AccountId: 011433970860
ContactId: 789175f3-067e-4883-aed7-2dcdd2ef3197
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352700 ms
Total Talk Time (AGENT): 66890 ms
Total Talk Time (CUSTOMER): 128994 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/789175f3-067e-4883-aed7-2dcdd2ef3197_20250616T16:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], I have a claim that I need to check status on.
[AGENT][NEUTRAL] I can help you with claim status. Who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And I'm with um let's see, this one, this facility, we have a bunch of them here. So it's Carl Hill Proctor Hospital and you guys are secondary to Aetna.
[AGENT][NEUTRAL] OK, what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]. That is my direct line. And can you spell your name for me, please?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what's the policy number for the claim?
[CUSTOMER][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] It's 02563039 M as in Mary, L Larry 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Can I get you to verify the patient's name and date of birth for me please?
[CUSTOMER][NEUTRAL] Yes, um, her patient's name is um.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, hold on, let me get their date of birth.
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][POSITIVE] Thank you so much for verifying that with me.
[AGENT][NEUTRAL] And do you have the claim number or the date of service?
[CUSTOMER][NEUTRAL] Um, well, we never received a remit or a claim number. The date of service is [PII]. Total amount bill was $28,366.25.
[AGENT][NEUTRAL] Alright just a moment to look that up.
[AGENT][NEUTRAL] And you said [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look here.
[AGENT][NEUTRAL] I'm sorry, what was the provider's name or the hospital name again?
[CUSTOMER][NEUTRAL] Carl Hill Proctor Hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing that claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, cause we built this, looks like they built this on.
[CUSTOMER][NEUTRAL] On [PII], so we should have received a response by now, um, and it would probably would have been with the primary, um, so I'm gonna go ahead and drop it to paper and bill it. I have the billing address as [PII]. Is that the correct address?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, uh, [PII].
[CUSTOMER][NEUTRAL] Yes, and this is ATL, is that the name of the insurance company?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And they'll do attention claims department.
[CUSTOMER][NEUTRAL] All right. Uh,
[CUSTOMER][NEUTRAL] Attention claims department and um can you give me the patience uh effective date on this plan?
[AGENT][NEUTRAL] It looks like this policy became active on [PII].
[CUSTOMER][NEUTRAL] The current
[AGENT][NEUTRAL] Yes, ma'am, it is currently active.
[CUSTOMER][NEUTRAL] OK. And uh what's your time of following at the primary?
[AGENT][NEGATIVE] But we don't have timely filing limits.
[CUSTOMER][NEUTRAL] 00, OK, timely filing limit. OK. All right, I'll go ahead and get a paper claim out there with the primary EOD. And do you have a call reference number?
[AGENT][NEUTRAL] So we don't have call reference numbers, but you can use my name and last initial in today's date, so it'll be [PII] in today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. You have a great day.
[AGENT][POSITIVE] Hi, thank you for calling APL. I hope you also have a great day.
[CUSTOMER][POSITIVE] OK, great.