AccountId: 011433970860
ContactId: 5a9b409b-95a4-484a-b23a-c8e22f7ad780
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 374339 ms
Total Talk Time (AGENT): 103176 ms
Total Talk Time (CUSTOMER): 121238 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/5a9b409b-95a4-484a-b23a-c8e22f7ad780_20250429T12:29_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, hi, [PII]. My name is [PII]. My, my last initial is [PII] from my calling beh of provider's office to check the claim status.
[AGENT][NEUTRAL] OK, I can help you with the claim status. Could you give me the policy number and a good phone number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, uh, is it your name [PII] only, right?
[AGENT][NEUTRAL] [PII], first initial last is [PII]
[CUSTOMER][NEUTRAL] Yeah, got it. Yeah, my uh member ID is 02595867.
[CUSTOMER][NEUTRAL] [PII], number [PII].
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[CUSTOMER][NEUTRAL] [PII], direct line.
[AGENT][NEUTRAL] OK, what were the 1st 3 digits?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And the callback number you're asking?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I have [PII] for your phone number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. Give me one moment to pull up the file OK.
[CUSTOMER][NEUTRAL] Yes, direct line.
[AGENT][NEUTRAL] Give me one moment to pull up the file.
[CUSTOMER][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Verify the, excuse me, verify the patient's name and date of birth for me, please.
[CUSTOMER][NEUTRAL] Your patient name is [PII] and the last name is [PII], [PII] and the date of birth [PII].
[AGENT][NEUTRAL] Thank you and what's the date of service in charge?
[CUSTOMER][NEUTRAL] Uh [PII] with the charge amount of $2820 even. That is $2820 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the procedure code on the claim?
[CUSTOMER][NEUTRAL] One second. The postal code is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the provider's name?
[CUSTOMER][NEUTRAL] Uh it's uh [PII] and the last name is [PII]
[AGENT][NEUTRAL] Is that from Sheridan Health Corp?
[CUSTOMER][NEUTRAL] Yes, that is from the group, from the Sheridan Health Group.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I showed this claim was received on [PII] processed and processed on [PII]. Uh, we are requesting a copy of the major medical explanation of benefits.
[CUSTOMER][NEUTRAL] Uh, you mean medical records?
[AGENT][NEUTRAL] No, this, this policy is secondary to the primary insurance which would be major medical insurance. We need a copy of their explanation of benefits.
[CUSTOMER][NEUTRAL] Uh, you, you're the secondary, uh, you need the primary UOB, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. What is there any, uh, insurance name listed in your system is which is primary?
[AGENT][NEUTRAL] We're showing Blue Cross Blue Shield, but you wanna check with your patient as well.
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield. One second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] For your confirmation, can I get uh the member ID also?
[AGENT][NEUTRAL] The member ID for.
[CUSTOMER][NEUTRAL] For BCBS.
[AGENT][NEUTRAL] We do not have their information, sir. You'll need to get that from the patient.
[CUSTOMER][NEUTRAL] OK, you need the primary UV, uh, and, uh, the primary UV uh the primary insurance BCBS and you don't have any details, right?
[AGENT][NEUTRAL] We do not have any information as far as their policy number.
[CUSTOMER][NEUTRAL] Yeah, can I get the claim number?
[AGENT][NEUTRAL] So you'll need to contact the patient to obtain that information.
[CUSTOMER][NEUTRAL] Yeah, got it. Can I get the claim number?
[AGENT][NEUTRAL] The claim number is 3587489, and [PII], you can also check your status online at [PII]. Did you have any other questions?
[CUSTOMER][NEUTRAL] Uh, just the call reference number?
[AGENT][NEUTRAL] It's gonna be my name in today's date, [PII] and first initial of my last name is [PII].
[CUSTOMER][POSITIVE] OK, [PII], I think that's it from my end and thank you for assisting me.
[AGENT][POSITIVE] You're welcome thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah, bye bye.
[AGENT][NEUTRAL] Bye bye.