AccountId: 011433970860
ContactId: 601dad07-1af2-419e-9402-50cdc9a7b70a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268619 ms
Total Talk Time (AGENT): 105771 ms
Total Talk Time (CUSTOMER): 118463 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/601dad07-1af2-419e-9402-50cdc9a7b70a_20250401T17:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. I'm calling from provider office for patient claim status.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII], [PII] for my first name. My last initial is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got it thank you and then then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII] the [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 02313175, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] All right, and then what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] birth. Date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that, man. Uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] The of it was [PII].
[AGENT][NEUTRAL] I'm sorry, and then could you, what was the date of birth for this number?
[AGENT][NEUTRAL] Could you repeat that?
[CUSTOMER][NEUTRAL] Yes, January, yes, [PII].
[AGENT][NEUTRAL] Oh no, I'm sorry, could you, uh, verify the date of birth for this member again? I apologize.
[CUSTOMER][POSITIVE] Oh, I'm sorry. I thought the data service. No problem.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] Uh, the member date of birth is [PII]. Member is a child, dependent, the primary policy holder is [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Got it. OK. There are 2 [PII]. I just wanted to make sure I have the right one. OK, so I will say, um, I don't have any claims on file for this member.
[CUSTOMER][NEUTRAL] OK. If the member is currently active coverage?
[AGENT][NEUTRAL] Right, so, um, the effective date for this policy was uh [PII], and it is currently active.
[CUSTOMER][NEUTRAL] OK. Uh yes, ma'am. I have submitted the claim over fax. Fax number [PII], that was printed in the back of the ID card that was around in the [PII].
[AGENT][NEUTRAL] Yes, it is our fax number.
[AGENT][NEUTRAL] Yes, that is our fax number.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Oh, I submitted the fax with the attached the primary EOB on the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You sent that out [PII] you said?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] Hm, did you, uh, get a response saying that it was successfully, uh, sent?
[AGENT][NEUTRAL] I know at the beginning of that month we did have some issues with our fax machine.
[CUSTOMER][POSITIVE] Yes, yep.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh, I, I'm not sure about it. It was successfully sent, but when I send it, it shows that your, your, your claim, I mean, your document has been sent.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK, well, again I'm not showing that it has been received, uh, if I would have just resend it if you're able to, um, of course we do have our fax number. I've also got a payer ID, um, if you're able to do that electronically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh what is the timely filing limit for the um claim to be signed again?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, so I can redo it again.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][POSITIVE] All right. All right. Thank you so much for your help.
[AGENT][NEUTRAL] Of course, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] That will be it. And do you do call reference number as well, ma'am?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] It would just be my first name, last initial, and today's date. Uh, so my name is spelled [PII]
[CUSTOMER][POSITIVE] Thank you very much for your help.
[AGENT][POSITIVE] Of course, thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.