AccountId: 011433970860
ContactId: 801dec07-7060-41e2-b378-310fba00224f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 584390 ms
Total Talk Time (AGENT): 153440 ms
Total Talk Time (CUSTOMER): 134950 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/801dec07-7060-41e2-b378-310fba00224f_20250516T19:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII]. I'm calling from the provider's office checking on the claim status.
[AGENT][NEUTRAL] OK, I can check in a claim for you. I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII] is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Policy number is, wait a moment.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 01978624 ML 7.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member, please?
[CUSTOMER][POSITIVE] Uh, [PII], I'm [PII]. I'm there.
[CUSTOMER][NEUTRAL] Patient date of birth is [PII].
[AGENT][NEUTRAL] I'm so sorry. I think I must have misheard the uh policy number. Could you repeat that for me?
[CUSTOMER][NEUTRAL] Yes. Oh.
[CUSTOMER][NEUTRAL] The policy ID is 1978634.
[AGENT][NEUTRAL] 34. OK. Sorry about that. One moment.
[AGENT][NEUTRAL] And what was the name of the member?
[CUSTOMER][NEUTRAL] Uh, [PII]. Date of birth of [PII].
[AGENT][POSITIVE] OK, I apologize, thank you so much for verifying all of that. um, what was the date of service for this client, please?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII], total charge amount is $436 even.
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] Uh, what was the, uh, tax ID for this, uh, policy or for the provider please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, was the remaining balance after major medical paid, was that $13.19?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] The remaining balance after major medical paid was that $13.19.
[CUSTOMER][NEUTRAL] I don't see $13.
[CUSTOMER][NEUTRAL] The total bill amount is $444 even, right? Sorry for that.
[CUSTOMER][NEUTRAL] The total balance is $436 right?
[AGENT][NEUTRAL] Uh, I know, but this is a secondary medical policy. So was that the amount before or after major medical paid?
[CUSTOMER][NEUTRAL] Yes, previously, the United Healthcare has paid, right?
[CUSTOMER][NEUTRAL] Process to pay and the process this claim.
[AGENT][NEUTRAL] OK, so then it appears that we've not received that claim.
[AGENT][NEUTRAL] The only claim I have on file for this state of service from this provider is for $13.19.
[CUSTOMER][NEUTRAL] OK, there is no
[CUSTOMER][NEUTRAL] Yeah, but uh I, my bill amount is uh $436 right?
[AGENT][NEUTRAL] I understand, uh, then it does not look like we've received that claim. The only claim I have on file for this state of service from that provider is for $13.19.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. I got it. The member effective date, please?
[AGENT][NEUTRAL] That was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]. I'm still active, right?
[AGENT][NEUTRAL] It's [PII] was the effective date.
[AGENT][NEUTRAL] And yes it is currently active.
[CUSTOMER][NEUTRAL] OK. May I know the
[CUSTOMER][NEUTRAL] OK, may I know this mailing address, please?
[AGENT][NEUTRAL] That is [PII]
[CUSTOMER][NEUTRAL] To submit the claim
[AGENT][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, may I know the pay ID and timely filing, please?
[AGENT][NEUTRAL] Payer ID is 60801 and there is no timely filing limit.
[CUSTOMER][NEGATIVE] To submit the claim, there is no the timely filing.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Spell out your name, please?
[AGENT][NEUTRAL] It's [PII] and was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes, I have 4 more claims. And your last name is your name, please?
[AGENT][NEUTRAL] Last initial is A Were these other claims for different members or for the same member?
[CUSTOMER][NEUTRAL] Please bear with me. I will checking on that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Different
[AGENT][NEUTRAL] They are for different members? OK uh one.
[CUSTOMER][NEUTRAL] One is different
[AGENT][NEUTRAL] The other claims are for different members?
[CUSTOMER][NEUTRAL] Yeah, one is different and 22 is same and.
[CUSTOMER][NEGATIVE] No, no. Uh, 2 is different, 2 is, uh, 2 is the same, 2 is the same, and 1 is different only. This one only different.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there is another, there is another claim that we need to look at for this number?
[CUSTOMER][NEUTRAL] Have 4 games evening.
[CUSTOMER][NEGATIVE] No, no, no.
[AGENT][NEUTRAL] OK, so we're we're done with this number, is that right?
[CUSTOMER][NEUTRAL] No, this number is only one.
[CUSTOMER][NEUTRAL] Yes, that, yes, yes. Call reference number.
[AGENT][NEUTRAL] OK, alrighty. Give me, uh, reference number would be uh my first name, last initial and today's date. Um, give me just a moment, I'll let you know when I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, are you there?