AccountId: 011433970860
ContactId: 8417d4f4-50c4-4c44-8569-c5dca08c1f5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 486820 ms
Total Talk Time (AGENT): 199094 ms
Total Talk Time (CUSTOMER): 114910 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/8417d4f4-50c4-4c44-8569-c5dca08c1f5c_20250506T12:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from Bell Clinic. Need to see if you received the claim and what our status is.
[AGENT][NEUTRAL] OK, [PII], you're needing to see if a claim has been received and if so what the status is, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] OK, perfect. Thank you. And what is the member's policy number?
[CUSTOMER][NEUTRAL] It is 02312747.
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments to get the member's information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And any information that is provided today, [PII] would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] Data service is 23-2025.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And total charge amount is.
[CUSTOMER][NEUTRAL] $56,32.40.
[AGENT][NEUTRAL] OK, and that was 23 of $25 for $56,032.40. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the name of the facility?
[CUSTOMER][NEUTRAL] Bell Clinic Incorporated.
[AGENT][NEUTRAL] OK, so I do not, I have a claim on file for that data service, but not for the bill amount that you're giving me.
[AGENT][NEUTRAL] So there's, yes.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Is it a large amount as well?
[CUSTOMER][NEUTRAL] Because that is the only plan.
[AGENT][NEUTRAL] Mm. No, ma'am. It would be, no.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Looks like, OK.
[CUSTOMER][NEUTRAL] OK, so you don't have this one. OK, let me verify.
[AGENT][NEUTRAL] No, ma'am. And when
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So it still needs to go to the [PII].
[AGENT][POSITIVE] Yes, ma'am, that is correct. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we will have to have a copy of her primary insurance company's explanation of benefits along with the claim and then you may already have this [PII], but we also have a portal in which you should be able to check claim status once we've received and processed the claim.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And the website for that portal is located at [PII].
[AGENT][NEUTRAL] But give me just a moment because I do want to look at this claim that we received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It looks like this one was printed in mail on [PII], so that might be why you don't have it yet.
[AGENT][NEUTRAL] OK. Yes. We, we do not, mm.
[AGENT][NEUTRAL] No. Um, well, actually, just a moment.
[AGENT][NEUTRAL] So the claim was received, the claim that was received does reflect that build amount that you gave me. However, it is showing as $3,597 for the actual charges.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's crazy.
[CUSTOMER][NEGATIVE] It's 2 claim it's 2 pages. I'm wondering if they just got the one page.
[AGENT][NEGATIVE] It is 2 pages, but we did not.
[CUSTOMER][NEUTRAL] Because that's 3597.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That 3597 is the second page.
[AGENT][NEUTRAL] Yeah, and it came as the first page with the total bill amount at the bottom, but we did not receive the explanation of benefits.
[CUSTOMER][NEUTRAL] OK, so you need.
[AGENT][NEUTRAL] It was only the claim.
[AGENT][NEUTRAL] So we really just need.
[CUSTOMER][NEUTRAL] You need both pages of the plane.
[CUSTOMER][NEUTRAL] And the EB
[AGENT][NEUTRAL] Well, we have
[AGENT][NEUTRAL] We have 2 pages, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But we need the, yeah, we'll need the primary EOB is really what we need.
[CUSTOMER][NEUTRAL] OK, alright, do you have a claim number for that one yet?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 3,592,880.
[CUSTOMER][NEUTRAL] Alright, is there a fax number that I can fax the EOB to?
[AGENT][NEUTRAL] Yes, you can send that to [PII].
[AGENT][NEUTRAL] 3659423 attention claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give me just a moment, um.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me make, let me make a note right quick on something. One second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so yes ma'am, so if you'll send that explanation of benefits, I have made a note on this, uh, policy as well regarding that amount because the claim does show the correct total bill amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I will get that sent out today. Do y'all do call references, [PII]?
[AGENT][NEUTRAL] I see.
[AGENT][POSITIVE] You will actually use my name along with today's date.
[CUSTOMER][POSITIVE] All right, thank you so much and you have a great rest of your day.
[AGENT][POSITIVE] All right, well, you, I hope you do too, [PII], and if that is all I can help you with, thank you again for calling APL today.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye