AccountId: 011433970860
ContactId: a842cafb-652c-432e-aba1-41297d269c31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 653909 ms
Total Talk Time (AGENT): 107542 ms
Total Talk Time (CUSTOMER): 167420 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/a842cafb-652c-432e-aba1-41297d269c31_20250604T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling you from provider's office checking on the claims.
[AGENT][NEUTRAL] OK, I could check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. We spell it out as A [PII]. And could you please fill up with your name as well?
[AGENT][NEUTRAL] Uh, it's [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then uh can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. That is [PII]. It's a direct line.
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][POSITIVE] Thank you, I have the policy number. Uh yes.
[CUSTOMER][NEUTRAL] Just a moment. The policy number is 0222366 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK, um, I'm sorry, could you repeat that policy number, please? I don't think I heard it correctly.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That is 02223665 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] OK, thank you and then uh what was the name and date of birth for the member?
[CUSTOMER][POSITIVE] OK thank
[CUSTOMER][NEUTRAL] That is [PII] and the date of birth [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. uh, what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that was [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and then, uh, what was that bill amount please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] $2,202.05.
[AGENT][NEUTRAL] All right, thank you. One moment, please.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, could you give me the, uh, tax ID for this provider, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure. That is uh [PII].
[AGENT][POSITIVE] All right, I appreciate that.
[AGENT][NEUTRAL] OK, so we did receive this claim, uh, looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, can you please send me the receipD?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The claim received date and all that information.
[AGENT][NEUTRAL] Oh sure, yeah, so this claim was received [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Sorry, it is [PII].
[AGENT][NEUTRAL] Yes, that was when it was processed.
[CUSTOMER][NEUTRAL] Is it paid?
[AGENT][NEUTRAL] No, as we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] Call primary.
[CUSTOMER][NEUTRAL] Process and it is pending for a copy of Prime AB.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can you please hold the call for a moment?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. Uh, OK, [PII]. Can you please check if you can, uh, see any, um, I mean,
[CUSTOMER][NEUTRAL] Just a moment. Any primary insurance for this patient? Do you need any for that?
[AGENT][NEUTRAL] Yes, we need their primary EOB as this is their secondary medical policy. I don't have a way of seeing who they have or had as their primary EOB or as their primary.
[CUSTOMER][NEUTRAL] the.
[CUSTOMER][NEUTRAL] I have or have to ask their primary or other primary.
[CUSTOMER][NEUTRAL] OK, just allow me a moment.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And could you please check if you can see any uh primary insurance name from your end?
[AGENT][NEUTRAL] I do not. I don't have that information as this is their secondary medical.
[CUSTOMER][NEUTRAL] In their second
[CUSTOMER][NEUTRAL] OK, sir, uh this uh insurance is secondary?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] OK. So can you
[CUSTOMER][NEUTRAL] Mm, OK. So, can you please tell me, uh, when was the last call updated for the patient?
[AGENT][NEUTRAL] What was that? I'm sorry?
[CUSTOMER][NEUTRAL] Uh, COB coordination of benefits when the cop is updated for the patient.
[AGENT][NEUTRAL] There is no
[AGENT][NEGATIVE] There is no coordination of benefits.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] No, COB was updated, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And uh you don't see any primary insurance name uh uh from your end as well.
[AGENT][NEUTRAL] I do not.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can I get reference number?
[AGENT][NEUTRAL] Reference number would be my first name, last initial [PII]'s date and so my last initial is A.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Specialist
[AGENT][NEUTRAL] Was there anything else I can help you with?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK, thanks for calling APL have a great rest of your day.
[CUSTOMER][POSITIVE] OK, thanks for calling
[CUSTOMER][NEUTRAL] And also could you please tell me the uh claim number if you have for this.
[AGENT][NEUTRAL] Yes, that is 354-729-5.
[CUSTOMER][NEUTRAL] Yes, it's 3
[CUSTOMER][NEUTRAL] 4
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you have a great rest of your day.