AccountId: 011433970860
ContactId: 9cc9a8c9-6002-4119-b153-67da7f1465b9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 613440 ms
Total Talk Time (AGENT): 120513 ms
Total Talk Time (CUSTOMER): 164535 ms
Interruptions: 5
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/9cc9a8c9-6002-4119-b153-67da7f1465b9_20250214T17:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from provider's office checking my claim status.
[AGENT][NEUTRAL] OK [PII], I can help you with claim status. Can I please get your call back number?
[CUSTOMER][NEUTRAL] Mhm and my call back number would be [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is the patient's name?
[CUSTOMER][NEUTRAL] OK, and the patient's first name would be, uh, uh, just a moment.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][POSITIVE] It's loading actually.
[AGENT][POSITIVE] OK, you can go ahead and take your time, sir.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. And the patient's first name spells like [PII].
[CUSTOMER][NEUTRAL] Uh, I'm so sorry, it's a middle name.
[AGENT][NEUTRAL] OK, and what's the patient's last?
[CUSTOMER][NEUTRAL] Uh, it's a middle name actually. The patient's last name is [PII].
[AGENT][NEUTRAL] OK, and what's the patient's date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And the policy number please.
[CUSTOMER][NEUTRAL] Yeah, and the policy number is 1337111 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is the patient's name, uh, [PII]?
[CUSTOMER][POSITIVE] Yeah, exactly, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you and then what is the date of service?
[CUSTOMER][NEUTRAL] OK, and the date of service is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the charge amount please sir?
[CUSTOMER][NEUTRAL] And the charge amount is $348 even.
[AGENT][NEUTRAL] And then what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] OK, uh, just a moment.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] 0 $55 even.
[AGENT][NEUTRAL] Thank you and then what is the name of the facility you're calling from, [PII]?
[CUSTOMER][NEUTRAL] And the facility name is Gastro Health.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, sir, while I look up this claim for you and I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Oh shoot, I didn't wanna do that.
[AGENT][NEUTRAL] [PII], get off my Wi Fi.
[AGENT][NEGATIVE] Don't get on it again, please.
[AGENT][NEGATIVE] It just keeps connecting. That's why I told you to take it out of your phone.
[AGENT][NEUTRAL] Huh?
[AGENT][NEGATIVE] Yeah, it just that's why I said take it out so it doesn't keep connecting automatically.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me, [PII]. So I did find the claim.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] The claim number is 346-438-9. The claim was received on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And processed on [PII]. The claim was denied because office visits are not covered under the patient's policy.
[CUSTOMER][NEUTRAL] Just one.
[CUSTOMER][NEUTRAL] OK, claim was denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] My.
[CUSTOMER][NEGATIVE] And it's denied because offices are not put on the patient's plan.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you please send me a copy of EOB through FAs?
[AGENT][NEUTRAL] Yes, I can send the EOB. What is your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I get that um EOB faxed over to you. I'll be right back.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] All right, OK.
[AGENT][NEUTRAL] You.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me [PII]. I've got that EOB on its way to you now.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can you hear me? Hello?
[AGENT][NEUTRAL] Yes I can hear you.
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] OK, thank you for confirming. And when can I expect the fax to be received?
[AGENT][NEUTRAL] Uh, I've already sent it so you just have to give it time to come through the um fax machine.
[CUSTOMER][NEUTRAL] OK, I got it.
[CUSTOMER][NEUTRAL] Uh-huh, OK.
[CUSTOMER][NEUTRAL] Alright, and can I have a call reference ma'am for this one?
[AGENT][NEUTRAL] Yes sir, you can use my name [PII] in today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] All right, oh yeah, I'm sorry.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][POSITIVE] Alright [PII], thank you so much for the information which you have provided. Have a wonderful day ahead.
[CUSTOMER][POSITIVE] Take care bye bye.
[AGENT][POSITIVE] You too [PII]. You have a good weekend thanks for calling APL by bye [PII].
[CUSTOMER][POSITIVE] Thank