AccountId: 011433970860
ContactId: 69ba9e0f-aa2e-4765-b707-9bb4e73ef9c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322579 ms
Total Talk Time (AGENT): 125497 ms
Total Talk Time (CUSTOMER): 119507 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/69ba9e0f-aa2e-4765-b707-9bb4e73ef9c8_20250624T12:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from Lexington Health Incorporated, and I'm trying to obtain some claim status for one of our patients, please.
[AGENT][POSITIVE] All right. I'm happy to check on a claim for you today. Can I get the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, 02217767.
[AGENT][NEUTRAL] Thank you. And then for documentation, do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what are we looking at for the data service?
[CUSTOMER][NEUTRAL] 10 I'm sorry [PII] 2024.
[AGENT][NEUTRAL] OK. And the building.
[CUSTOMER][NEUTRAL] And the bill amount, the original bill amount was $432.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 132.
[CUSTOMER][NEUTRAL] Yeah, 4:32.
[AGENT][NEUTRAL] 0, 432.
[CUSTOMER][NEUTRAL] Yes, so part of the claim did process. It left the balance of one of the claims, uh, CBT 73502 unpaid. So, um, we sent that back over. I was just trying to follow up to see if that code, um, the charge was paid.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I don't see a claim for 432. Data service was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I'm not seeing anything on file for that amount.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, because I called back in when did I call on it?
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I, uh, it's only been a month. I called, I called a little bit over a month ago and so I mailed the claim in.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, and these, so this patient's plan.
[AGENT][NEUTRAL] Their claims actually processed through IMA so it may take even longer because it's not going directly through us.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, do you have a number for IMA?
[AGENT][NEUTRAL] Let me see if there's I don't know.
[AGENT][NEUTRAL] Yeah, their claims go through IMA and Egan.
[AGENT][NEUTRAL] Let me see if I have any sort of number.
[AGENT][NEUTRAL] I don't see. I was gonna, I checked on the card. I don't see a number on the card for him.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I believe it's your number that's on the card.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Which is really, I don't know why they do that like all all of the um.
[CUSTOMER][NEUTRAL] The third party, uh, insurances do that and we have to hunt around to try and find contact information to follow up.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, here is this number, um [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But I mean we do get the claim information. I mean, as far as like it would be on our side. I just don't see anything as of right now for that date or that amount.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, do you know what the turnaround time is like once they receive the claim just about?
[AGENT][NEUTRAL] I mean, generally, once claims are received, it's about 10 business days when it should be processed all the way through, but if it was sent in the mail, it may just be taking a little bit longer to show, you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, can I have your name again? I'm sorry, and the, uh, the initial of your last name.
[AGENT][POSITIVE] No, no problem.
[AGENT][NEUTRAL] Yeah, absolutely. My name is [PII], that's [PII] my [PII].
[CUSTOMER][NEUTRAL] And is there a call reference number [PII] for today's call?
[AGENT][NEUTRAL] Yeah, you can use my name with today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I thank you for your time you have a good rest of your day.
[AGENT][POSITIVE] You as well. Take care. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye