AccountId: 011433970860
ContactId: 570aeac5-f313-4c43-b72f-85e69024d2bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283000 ms
Total Talk Time (AGENT): 141107 ms
Total Talk Time (CUSTOMER): 117161 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/570aeac5-f313-4c43-b72f-85e69024d2bc_20250428T13:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi, uh, my name is [PII]. I have a question about, um, a, a bill that I think I submitted, um, to get covered, but I'm not sure. I didn't know if you could look it up for me.
[AGENT][NEUTRAL] OK, sure, yeah, I can check claim history for you. And may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] OK. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is um 02545403.
[AGENT][NEUTRAL] Thank you. And Miss [PII], for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, [PII], and [PII]. I don't know if I repeated something wrong.
[AGENT][NEUTRAL] Uh, well, the email address, I'm missing the email address.
[CUSTOMER][NEUTRAL] Oh, OK, uh, [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Looks like we probably have your email from work.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, perfect, thank you. All right, Ms. [PII], and what is the date of service for that claim?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] And of this year.
[CUSTOMER][POSITIVE] Oh yeah. Oh, yes, let's make sure. Let's make sure I got this correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And how much is the total charge?
[CUSTOMER][NEUTRAL] Um, I don't know what the total charge is cause I don't, let me go to it. Actually, I can't go to it. Um, it says it is.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 555 and 6 months.
[AGENT][NEUTRAL] It may be this one let me look into this one. OK, one moment.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] And I, I see it in here, but I don't know if I submitted anything.
[CUSTOMER][NEUTRAL] Like the code.
[AGENT][NEUTRAL] Mm. Mm.
[AGENT][NEUTRAL] All right. Is it for Doctor [PII]?
[CUSTOMER][NEUTRAL] Um, it's for total access urgent care.
[AGENT][NEUTRAL] Total as the urgeon care. Yeah, the, the, the physician was [PII]. OK. Um, yeah, uh, we do have the claim, the, the thing that is missing or the paper that is missing is the explanation of benefits from the primary insurance. So we're still missing the primary explanation of benefits. They did submit a claim, but it was incomplete. We only received the page with all the coding, so we do have the diagnosis code and everything. We just need the copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] Oh OK, alright, perfect. OK, I will, um, get that submitted when I submit it, I submit a whole new a whole new one, right, correct? I have all the files.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can submit the whole claim or you can just go ahead and submit just the um EOB and just submit it as a new um document or new claim, and we'll go ahead and put it together.
[CUSTOMER][NEUTRAL] OK, that
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so what was the second part you just said?
[AGENT][NEUTRAL] They will go ahead and put it all together. Once we receive it we'll go ahead and combine the one we have and the one you're sending and go ahead and process and pay it. OK, so you don't have to send the whole claim. It's just what we're needing mhm.
[CUSTOMER][NEUTRAL] OK, yeah
[CUSTOMER][NEUTRAL] Got you. OK.
[CUSTOMER][NEUTRAL] OK, so all I have to do is send the explanation of benefits.
[AGENT][NEUTRAL] Yes, for that data service. Mhm.
[CUSTOMER][NEUTRAL] OK, because you guys already have the bills from total access urgent care.
[AGENT][NEUTRAL] That is true.
[AGENT][NEUTRAL] Yes, we do. We do have the bill with the diagnosis code and everything. Um, the total charge I see here is the $555.06 which that's a, that's a total charge, OK?
[CUSTOMER][NEUTRAL] OK, got you, and then how come did I just forget to submit the other page?
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] The explanation of benefits, did I forget to submit that?
[AGENT][NEUTRAL] Uh,
[AGENT][NEGATIVE] No, you did not submit the claim. This claim came directly from Totales Urgent Care. They just only submitted the first page. Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Got you. OK.
[CUSTOMER][POSITIVE] Got you. OK, OK. I didn't know they did that, so, OK, that's perfect. OK, I thought I was like I'm willing to losing my mind. I don't understand. OK, all right, thank you so much, and I will get this sent over.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] No problem, Ms. [PII]. You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] And that's it.
[AGENT][POSITIVE] Alright well thank you for calling ATO have a good week.
[CUSTOMER][POSITIVE] Alright you too thank you.
[AGENT][POSITIVE] Thank you. You're welcome.
[CUSTOMER][NEUTRAL] Bye bye.