AccountId: 011433970860
ContactId: ad1984cf-7ed3-408b-8b3d-e8160ea0b652
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 671900 ms
Total Talk Time (AGENT): 182309 ms
Total Talk Time (CUSTOMER): 176195 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/ad1984cf-7ed3-408b-8b3d-e8160ea0b652_20250618T18:23_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi, sorry, may you help me with the plan status?
[AGENT][POSITIVE] Yes, ma'am, I can assist you with claim status. First, could I get your name and a good call back number?
[CUSTOMER][NEUTRAL] Sure. My name is [PII] and my callback number is [PII]. And my extension number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] OK, perfect. The policy number is 02382389023.
[AGENT][NEUTRAL] Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII], and her date of birth is on [PII].
[AGENT][NEUTRAL] Thank you. And what's the date of service and bill charges on the claim?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Date of service was sent.
[CUSTOMER][NEUTRAL] [PII], and the bill amount was for 489.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Mm. No problem.
[AGENT][NEUTRAL] OK, yes, ma'am. We received that claim on [PII].
[AGENT][NEUTRAL] That's when we received it and the claim processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the claim number is 3589902.
[AGENT][NEGATIVE] And this claim denied um the first line denied because it was for an office visit, and office visits are not covered under the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Perfect. I got it. Thank you so much. Sorry, uh, may you send me the UB with this information? We did now with you, uh,
[CUSTOMER][NEUTRAL] Did you uh
[CUSTOMER][NEUTRAL] The policy?
[AGENT][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] Basically.
[AGENT][NEUTRAL] Yes, it was mailed to the provider's office, but I can fax it to you.
[CUSTOMER][POSITIVE] Yes, please. I will really appreciate it if you fax me. DOB.
[AGENT][NEUTRAL] What's the, what's your fax number?
[CUSTOMER][NEUTRAL] The fax number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. [PII] and what were the last four digits?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so that's attention, [PII], [PII].
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][NEUTRAL] OK. You should receive it in about 10 minutes. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yes. May I consult you for another claim?
[CUSTOMER][NEUTRAL] For different patients?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, one moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thanks for your patience, [PII]. I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] OK, the next policy number is 022729.
[CUSTOMER][NEUTRAL] 12.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] And her date of birth is on [PII].
[AGENT][NEUTRAL] OK, thank you. Now I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] Sure. The date of service was on [PII] and the total charges was for 224.
[AGENT][NEUTRAL] OK. Yes, ma'am. We received this claim on [PII].
[AGENT][NEUTRAL] And it processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the claim, the claim number is 3504818.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim denied because um well, just let me advise you that verification of coverage does not guarantee payment of claims. Um this claim denied because the effective date on this policy was [PII], and this policy expired on [PII].
[CUSTOMER][NEUTRAL] OK, I understand.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK. And do you need a copy of this EOB also?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh yes, please. That will really helpful.
[AGENT][NEUTRAL] OK. And again, the fax number is [PII].
[CUSTOMER][POSITIVE] Yes, the same one. Thank you.
[AGENT][POSITIVE] OK. Yes. And you should receive it in about 10 minutes. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yes, I got it another claim for a different patient.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, I'm ready for the next policy number.
[CUSTOMER][NEUTRAL] OK, the next policy number is 02389023.
[AGENT][NEUTRAL] Thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Her name is [PII], and her date of birth is on [PII].
[AGENT][NEUTRAL] The date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] The date of service was on [PII], and the bill amount was for 224.
[AGENT][NEUTRAL] OK, we received this claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3589902 and it denied office visits are not covered um under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect. I got it. Thank you so much. So I think that that's gonna be for this call. May you give me a reference number, please?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is [PII]. Um it's spelled [PII] Last initial is [PII], and today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect, [PII]. Thank you so much for your help today.
[AGENT][POSITIVE] OK. And since there isn't anything else, [PII], I thank you for calling APL. You have a great day. Mm bye.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.