AccountId: 011433970860
ContactId: 6e10a239-d3c3-4b47-8e63-229371b3d444
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309779 ms
Total Talk Time (AGENT): 120134 ms
Total Talk Time (CUSTOMER): 107860 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/6e10a239-d3c3-4b47-8e63-229371b3d444_20250620T17:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for contacting ATL. My name is [PII]. How may I?
[CUSTOMER][NEUTRAL] Hi, this is Via calling from provider's office, checking for the claim status. Before we start, can you please spell out your name and this call is getting recorded for the quality and training purpose.
[AGENT][NEUTRAL] It's [PII] and [PII], what is that policy number that we're looking at today for the claim?
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] Your voice is uh resounding. Uh, can you please?
[AGENT][NEUTRAL] Yeah. Yeah, I'm sorry, I can't hear you very well either. My name is [PII]
[AGENT][NEUTRAL] And I just need the policy number so I can look up the claim, please.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 01852088 M Mike Lima 8.
[AGENT][POSITIVE] Thank you. If I can have a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Excuse me just a second please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the number is [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, 01852088 M Mike Lima 8.
[AGENT][NEUTRAL] OK, thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and the date of birth [PII].
[AGENT][NEUTRAL] Thank you. And the date of service for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the bill amount is $685 even.
[AGENT][POSITIVE] OK, thank you very much. I'm just looking at that now.
[AGENT][NEUTRAL] OK, it looks like uh the um policy does not cover office visits or treatment within the physician's office.
[AGENT][NEUTRAL] Your claim number is 36.
[AGENT][NEUTRAL] 05
[AGENT][NEUTRAL] 289.
[AGENT][NEUTRAL] And we received that claim.
[AGENT][NEUTRAL] On the [PII], we processed it on the [PII].
[AGENT][NEUTRAL] But this policy only covers treatments.
[AGENT][NEUTRAL] Within a hospital.
[AGENT][NEUTRAL] So the.
[AGENT][NEUTRAL] So the, the um charges are not covered.
[AGENT][NEUTRAL] Due to the, the, uh, the patients uh insurance plan.
[CUSTOMER][NEUTRAL] Which plan does the patient have?
[AGENT][NEUTRAL] This is a secondary insurance.
[AGENT][NEUTRAL] Now, it may be covered through their primary insurance, but it's not covered through their secondary insurance.
[CUSTOMER][NEUTRAL] Yeah. Uh, it is already covered by the primary insurance. There is a co-payment of $35.
[AGENT][NEUTRAL] Right, yes, I, I understand. um, it's just that it's not covered by this policy. So it may be covered by the primary insurance, but it's not covered by this policy.
[AGENT][NEUTRAL] So they, they have two insurances.
[CUSTOMER][NEGATIVE] Uh, it does not
[CUSTOMER][NEUTRAL] Yeah, I, I know it does not cover as per patient's plan. Uh, like which plan like it is a supplemental plan or what, which kind of plan is it?
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] It's a supplemental plan. That's correct.
[AGENT][NEUTRAL] Yes, this is a secondary or supplemental plan.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm. And it does not cover office visit or the just place of service level?
[AGENT][NEGATIVE] It doesn't cover the place of service 11.
[CUSTOMER][NEUTRAL] OK. And also the office visit, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. And the claim number is 3605289, right?
[AGENT][POSITIVE] That is right.
[CUSTOMER][NEUTRAL] And received on [PII] and the denied on [PII]. Can you also fax us the UV to our fax number?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Yes, and what is that fax number please?
[CUSTOMER][NEUTRAL] One second. Uh, it's [PII].
[AGENT][POSITIVE] OK, I can do that. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] Uh, no. Uh, what will be the turnaround time?
[AGENT][NEUTRAL] Uh, you should, you should be getting this, uh, within the next, um, uh, 24 hours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And call reference number for today's conversation?
[AGENT][NEUTRAL] My name is
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]
[AGENT][NEUTRAL] I in kite and we'll use that today's date as a reference.
[CUSTOMER][POSITIVE] Thank you so much and bye for now. Bye-bye.
[AGENT][POSITIVE] OK, thank you for contacting UT.