AccountId: 011433970860
ContactId: 7acc931c-9d26-446f-80fe-e5c54e8127ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225720 ms
Total Talk Time (AGENT): 121169 ms
Total Talk Time (CUSTOMER): 50208 ms
Interruptions: 2
Overall Sentiment: AGENT=1.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/7acc931c-9d26-446f-80fe-e5c54e8127ca_20250403T15:00_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK I could try.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling with the provider's office. I'm needing to see if a claim that I faxed in on [PII] was received.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], so you're checking to see if we received a claim for a member, is that correct? Yes, ma'am, I can help you with that. And [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] My direct line is [PII] and I'm [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] 02357209
[AGENT][NEUTRAL] OK, [PII], thank you. One moment while I get all of the member's information pulled up please.
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount please?
[CUSTOMER][NEUTRAL] [PII] and $90.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this claim, yes, this claim has been received. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, it's actually been received multiple times. The most recent claim was that was received was denied as a duplicate.
[AGENT][NEUTRAL] Uh, the original claim, do you need the original claim information?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so it was received on [PII].
[AGENT][NEUTRAL] And it was processed and denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is going to be 355.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 7155.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the reason for the denial on this claim states that services were rendered after coverage was terminated. This policy term 7-12024.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Now if you need a copy of the uh explanation of benefits [PII], you can print that from our portal.
[AGENT][NEUTRAL] By going to secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much for that bit of information. Is there uh like a call reference number I can get?
[AGENT][POSITIVE] Well, you, you are certainly welcome.
[AGENT][POSITIVE] Sure, you would actually use my name along with today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you Ms. [PII] you have a wonderful rest of your day. Thank you so much again for the help.
[AGENT][POSITIVE] Well, you're welcome. Oh, well, you're certainly very welcome, [PII]. So again, if that is all I can help you with, thank you for calling ATL and I hope you have a wonderful day as well.
[CUSTOMER][POSITIVE] Thank you ma'am bye bye.
[AGENT][POSITIVE] Mhm. You're welcome. Bye bye.