AccountId: 011433970860
ContactId: 6ab8e319-f74c-44e4-9789-288076ec1777
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315500 ms
Total Talk Time (AGENT): 153047 ms
Total Talk Time (CUSTOMER): 90236 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/6ab8e319-f74c-44e4-9789-288076ec1777_20250207T21:30_UTC.wav
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[AGENT][NEUTRAL] Contacting APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. hello, can you hear me?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, I'm sorry I didn't catch your name.
[CUSTOMER][NEUTRAL] Myself, [PII]. I'm calling from Little Children Hospital providers. I'm looking for clinic status.
[AGENT][NEUTRAL] OK, we'll go ahead and help you with the claim status. What's that policy number, please?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I can help with the claim status. What is that policy number, please?
[CUSTOMER][NEUTRAL] Yeah, just a moment.
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] 023
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] 822
[AGENT][NEUTRAL] 8, OK, so it's 02300822. Is that correct?
[CUSTOMER][NEUTRAL] Yes, 02300822.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Conception.
[AGENT][NEUTRAL] Thank you. And her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. What, uh, I just need a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the data service that we're looking for for [PII]?
[CUSTOMER][NEUTRAL] Date of service is uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and is there a particular bill amount?
[CUSTOMER][NEUTRAL] $2,466.47.
[AGENT][POSITIVE] I appreciate that. Thank you. Your claim number.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] It's 353 4.
[AGENT][NEUTRAL] 958
[AGENT][NEUTRAL] We received your claim on the [PII] and we processed it on the [PII]. Now, as we are [PII]'s secondary insurance.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We will need a copy of the explanation of benefits.
[AGENT][NEUTRAL] From her primary insurance in order to process this.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So what we did was we pended the claim until we had a copy of her EOB from her major medical and if we could get.
[CUSTOMER][NEUTRAL] Email address
[AGENT][NEUTRAL] Pardon?
[CUSTOMER][NEUTRAL] Give me address for your submission.
[AGENT][NEUTRAL] Yes, certainly, the um
[AGENT][NEUTRAL] Uh, address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] That is in [PII] City, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And our zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry, [PII]
[AGENT][NEUTRAL] Yes, it's um our zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] And I have one more claim.
[AGENT][NEUTRAL] OK, and what is, is it for the same individual or is this for someone else?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is uh another patient.
[AGENT][NEUTRAL] Yes, and what's the policy number, please?
[CUSTOMER][NEUTRAL] 01523996
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please?
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Go, go back.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and the date of service for [PII]?
[CUSTOMER][NEUTRAL] Date of [PII].
[CUSTOMER][NEUTRAL] Charges $859.94.
[AGENT][NEUTRAL] Thank you. Your claim number is 354.
[AGENT][NEUTRAL] 2304.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like we received your claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On the [PII] and we processed it on the [PII] of last year.
[AGENT][NEUTRAL] Now, this is the same thing. Um, we are the secondary insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so uh we'll need the major medical EOB in order to finish processing that claim. So it's not denied, it's just pended until we get that EOB and then once we do that, then we'll be able to finish processing the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, thank you. Please just spell out your name.
[AGENT][NEUTRAL] It's [PII] and we're gonna use that today's date as a reference. Is there anything else at all I can help with?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] CI. Could you repeat that?
[AGENT][NEUTRAL] My name is, uh yes, [PII]
[AGENT][NEUTRAL] And the first letter of my last name is [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] OK, well, thank you for contacting ATL. You have a good day.