AccountId: 011433970860
ContactId: 708a79c2-6eaa-41a0-821d-2b7c987264c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 709859 ms
Total Talk Time (AGENT): 202705 ms
Total Talk Time (CUSTOMER): 326770 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/708a79c2-6eaa-41a0-821d-2b7c987264c2_20250407T20:37_UTC.wav
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[AGENT][NEUTRAL] This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. You said [PII], right?
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] Hey, this is [PII] in customer service. I have [PII] with uh provider's office checking on the claim status for the policy.
[AGENT][NEUTRAL] OK, I can help with that. Did, uh, what's the policy number?
[CUSTOMER][NEUTRAL] Mhm. That will be 248.
[CUSTOMER][NEUTRAL] 3111.
[AGENT][NEUTRAL] 3111. OK, great. Yeah, I can help with that. Sure.
[CUSTOMER][NEUTRAL] Um, and everything has been verified.
[AGENT][POSITIVE] OK, I appreciate it. Thanks.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right, excuse me, I'm sorry, [PII], this is [PII] in the claims department, um, can look up a claim for you. Uh, who is the, um, dependent that we're looking at?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is going to be [PII] [PII] [PII] [PII] [PII], [PII], and the last name will be [PII] and the date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Thank you. What date of service are we looking at?
[CUSTOMER][NEUTRAL] Date of service, date of service is [PII]. And the bill charge amount is going to be, keep a moment.
[CUSTOMER][NEUTRAL] I'm so sorry. The date of service is gonna be uh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Under the bill charge amount is
[CUSTOMER][NEUTRAL] Going to be 2,4482448.
[AGENT][NEUTRAL] 2448. OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, um,
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] For [PII], uh, we do have a, uh,
[AGENT][NEUTRAL] We, we have one claim uh for that data service it's, it's not for that bill amount though, um.
[CUSTOMER][NEGATIVE] So just to make it, not one, I made a multiple calls.
[AGENT][NEUTRAL] So it doesn't look like I have your claim.
[CUSTOMER][NEUTRAL] And every time I
[AGENT][NEUTRAL] Uh, is this for a facility bill?
[CUSTOMER][NEUTRAL] so I'm just asking.
[CUSTOMER][NEUTRAL] Uh, is it for the, uh, provider, professional.
[AGENT][NEUTRAL] Oh, OK, OK. So it doesn't look like they've turned that in yet. Um, now there's no timely filing, uh, but, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, it doesn't look like I have your claim yet.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] So I can take.
[CUSTOMER][NEUTRAL] Yeah. So, have you received this claim, ma'am?
[AGENT][NEUTRAL] No, we haven't received the claim, so uh you can either fax it or mail it to us, um.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. It means there is no claim on file, right?
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] I, I beg your pardon?
[CUSTOMER][NEUTRAL] It means there is no claim on file, right?
[AGENT][NEUTRAL] No, no, there's no claim on file uh for that, um, for that bill amount for the physicians.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Lemon while needturi.
[CUSTOMER][NEUTRAL] to the
[CUSTOMER][NEUTRAL] Submit
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] Again. OK. Uh, can you help me with your mailing address?
[AGENT][NEUTRAL] Yes, it's um
[AGENT][NEUTRAL] Our mailing address is [PII].
[CUSTOMER][NEUTRAL] Only [PII].
[AGENT][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Your mailing address
[AGENT][NEUTRAL] Uh, yeah, yes, it's a [PII] address. It's, it's not a street address, it's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, that is it, that is I want to know.
[AGENT][NEUTRAL] Right, yeah, [PII].
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh. And the next?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Can you spell it?
[AGENT][NEUTRAL] And our zip code? Sure, absolutely. It's um [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] Amen.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, you said [PII] and the letter uh MOK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, no, it's, uh, you've got the [PII] address, right, [PII]. So it's [PII].
[AGENT][NEUTRAL] [PII] and then [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][POSITIVE] It's spelled OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] And what is the city?
[AGENT][NEUTRAL] It's uh that's, it's [PII].
[CUSTOMER][NEUTRAL] What is the abbreviation?
[AGENT][NEUTRAL] Oh, it's OK.
[CUSTOMER][NEUTRAL] OK. OK. And what is the zip code?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] a
[CUSTOMER][NEUTRAL] OK. And what should be the attention?
[AGENT][NEUTRAL] Attention claims, it's uh APL and claims.
[CUSTOMER][NEUTRAL] OK. Attention claim. And uh when, when he was effective?
[AGENT][NEUTRAL] The, it looks like the policy went into effect on [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] To still active, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you give me the uh call reference number?
[AGENT][NEUTRAL] It's my name
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] What's
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Can you spell your name?
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] OK. I have one or more members, uh, [PII]. Can you also help me out?
[AGENT][NEUTRAL] OK. And what is that policy number, please?
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][POSITIVE] I really appreciate your patience.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, the, uh,
[CUSTOMER][NEUTRAL] Policy number will be
[CUSTOMER][NEUTRAL] Yeah, the policy number will be 015.
[CUSTOMER][NEUTRAL] 30968 M as in [PII] Lima number 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Patients first name is [PII] and the last name is
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what is the data service that we're looking for?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The date of service will be
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] And is there a particular bill amount that I should look for?
[CUSTOMER][NEUTRAL] $3600 even. 3600.
[AGENT][NEUTRAL] OK, great. Let me just see what we have here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it doesn't look like I have your claim for this either. Um, you could send it to the same address uh that uh that we just talked about.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] There's no claim on file as well, right?
[AGENT][POSITIVE] Oh, that's correct, right. That's right.
[CUSTOMER][NEUTRAL] But that
[CUSTOMER][NEUTRAL] OK. All right. Give me a moment.
[CUSTOMER][NEUTRAL] All right. And uh the reference number would be the same, correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the timely filing limit?
[AGENT][NEGATIVE] There's, there's no timely filing on these policies.
[CUSTOMER][POSITIVE] OK. Not an issue.
[CUSTOMER][NEUTRAL] So shall be moved to the next member and this is the last one.
[AGENT][NEUTRAL] OK, yes, and the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Professional
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The last policy number will be?
[CUSTOMER][NEUTRAL] 0225577 5 M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] The patient.
[CUSTOMER][NEUTRAL] The patient's first name is going to be [PII] and the last name is [PII] and the date of birth is [PII]. Yeah, the date of service will be [PII]. And the bill charge amount is going to be.
[AGENT][NEUTRAL] Thank you. And what uh date of service were you looking for for [PII]?
[CUSTOMER][NEUTRAL] $6,396.92. 6396.92.
[CUSTOMER][NEUTRAL] Very
[AGENT][NEUTRAL] OK, I'm, I'm sorry, that's not coming up either.
[AGENT][NEUTRAL] It doesn't look like we have that, that policy either, I mean that claim either.
[CUSTOMER][NEUTRAL] There's a no claim on file?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] No, I'm sorry, there isn't.
[CUSTOMER][NEUTRAL] 21
[CUSTOMER][NEUTRAL] OK. That will be the same scenario as the previous claim, right?
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] No, we, we changed our, we changed our um mailing address, so that [PII] City address is the one that you want to send them to.
[CUSTOMER][NEUTRAL] For.
[CUSTOMER][NEUTRAL] OK. The address which you have given me, that is [PII], right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And the city is going to be OK. And the ZIP code is [PII], right?
[AGENT][POSITIVE] Oh, that's right.
[CUSTOMER][NEUTRAL] What's your pay ID?
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Give me a moment.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. It was nice talking to you.
[AGENT][POSITIVE] OK, well, thank you.
[CUSTOMER][POSITIVE] And a wonderful day. Bye. Take care.
[AGENT][POSITIVE] Mhm. Thanks for contacting ATL. Have a good day.