AccountId: 011433970860
ContactId: a404c972-0253-43f8-b88f-98af3a3f6c5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1117229 ms
Total Talk Time (AGENT): 175492 ms
Total Talk Time (CUSTOMER): 285190 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/a404c972-0253-43f8-b88f-98af3a3f6c5c_20250331T17:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from provider office to check the claim status.
[AGENT][NEUTRAL] OK, [PII], I can help you with client status. Do you have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 116716762.
[AGENT][NEUTRAL] And the patient, what's the last name of the patient?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] and the last name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Um, I, how do you spell that? because I'm not pulling up the policy number you gave me.
[CUSTOMER][NEUTRAL] OK. And my last name is [PII].
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] First name, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] you.
[CUSTOMER][NEUTRAL] me
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, do you have a for the patient by chance, a social security number?
[CUSTOMER][NEUTRAL] I don't have it.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And I was the first name, did you say [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] The first name was what?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Sorry, it was the last name. First name is [PII]
[AGENT][NEUTRAL] I'm not pulling anything up with that name.
[AGENT][NEGATIVE] Not finding them in the system.
[CUSTOMER][NEUTRAL] Wait a moment.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Did you have another name to try or uh ID?
[CUSTOMER][NEUTRAL] Mm, yes, I'm checking in my insurance card. Is the information is appropriate or not?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Could you please check it with other payer ID if the member is matching or not?
[AGENT][NEUTRAL] With the payer ID?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] From insurance card, I found other one.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, the only thing I can look up is policy number, last name, or social.
[AGENT][NEUTRAL] Do you have the group number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 788,380.
[AGENT][NEUTRAL] I'm not finding anything under that.
[AGENT][NEUTRAL] You have the name of the group?
[CUSTOMER][NEUTRAL] It's JC I A.
[CUSTOMER][NEUTRAL] Electrical contact.
[AGENT][NEUTRAL] What what was that JCN?
[CUSTOMER][NEUTRAL] A like Alpha, electrical, C O N T.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, I'm not pulling anything up under that.
[CUSTOMER][NEUTRAL] Is the policy number you got it right. I'll reverify it. It's 116716762.
[AGENT][NEGATIVE] Yeah, those are that's too many numbers.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEGATIVE] Yeah, I can't pull anything up under any of the information that you've given me.
[CUSTOMER][NEUTRAL] OK. Do you have the reference number?
[AGENT][NEUTRAL] The reference number is my name, [PII]. Today's date, Stephanie, D as in dog, and then today's date.
[AGENT][NEUTRAL] And then is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Could you please help me with the one more account?
[AGENT][NEUTRAL] Yes, what's that policy number?
[CUSTOMER][NEUTRAL] It's 226-745-5.
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is?
[CUSTOMER][NEUTRAL] [PII]. And the first name is [PII].
[AGENT][NEUTRAL] And the date of birth?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And did you say you need a claim status or benefits?
[CUSTOMER][NEUTRAL] Yes, claim status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And could you repeat your name for me please and your callback?
[CUSTOMER][NEUTRAL] My name is [PII] and the callback is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what was that date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] $10,0024.79.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, it looks like.
[AGENT][NEGATIVE] That claim was denied.
[AGENT][NEUTRAL] We need an explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] Yeah, we have already sent it too many times. Uh, I'll verify the fax number that we have submitted to.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So, the fax number we have submitted is [PII]. Is it the correct fax number that we have submitted previously, correct?
[AGENT][POSITIVE] Uh, yes, that is correct. Actually, it looks like we did receive that. Let me give you the information on it.
[AGENT][NEUTRAL] Um, we made a payment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Of 20062104.
[CUSTOMER][NEUTRAL] What was it, same number?
[AGENT][NEUTRAL] Claim number is 3,579,610.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Could you please provide the receipt and the date?
[AGENT][NEUTRAL] Received date was [PII] that was paid on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any timely filing?
[AGENT][NEUTRAL] No, but the claim was paid. We paid it. We made a payment to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have the reference number?
[AGENT][NEUTRAL] My name and uh [PII], last initial [PII], and today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Could you please provide
[CUSTOMER][NEUTRAL] Wait a moment.
[CUSTOMER][NEUTRAL] Yeah, could you please provide one more account?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you please pay one more account?
[AGENT][NEUTRAL] Check one more account?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, what's the account number?
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Account number is G like Gary 0801.
[AGENT][NEUTRAL] Is that the policy number?
[AGENT][NEUTRAL] I need that policy number. Sorry about that.
[CUSTOMER][NEUTRAL] Yes, the policy number is G like Gary 0801.
[AGENT][NEUTRAL] Um, that's not a good policy number. Do you have any other number?
[CUSTOMER][NEUTRAL] Uh, wait a moment.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 579.
[CUSTOMER][NEUTRAL] 02254100.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Uh, too many numbers.
[AGENT][NEUTRAL] You have the name of the patient?
[CUSTOMER][NEUTRAL] Patient.
[CUSTOMER][NEUTRAL] First name is [PII]. Last name is [PII].
[AGENT][NEUTRAL] How do you spell that?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] First name is [PII], and the last name is [PII].
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] You have the patient's date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Day of service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Fill them up.
[CUSTOMER][NEUTRAL] Bill on $25,135 even.
[AGENT][NEUTRAL] OK, it looks like that claim was received [PII].
[AGENT][NEUTRAL] Denied on [PII].
[AGENT][NEUTRAL] And it looks like.
[AGENT][NEUTRAL] We need the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK. So, could you please verify me that we have submitted is to correct or wrong mailing address previously?
[CUSTOMER][NEUTRAL] We have submitted it.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] 2, it's PO.
[CUSTOMER][NEUTRAL] To the fax number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no. On the fax number, it is [PII]. Is this the correct one?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] So they, you haven't received it yet?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] 3562843
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thanks for providing. Have a nice day. Take care. Bye-bye and nice talking to you.
[AGENT][POSITIVE] OK, thanks for calling ATL. Have a good day.