AccountId: 011433970860
ContactId: 7aecaff6-2c5d-4f50-95a1-8e4193df4441
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214520 ms
Total Talk Time (AGENT): 78619 ms
Total Talk Time (CUSTOMER): 83490 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/7aecaff6-2c5d-4f50-95a1-8e4193df4441_20250319T18:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. This is [PII] calling you from the provider's office, checking on the claim status. And my last name first initial is [PII]. How are you doing today?
[AGENT][POSITIVE] Thank you. I'm good, [PII]. How are you?
[CUSTOMER][POSITIVE] I'm also good. Thank you so much for asking.
[AGENT][POSITIVE] Happy to check on a claim today. What's the patient's policy number?
[CUSTOMER][NEUTRAL] Uh, sure. The patient's policy number is 01982200 M Mike Lima 8.
[AGENT][NEUTRAL] All right, thank you. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] Uh yeah. The date of service was [PII]. And this is the Medicare crossover claim with the bill amount $137.13.
[AGENT][NEUTRAL] All right. Looks like.
[AGENT][NEUTRAL] We did receive a claim for the state of service, um, let's see one moment.
[AGENT][NEUTRAL] It looks like the claim was denied that office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK. And uh is there any other policy number that you have for the office visit?
[AGENT][NEUTRAL] No, we do not. We're the secondary insurance, you would need to check with the insured to know, see what their other insurances.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And uh is there any other insurance active for the member?
[AGENT][NEUTRAL] Not with us at this time, no.
[CUSTOMER][NEUTRAL] OK just one moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the member's policy. OK. Uh, perfect. And what is the received date and the denial date of the claim?
[AGENT][NEUTRAL] Uh, the claim was received on [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Claim was denied on [PII].
[CUSTOMER][NEUTRAL] OK. And what is the claim number?
[AGENT][NEUTRAL] 356.
[AGENT][NEUTRAL] 472 6.
[CUSTOMER][NEUTRAL] OK, perfect. And could you please help me with the call reference number?
[AGENT][NEUTRAL] Call reference is my name with my last initial than today's date. My name again is [PII], that's.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, yeah, please go ahead.
[AGENT][NEUTRAL] My last initial is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK. Perfect. Thank you so much, [PII], for your help. Have a great day. Bye-bye and take care.
[AGENT][NEUTRAL] You as well. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.