AccountId: 011433970860
ContactId: 61b6730c-5f64-4a20-a530-d0e804a1bbb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 588450 ms
Total Talk Time (AGENT): 171770 ms
Total Talk Time (CUSTOMER): 282942 ms
Interruptions: 7
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/61b6730c-5f64-4a20-a530-d0e804a1bbb1_20250509T16:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. speaking. May I help you?
[CUSTOMER][NEUTRAL] This is Mo calling from For office regarding the claims inquiry.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is again?
[CUSTOMER][NEUTRAL] This is [PII] and last initial, last name [PII] would be [PII].
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Just one second, I will provide you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] The member ID would be 02117579 M for Mary, L for Rosy H.
[CUSTOMER][NEUTRAL] 10th class, sir?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Sorry? That would be 02117579 M for Mary, L for Lucy, and number 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] I I can provide you with a callback number for.
[CUSTOMER][NEUTRAL] Uh, that would be [PII] and the extension would be [PII].
[AGENT][NEUTRAL] OK, say that phone number again. I cannot hear you.
[CUSTOMER][NEUTRAL] That would be [PII] and the extension would be [PII].
[AGENT][NEUTRAL] OK, thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] One second, the question.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And the patient name is in the uh the patient name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] D of service is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and the amount of the charge?
[CUSTOMER][NEUTRAL] Do.
[CUSTOMER][NEUTRAL] Uh, the total charge amount would be $2,071 even.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said the data service was [PII]?
[CUSTOMER][NEUTRAL] The it's [PII].
[AGENT][NEUTRAL] OK, I don't show we received that claim. Can you verify the mailing address it was submitted to you?
[CUSTOMER][NEUTRAL] Once again, I will verify that one.
[AGENT][NEUTRAL] Well, and
[AGENT][NEUTRAL] And also the patient was not active at this, also, the patient was not active at the time of service. The policy terminated [PII].
[CUSTOMER][NEUTRAL] Could you please provide your uh
[CUSTOMER][NEUTRAL] [PII] November.
[CUSTOMER][NEUTRAL] Could you please spell your spell out your name?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Sure, it's [PII], and give me one moment, I do show they have another policy, and I'll give you that policy number when you're ready.
[CUSTOMER][NEGATIVE] One second, this, this policy number is not active.
[AGENT][NEUTRAL] The policy number you gave, the 2117579 termed on [PII]. They have a current policy that is active and I can give you that number when you're ready.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, on hand.
[CUSTOMER][NEUTRAL] Turn on when was it, what term?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] No, [PII]. OK, thank you.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the, the, uh, the active policy ID?
[AGENT][NEUTRAL] Uh, that policy number is 2273083.
[CUSTOMER][NEUTRAL] 2273083. Is this correct?
[AGENT][NEUTRAL] That is correct. Effective [PII]. And after you said the data service is [PII] at [PII] in the amount of $2,0071 do you have the balance after Primary is processed the claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, the after primary process, the, uh, remaining balance would be the 41313.05 cents.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from fraud office regarding the claims inquiry. This is uh um my facility uh that the, the pathology group, Northwest Florida PLLC.
[AGENT][NEUTRAL] What's the name of the provider's office?
[AGENT][NEUTRAL] OK, I don't show we received that claim, um, but can you verify the mailing address the claim was submitted to?
[CUSTOMER][NEUTRAL] Could you please first provide me with the policy effective date, the new 1, 2273083?
[AGENT][NEUTRAL] As I stated, the new policy effective date is [PII], and the policy is active.
[CUSTOMER][NEUTRAL] Still uh still active.
[CUSTOMER][NEUTRAL] Is it correct? OK. Uh.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The mailing address would be the [PII].
[CUSTOMER][NEUTRAL] MS
[CUSTOMER][NEUTRAL] ZIP code is [PII]. Is it correct? And payer ID would be 6. OK. Could you please provide me the mailing address?
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Once you sorry, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] City and state.
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Uh, state, state also, [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And ZIP code?
[CUSTOMER][NEUTRAL] [PII] on payer ID.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801 and timely following limit?
[AGENT][NEUTRAL] Uh, there's no time limit to submit claims.
[CUSTOMER][NEUTRAL] Mm, no time limit.
[AGENT][NEUTRAL] OK, and is there anything else, [PII], I can assist you with today?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Once again, um, this, this insurance will accept paper as well.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] This insurance will accept the paper and or electronic.
[CUSTOMER][NEUTRAL] Claims.
[AGENT][NEUTRAL] Uh, either way is fine. You can mail it or you can send it electronically.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK. OK. Thank you for helping out of this claim.
[CUSTOMER][NEUTRAL] And could you, if we have any in the group number for this uh new policy ID?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, it's the same 21471.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] Same group number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second. Could you please provide me the reference number for this call?
[AGENT][NEUTRAL] Uh, you may use my name in today's date and my name is [PII] last [PII] [PII].
[CUSTOMER][NEUTRAL] And today's date.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Mhm. Thank you for calling APL.
[CUSTOMER][POSITIVE] Have uh thank you for helping us.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] Bye for now. Have a good day and weekend.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You too, bye.