AccountId: 011433970860
ContactId: 8d406c17-23fc-4bbc-b21f-4ec4cf5f1048
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 618520 ms
Total Talk Time (AGENT): 222052 ms
Total Talk Time (CUSTOMER): 288921 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/8d406c17-23fc-4bbc-b21f-4ec4cf5f1048_20250313T12:25_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII]. I'm calling with the endoscopy center and um I have access to the portal, but I don't have a patient's social security number, so I'm unable to find the information that I need.
[AGENT][POSITIVE] I'll be glad to help you, [PII]. What, what can I help with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, so I've got a an an EOB indicating that it's a duplicate payment. I just need to confirm when the claim was initially processed and paid.
[AGENT][NEUTRAL] OK, yes, and what is the policy number, please?
[CUSTOMER][NEUTRAL] 02175468
[AGENT][NEUTRAL] 68. Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, that is [PII].
[AGENT][POSITIVE] I appreciate that. What date of service are we looking for, for [PII]?
[CUSTOMER][NEUTRAL] Date of service was [PII] and the charged amount was $2,806.
[AGENT][NEUTRAL] OK, thank you. I'm just looking at that now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] I don't have anything for [PII] for that amount. Now, what I do show uh CPT code 45385, um, and we made a payment of $60 on that.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, I, the AOB has a claim number. Would that help?
[AGENT][NEUTRAL] Uh, yes, is it ending at 639-6 or um 0347?
[CUSTOMER][NEUTRAL] 034 0347.
[AGENT][NEUTRAL] Right, yes. OK, so the original, the original claim on this is uh the 1 349-6396.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] We made that payment, uh let me just check here, and that would have been $60 and it looks like.
[AGENT][NEUTRAL] That payment was made.
[AGENT][NEUTRAL] On, uh,
[AGENT][NEUTRAL] On
[AGENT][NEUTRAL] [PII]. Now the claim was sent in to us again, uh back in January, on [PII], and it was processed on [PII], but it was, it was a duplicate of the of the claim that we had already paid and so.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so let me see, so now if I, since I have the correct because for some reason when I'm looking, I put in the claim number that the EOB came in and it didn't populate but hopefully with the.
[CUSTOMER][NEUTRAL] Claim that the payment was issued.
[CUSTOMER][NEUTRAL] I mean, I don't know if you're familiar with it should show regardless, right?
[AGENT][NEUTRAL] Yes, it should. I would, I would think so. Um, yes, I'll just.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me just double check on this one if you don't mind hold on.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] That way.
[CUSTOMER][NEUTRAL] Give me a second. It flagged me out. Apparently I decided I was there too long. Give me just a second.
[CUSTOMER][NEUTRAL] 62 4 19.
[CUSTOMER][NEUTRAL] 66
[CUSTOMER][NEUTRAL] Search
[CUSTOMER][NEUTRAL] You said the claim number is 349-696?
[AGENT][NEUTRAL] 639-6.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, OK, one more time 639.
[AGENT][NEUTRAL] Um, yes, it's uh 349.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 639-6.
[CUSTOMER][POSITIVE] Bless you.
[AGENT][POSITIVE] Oh, thank you. I, uh, I'm sorry. I tried to cover that up.
[CUSTOMER][NEUTRAL] You're fine.
[AGENT][NEUTRAL] It's just allergy season, you know.
[CUSTOMER][NEUTRAL] And I, I know it happens. OK, so that was 349-639.
[AGENT][NEUTRAL] Uh, it's 349.
[AGENT][NEUTRAL] 6396.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEGATIVE] Yeah, see it's not giving me anything for it 63.
[CUSTOMER][NEUTRAL] Allow me to correct myself. I'm sorry, I prepare, so it's 349-639-6 correct?
[AGENT][NEUTRAL] Uh, yeah, 349-639-6.
[CUSTOMER][NEUTRAL] 6396.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And you do have uh.
[CUSTOMER][NEUTRAL] Yeah, I can find the claim under that.
[CUSTOMER][NEUTRAL] Would it be possible to get a copy of the explanation of benefits for the August? OK.
[AGENT][POSITIVE] Yes, absolutely.
[AGENT][NEUTRAL] Yeah, I, I can send that to you. What is the fax number, [PII], that I can send that to you?
[CUSTOMER][NEUTRAL] That number is [PII].
[AGENT][NEUTRAL] And may I send that to your attention?
[CUSTOMER][POSITIVE] Yes, that would be appreciated.
[AGENT][POSITIVE] OK. I, I will certainly be glad to do that. And is there anything else at all that I may help with?
[CUSTOMER][NEUTRAL] Uh, yes, I might have a different patients. Let me double check on my list if you allow me, please. Uh, this one is fine.
[AGENT][POSITIVE] Sure, absolutely.
[CUSTOMER][NEUTRAL] And this one is fine.
[CUSTOMER][NEUTRAL] Write it in full, paid it in full.
[CUSTOMER][NEUTRAL] Uh, OK, this station, um.
[CUSTOMER][NEUTRAL] Her ID number is [PII].
[AGENT][NEUTRAL] Thank you. And her name and date of birth, please?
[CUSTOMER][NEUTRAL] Her name is [PII]. He let me pull up her date of birth. Sorry, gotta keep going to different places and on her, I guess I would just need to confirm what the termination of coverage was because that's what the AOB is indicating, uh.
[AGENT][NEUTRAL] Oh, yes, certainly. Now, she had a policy with us from [PII].
[CUSTOMER][NEUTRAL] Hold on
[AGENT][NEUTRAL] Until [PII]. Now, after [PII], uh the uh policy lapsed and she never had another one with us.
[CUSTOMER][NEUTRAL] OK, so there was no coverage after that day for her. OK, so that would make sense. Let me just give me a second over here for us.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I apologize, I have to go to to a different screen. thank you.
[AGENT][NEUTRAL] No, no, that's fine.
[CUSTOMER][NEGATIVE] And one of them is not very helpful and 004.
[CUSTOMER][NEUTRAL] Yeah, so, yeah, her date of birth is [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], OK, and.
[CUSTOMER][POSITIVE] OK, perfect. OK, understood and this one here.
[CUSTOMER][POSITIVE] Oh, I have one more if you could please last one promise.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, it's, uh.
[CUSTOMER][NEUTRAL] Account number
[CUSTOMER][NEUTRAL] Policy number is 02263266.
[AGENT][NEUTRAL] And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] And and [PII], date of birth [PII].
[AGENT][NEUTRAL] Thank you. And what date of service are we looking for for Ms. [PII]?
[CUSTOMER][NEUTRAL] I have [PII] charge amount $1,243.
[AGENT][NEUTRAL] OK. Um, now the claim for this one.
[AGENT][NEUTRAL] Uh, it's 35.
[AGENT][NEUTRAL] 49
[AGENT][NEUTRAL] 164. And what we did was we paid $400 for that. Um, now that was processed.
[AGENT][NEUTRAL] On uh
[AGENT][NEUTRAL] [PII]. So, uh, we received it on the [PII], we processed it, uh, on the [PII] and
[AGENT][NEUTRAL] A check for $400 was uh was paid at that time.
[CUSTOMER][NEUTRAL] OK, could I ask to please, uh, provide me with a copy of that AOB as well.
[AGENT][NEUTRAL] Certainly, and it's [PII]. Is that correct?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][POSITIVE] OK, I can certainly do that. I'll be glad to.
[CUSTOMER][NEUTRAL] OK, yeah, because for some reason I can't get it on the.
[CUSTOMER][NEUTRAL] On the portal.
[AGENT][POSITIVE] Oh OK. Well, no, no, that's fine. Uh, we don't mind helping at all. I mean, it's just, it's just, you know, uh, sometimes it's more convenient, you know, if you do it after hours, you know, when, when we're not answering the phone. Yes, absolutely. I will be glad to, uh, send this to you and um you should be getting it. It'll be sometime today cause I'm gonna have to pull these things up and and then get them to you, but I will send it today to that uh um fax number ending in [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh, OK, OK, alright, no problem.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right perfect thank you very much I appreciate that information and uh have a great rest of the day almost the weekend so there's that.
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][POSITIVE] OK, well, thank you. You too. Yeah, thank you. Thanks for contacting APL. Have a good day.
[CUSTOMER][NEUTRAL] Yeah.