AccountId: 011433970860
ContactId: 94096e31-47ca-462f-92c9-caa3e609c9c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264420 ms
Total Talk Time (AGENT): 102529 ms
Total Talk Time (CUSTOMER): 83796 ms
Interruptions: 4
Overall Sentiment: AGENT=1.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/94096e31-47ca-462f-92c9-caa3e609c9c5_20250408T14:32_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, my name is [PII] and I'm calling from New Orleans physician Services to get see if you all received a secondary claim from us.
[AGENT][NEUTRAL] OK [PII], so you're wanting to verify if a claim was received or not, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy.
[CUSTOMER][NEUTRAL] And can I get your first name again?
[AGENT][NEUTRAL] Again, my name is [PII].
[CUSTOMER][NEUTRAL] Oh [PII], OK, [PII], thanks. The uh the patient's policy, I have 02135061.
[AGENT][POSITIVE] Uh-huh. You're welcome.
[AGENT][POSITIVE] OK, thank you one moment please, [PII].
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] bigger.
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Enjoy again, any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] Oh, this is old. 22024.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the total amount of the claim, so you only have a year to get, we have a year to get that is 281.
[CUSTOMER][NEUTRAL] And there was a $60 patient um responsibility after Blue Cross pay.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It went to their co-pay amount.
[AGENT][NEUTRAL] OK, so this claim was received, this claim was received. OK, give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] This claim was received [PII].
[AGENT][NEGATIVE] And it was processed and denied on March.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What was the denial reason of the claim number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, the claim number is 3,432,550, and the reason for the denial is that office visits are not covered under the supplemental policy.
[CUSTOMER][NEUTRAL] OK. All right. What, uh-huh.
[AGENT][NEUTRAL] And if yes, ma'am, and if you need a copy of that EOB Joy, you can go to our portal which is located at [PII].
[AGENT][NEUTRAL] And now that you have the claim number you should uh you should be able to go.
[CUSTOMER][NEUTRAL] Wait, let me see. 6 SEC.
[AGENT][NEUTRAL] Yes, the portal website is secured. [PII].
[CUSTOMER][POSITIVE] Secured
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well thank you and have a good day.
[AGENT][POSITIVE] Well, you're certainly, Oh, well, yes, ma'am. You too. I hope you have a nice day. And is there anything else, [PII], I can help you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] You're welcome and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you.