AccountId: 011433970860
ContactId: 7825a630-de50-4ed1-8321-f0ad8b4bdf12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290399 ms
Total Talk Time (AGENT): 94719 ms
Total Talk Time (CUSTOMER): 100920 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/7825a630-de50-4ed1-8321-f0ad8b4bdf12_20250128T17:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII]. My name is [PII] and I'm calling on behalf of [PII]. I have still a, a pending payment for a patient who was seen back in [PII]. We went and we mailed out the primary insurance EOB and a HIPAA form, and we have not heard back. Can you check on that for me?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, absolutely, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] It is 01611875 M as in Mary, L as in Larry, and 8. Patient's name is [PII].
[AGENT][NEUTRAL] Thank you for that and then if I could just get her date of birth.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII], sorry.
[AGENT][POSITIVE] That's OK. Thanks so much. All right.
[CUSTOMER][NEUTRAL] And the balance is $30.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Data service was [PII].
[CUSTOMER][POSITIVE] Well, correct. Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] And just to confirm, [PII], did you say it was the office visit was in [PII] or [PII]? I'm sorry.
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so the bill amount that we should have gotten was for the $30 correct?
[CUSTOMER][NEUTRAL] Well, the whole bill was $175 and it went to United Healthcare and then the, the balance was $30 yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Gotcha. OK. So I have a claim number of 3441934.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, it does show denied as far as office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what's covered under this, this American public life procedures or what?
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] It's probably just treatment. Most of the time when I see office visits aren't covered, it's just covering any sort of treatment they have in office, not the office visit fee.
[CUSTOMER][NEUTRAL] And define treatment.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Like, um,
[CUSTOMER][NEUTRAL] Like, um, like an infusion or like therapy or?
[AGENT][NEUTRAL] Right, um, yeah, I'm just gonna see if it had a definition and just read it.
[AGENT][NEUTRAL] But yes, you know, it doesn't cover the actual copay for the visit itself.
[CUSTOMER][NEUTRAL] Like, does it cover like an ultrasound? But no, that's not a treatment, that's a diagnostic. Usually American public life only covers the.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So let me take the secondary here.
[CUSTOMER][NEUTRAL] Let me take this off, let me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Do you think you can send me that denial?
[AGENT][POSITIVE] Yeah, absolutely. What's a good fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah. Yes.
[AGENT][NEUTRAL] Alright, yep, so I can send that to you. Should I mark it attention with your name?
[CUSTOMER][NEUTRAL] It doesn't matter. It's [PII], but I'll get it anyway.
[AGENT][POSITIVE] OK. I am sending that to you now. You're very welcome. Anything else?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Right. Have a good day, [PII].
[CUSTOMER][NEUTRAL] The same to you. Bye-bye.
[AGENT][NEUTRAL] Uh-huh, bye-bye.