AccountId: 011433970860
ContactId: a6ebca48-fe4a-42bc-98c1-eb4c5b21c1e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1169359 ms
Total Talk Time (AGENT): 310990 ms
Total Talk Time (CUSTOMER): 328158 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/a6ebca48-fe4a-42bc-98c1-eb4c5b21c1e2_20250415T14:52_UTC.wav
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[AGENT][NEUTRAL] Contacting ATM. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] calling from the provider's office for fast CareLL.
[CUSTOMER][NEUTRAL] This is regarding a claim?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Regarding a claim, yes, I can help with the claim then and, and what is that policy number, please?
[CUSTOMER][NEUTRAL] Yes, um, the policy number.
[CUSTOMER][NEUTRAL] Just one second for all that, yeah, for the first one I have a total of 3 claims in the, so the first one would be 018.
[CUSTOMER][NEUTRAL] 231
[CUSTOMER][NEUTRAL] 48 M as in Mike, L as in Lima.
[CUSTOMER][NEUTRAL] And the number 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's for [PII].
[CUSTOMER][NEUTRAL] [PII] is the date of birth.
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Oh yeah, it's [PII].
[CUSTOMER][NEUTRAL] 01 2nd, give me a moment. I'll work.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Because I just got my line changed. One moment.
[CUSTOMER][NEUTRAL] Yeah, it's going to be 786.
[CUSTOMER][NEUTRAL] 923
[CUSTOMER][NEUTRAL] 4000.
[AGENT][NEUTRAL] OK, great. Thank you. And what date of service are we looking for for uh [PII]?
[CUSTOMER][NEUTRAL] And one quick, I'm sorry, I do have, yeah, I do have an extension it's 305.
[AGENT][NEUTRAL] 305. Thank you. And uh what is that data service that we're looking for for [PII]?
[CUSTOMER][NEUTRAL] Yes, uh, it will be [PII]. It's for $241.90 and it's a secondary claim.
[CUSTOMER][NEUTRAL] And [PII], I just missed the first initialtila.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] It's K as in kite. And so the date of service is [PII]. Is that correct?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, now I apologize. Uh then what was the, the um
[AGENT][NEUTRAL] Build them out on that again.
[CUSTOMER][NEUTRAL] Uh yes, it's gonna be $241.90.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, you're
[AGENT][NEUTRAL] Uh, claim number on this is um.
[AGENT][NEUTRAL] 343.
[AGENT][NEUTRAL] 64
[CUSTOMER][NEUTRAL] One moment please.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yeah, go ahead. 313.
[AGENT][NEUTRAL] Uh, yes, it's actually 343.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 6460.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like the um claim was processed. Now, a $50 check.
[AGENT][NEUTRAL] We sent out
[AGENT][NEUTRAL] And that check is a single paper check and the check number.
[AGENT][NEUTRAL] On this is 18.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh yeah, 18.
[AGENT][NEUTRAL] 43445. So that's 184.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 344 5 and that check would have gone out.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In the mail, uh, let's see.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] I'm just gonna check and see if it's been casting.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, that's 3 the check has been sent. What's the check date?
[AGENT][NEUTRAL] Uh, [PII], let's see.
[AGENT][NEUTRAL] It's the same date. Um, the date that it was sent out is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] OK, check date is [PII]. OK.
[AGENT][NEUTRAL] OK, it looks like it went to [PII].
[AGENT][NEUTRAL] [PII]. Does that sound correct?
[CUSTOMER][NEUTRAL] [PII], yes, OK.
[AGENT][NEUTRAL] Um, now, I don't know whether this, uh, if this check hasn't been received by you, we need to.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Possible that we need to reprocess it, um.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Let's see, I just wanna check one other thing cause it's
[CUSTOMER][NEUTRAL] So it has not be uh not yet cash, right?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah, I take it back. It was cashed. OK, yeah, it looks like it was cashed on [PII].
[CUSTOMER][NEUTRAL] It was cash on [PII]?
[AGENT][NEUTRAL] Uh, no, uh, it was cashed on [PII].
[AGENT][NEUTRAL] [PII], yeah.
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] The claim was paid for $50 right?
[AGENT][POSITIVE] That's correct, yes.
[CUSTOMER][NEUTRAL] A single chick.
[AGENT][NEUTRAL] Uh yes, it was a single paper check.
[CUSTOMER][NEUTRAL] OK, one quick moment.
[CUSTOMER][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Cash on [PII], right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh, could you please, uh, fax me or email me the copy of EOB?
[AGENT][NEUTRAL] Yes, what is your fax number?
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] Yeah, that would be 518.
[CUSTOMER][NEUTRAL] 467
[CUSTOMER][NEUTRAL] 8225.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can certainly do that and you said that there was another data service that we needed to look at?
[CUSTOMER][NEUTRAL] Uh, one quick, do you have any, uh, I do have different, two different patients. I'll be just checking the status.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] And may I have the call reference for this patient?
[AGENT][NEUTRAL] My name is [PII]. The first [PII]. We use that today's date as a reference.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] One moment. OK, I can go ahead with the next patient whenever you're ready, yeah, OK.
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] 190
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] the number 8.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, it's for [PII].
[CUSTOMER][NEUTRAL] [PII] is the date of birth.
[AGENT][NEUTRAL] Thank you. And what data service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's for uh.
[CUSTOMER][NEUTRAL] [PII]. It's for $361.90.
[CUSTOMER][NEUTRAL] And that's the total charge amount. And uh we have sent this claim via paper on [PII].
[AGENT][NEUTRAL] OK, let's look at it. we have here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we
[AGENT][NEUTRAL] Received the claim.
[AGENT][NEUTRAL] On the uh
[CUSTOMER][NEUTRAL] The claim is paid.
[AGENT][NEUTRAL] Uh, no, it looks like we received your claim on um the [PII].
[AGENT][NEUTRAL] [PII] and it was processed on the [PII].
[AGENT][NEUTRAL] Now, this sure.
[CUSTOMER][NEUTRAL] One moment, what's the claim number?
[CUSTOMER][NEUTRAL] OK, go ahead please.
[AGENT][NEUTRAL] Excuse me, the policy number, excuse me, the claim number is 349.
[AGENT][NEUTRAL] 1059.
[CUSTOMER][NEUTRAL] 3491059.
[AGENT][NEUTRAL] And again, we
[AGENT][NEUTRAL] Yeah, 34349.
[AGENT][NEUTRAL] Excuse me, um, please forgive me, I'm sorry. 3491059.
[CUSTOMER][NEUTRAL] Proceed on [PII], right?
[AGENT][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] Now, this policy doesn't cover anything within a physician's office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So nothing was paid on this.
[CUSTOMER][NEUTRAL] When, uh, so the claim was processed and denied on [PII], right?
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] I can fax you a copy of the EOB if you like.
[CUSTOMER][NEUTRAL] Uh, get to the same tax number and what's the denial reason, um, this policy does not cover any medical.
[CUSTOMER][NEUTRAL] Office visits, right?
[AGENT][NEUTRAL] That's right. It doesn't cover anything within the physician's office, so, um.
[AGENT][NEGATIVE] It doesn't cover the, the.
[CUSTOMER][NEUTRAL] So even if it is done as urgent care.
[AGENT][NEUTRAL] Right, yeah, so it doesn't matter whether it's a specialist office or not.
[CUSTOMER][NEUTRAL] OK. Do you people have, um, so for the American public, you follow your own guidelines or the primary guidelines, primary insurance guidelines?
[AGENT][NEUTRAL] Uh, we, it, they have their own guide the, each policy has their own guidelines. So, um, it may be covered under their primary insurance. Yeah.
[CUSTOMER][NEUTRAL] OK, you have your own guidelines, OK.
[CUSTOMER][NEUTRAL] But not under the secondary. OK. Uh, let me just document that in one, give me a quick moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that the.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] Policy
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] Cover.
[CUSTOMER][NEUTRAL] So what type of policy is that a dental policy?
[AGENT][NEUTRAL] This is a secondary or gap insurance.
[CUSTOMER][NEUTRAL] Policy will not cover these services done in the physician's office, right.
[CUSTOMER][NEUTRAL] Am I right?
[AGENT][POSITIVE] That's right, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so, OK, you guys won't cover any services?
[CUSTOMER][NEUTRAL] OK request.
[CUSTOMER][NEUTRAL] You, you could fax me the copy of you, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And do you have any other information for this claim?
[AGENT][NEUTRAL] Uh, do I have the date of
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Of what?
[CUSTOMER][NEUTRAL] Uh, do you have any information for this one?
[AGENT][NEGATIVE] Uh, that's the only information I've got is that it's, it wasn't, uh, processed because it's, it's not covered. That's it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Actually, the system is very slow, uh, so it's taking some time to load the next patient that's why I'm waiting here.
[CUSTOMER][NEUTRAL] OK. And all right. We can move on to the next patient whenever you're ready.
[AGENT][NEUTRAL] Yes, and that policy number?
[CUSTOMER][NEUTRAL] It's 023.
[CUSTOMER][NEUTRAL] 868.
[CUSTOMER][NEUTRAL] 73
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, and the number 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It's for [PII].
[CUSTOMER][NEUTRAL] [PII] is the date of birth.
[AGENT][NEUTRAL] And thank you. And what data service were we looking for for for just yet?
[CUSTOMER][NEUTRAL] For [PII], it's for $204.04 6.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we received the claim on the [PII].
[AGENT][NEUTRAL] [PII] and we process it on the [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And your claim number is 35, sure.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, I'm really sorry, it's connected.
[CUSTOMER][NEGATIVE] Actually I messed up.
[CUSTOMER][NEUTRAL] One quick moment please.
[CUSTOMER][POSITIVE] I'm really sorry to send you my sister.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. And when was it processed?
[AGENT][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, what's the same [PII] tonight?
[AGENT][NEUTRAL] It looks like it was paid and there was $75.
[CUSTOMER][NEUTRAL] 75. OK, uh, what's the claim number?
[AGENT][NEUTRAL] The claim number is 351.
[AGENT][NEUTRAL] 1239.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 351-1239 was received on [PII] processed and.
[CUSTOMER][NEUTRAL] Paid on
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And was it paid through check?
[AGENT][NEUTRAL] Yes, it was a single paper check.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] What's check number?
[AGENT][NEUTRAL] It's 2004.
[AGENT][NEUTRAL] 929.
[CUSTOMER][NEUTRAL] 2004.
[CUSTOMER][NEUTRAL] 2004929, right?
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] 3 $75.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Can you please uh verify with the check date?
[AGENT][NEUTRAL] Uh, the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. And the pay to address is [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Uh, may I have the cash date and the check cash.
[AGENT][NEGATIVE] Uh, I don't show that it was in cash, so what we can do is we can, uh, cancel this and resend it.
[AGENT][NEUTRAL] It looks like it went to the right address. They just, they just didn't they just didn't cash it yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you're reissuing the check, right?
[AGENT][NEUTRAL] That's right, yes. That is the address that it was sent to, so it looks like it was sent to the correct address. It's just that for whatever reason, it was, it was not cast.
[CUSTOMER][NEUTRAL] OK, so how long will it take for the check to reissue?
[AGENT][NEUTRAL] Uh, usually about 6 to 10 business days.
[CUSTOMER][NEUTRAL] OK, and could you please fax me the copy of your BCD?
[AGENT][NEUTRAL] I'm, I'm sorry, I beg your pardon?
[CUSTOMER][NEUTRAL] Can you please uh fax me the copy of your.
[AGENT][POSITIVE] Yes, absolutely. I can certainly do that.
[CUSTOMER][NEUTRAL] OK, I'll be waiting for you.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, is there anything else?
[CUSTOMER][NEUTRAL] Like Fairfax for the 3 claims and.
[AGENT][NEUTRAL] Certainly.
[CUSTOMER][POSITIVE] No, that's it gonna be perfect. Thank you. You have a great day. Take care. Bye.
[AGENT][POSITIVE] OK. Thanks for contacting EP.