AGENT][NEUTRAL] So I received two claims on that day. I'm waiting to see if this is your claim. Hold on one moment.
[CUSTOMER][POSITIVE] Take your time, ma'am.
[AGENT][NEUTRAL] Is there any other total bill that it could be?
[CUSTOMER][NEUTRAL] On the same date of service?
[AGENT][NEUTRAL] Yes, on, on [PII].
[CUSTOMER][NEUTRAL] No, ma'am. Uh, it's only one claim.
[AGENT][NEUTRAL] OK, um, well, in that case, then there's no claim on file for your data service or your total bill.
[CUSTOMER][NEUTRAL] But now you told me that uh there are 2 claims on file?
[AGENT][NEUTRAL] Right, there are 2 claims on file for that date of service, but they're different providers and they're different total bills. So for you, there's no claim on file.
[CUSTOMER][NEUTRAL] OK, no worries. Can you please confirm me the payer ID so I can read some with that.
[AGENT][NEUTRAL] Sure, 60801.
[CUSTOMER][NEUTRAL] OK. And do you have the effective date of patient policy with you?
[AGENT][NEUTRAL] Yes, hold on one moment.
[AGENT][NEUTRAL] And the policy effective date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And still active?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And uh I just want to verify one address. Is that the [PII]. Is that the correct uh claim mailing address?
[AGENT][NEUTRAL] No, let me give you the correct claim's mailing address. Let me know when you're ready.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Which city? Can you please repeat the city?
[AGENT][NEUTRAL] Ok
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Please uh spell that word.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the abbreviation is OK.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] Perfect. I got my answer. You can provide me the reference number. I'm resubmitting this claim.
[AGENT][NEUTRAL] OK, so there's no call reference number, but you can use my name in today's date. Um, the first initial of my last name is [PII].
[CUSTOMER][POSITIVE] Perfect. Uh, [PII], thank you so much for the information and happy weekend as well. Thank you so much, [PII]. Bye for now.
[AGENT][POSITIVE] Thank you, [PII]. Thanks for calling APL. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, [PII], thank you so much. Wonderful day. Bye for now.
[AGENT][POSITIVE] Alright, have a good day. Bye bye.
[CUSTOMER][NEUTRAL] You don't.