AccountId: 011433970860
ContactId: 7b237735-b233-4f89-b8bc-a13abe7ad509
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 327450 ms
Total Talk Time (AGENT): 148902 ms
Total Talk Time (CUSTOMER): 81220 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/7b237735-b233-4f89-b8bc-a13abe7ad509_20250422T15:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hi [PII]. I was calling to check to see if a patient's insurance is still active.
[AGENT][NEUTRAL] OK, I can see if that policy is active. um, what was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Do you have that policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number I have is 6073778.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so this policy is active. Effective date was [PII]. Uh, and if you'd like, I can send you the fax back that shows all of the covered procedures and benefit information.
[CUSTOMER][NEUTRAL] OK, um, you don't have to. I think I have it on file, but I did. I have two claims that were that weren't paid for in the past.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK. Let's take a look at that. Give me just a moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, these two claims were for [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what was the, that data service?
[CUSTOMER][NEUTRAL] The first one was, hold on one second, it was 8-29-2024.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 82924. OK, one moment please.
[CUSTOMER][NEGATIVE] Oh, OK, I see why they didn't pay for that one because it was supposed to be 6 months apart from the last one.
[AGENT][NEUTRAL] Oh, OK. I'm sorry, I'm still trying to find it. Bear with me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] For preventative services, yeah, 1 per 6 month period.
[CUSTOMER][NEUTRAL] OK, I'll say he's paid.
[CUSTOMER][NEUTRAL] He paid for
[CUSTOMER][NEUTRAL] He didn't pay for that one. OK. Then I have, um, this, this is treatment, um, this was [PII] for a filling number 19.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I've got a couple of claims for that date of service, um.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Procedure code is that uh 02 0 yeah, 2391, is that right?
[CUSTOMER][NEUTRAL] 2391 yes ma'am.
[AGENT][NEUTRAL] OK, yeah, so we had a couple of claims for that date of service we did pay one let me see.
[AGENT][NEUTRAL] Was it a provider is that uh [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Um, so for this one we did pay a benefit of $75.
[CUSTOMER][NEGATIVE] OK, when was that paid? I don't even have that posted on his account.
[AGENT][NEUTRAL] Give me just a moment. Sure, let me get that um.
[AGENT][NEUTRAL] Check number, hang on just a moment.
[AGENT][NEUTRAL] OK, uh, so this check was issued [PII], and I am showing that it has not cleared. So let me verify the address, uh, that we sent it to maybe, uh, yeah, let me verify the address really quick. Um, we have uh [PII].
[CUSTOMER][NEUTRAL] OK, maybe it was lost in the mail or something.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, OK, so alright, um, so I could just go ahead and have this voided and reissued, um, did you need this claim number check number or EOB?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, if you can just resend it, can you just send it with the ELB?
[AGENT][NEUTRAL] Um, I can, well, I don't know that I can resend it with the EOB, um, but I can fax that EOB over to you if you've got a fax number.
[CUSTOMER][NEUTRAL] Or can you yeah, you can fax over the EOB that's fine mhm.
[AGENT][NEUTRAL] Sure, what was that fax number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I will go ahead and get that sent to you now. I should get it within about 10 minutes or so, um, and then of course I will go ahead and get this check voided and reissued. Uh, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No ma'am, thank you.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.