AccountId: 011433970860
ContactId: b306e294-1527-44f0-8665-f2a70631a93f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333579 ms
Total Talk Time (AGENT): 202111 ms
Total Talk Time (CUSTOMER): 85708 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/b306e294-1527-44f0-8665-f2a70631a93f_20250401T17:02_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for contacting ATO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on the claims.
[AGENT][NEUTRAL] OK, I can help with the claim status. What's that policy number, please?
[CUSTOMER][NEUTRAL] It is 025765666.
[AGENT][NEUTRAL] 02576.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] OK. Do you mind repeating the policy number for me again? I apologize. My phone is kind of cutting in and out. You said 025.
[CUSTOMER][NEUTRAL] Yes, it's OK. Not an issue, not an issue. It is 02576566.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] It is [PII], is the initial child. Date of birth is [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] Thank you. What is the date of service for this individual?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And the bill amount.
[CUSTOMER][NEUTRAL] $953 even.
[AGENT][NEUTRAL] Thank you. Your claim number is 356.
[AGENT][NEUTRAL] 00173560017. Now, this uh claim we received it.
[AGENT][NEUTRAL] On um
[CUSTOMER][NEUTRAL] Sorry, your voice is not clear. Could you please repeat once? 356?
[AGENT][NEUTRAL] Oh, I apologize.
[AGENT][NEUTRAL] Yes, it's uh the, the claim number is 356.
[AGENT][NEUTRAL] 0017 and we received your claim on the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And process it on [PII].
[AGENT][NEUTRAL] But his policy, um,
[AGENT][NEUTRAL] Uh, doesn't look like it was active. Let me just check here because what they do is they, they have to be um active for each week that, uh, um, for each service, and we're showing that the policy wasn't active when this was on that data service.
[AGENT][NEUTRAL] So um let me just check here. This, it looks like the um EOB and I can fax you a copy of it. I was denied because the policy was not active on that data service.
[CUSTOMER][NEUTRAL] OK. Policy is turned on the data service.
[AGENT][NEUTRAL] Uh, that's correct, yeah. Yes, it was not, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, for it was not active for that, for that date.
[CUSTOMER][NEUTRAL] OK. What is the term date of the patient of this policy?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] I'm sorry, I don't have that information. I just, I just showed that, that it's not active anymore. It's just showing that it's not active. And I don't know whether it's just because of the group or but uh whatever, whatever reason, it's not, it's not showing it being active. And this is um this is group insurance, so it could be that the entire group uh just not active anymore.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] OK. It is not active for the data service. I got that information, but, but I want to what, uh, when it was termed, on which date it was termed, I want that information.
[AGENT][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Uh, I'm not seeing that. That's just it. It's showing, the only thing that it's showing.
[AGENT][NEUTRAL] It looks like we received a request.
[AGENT][NEUTRAL] Back in March to date to autolapse it uh back to um
[AGENT][NEUTRAL] I'm not, it doesn't really show it just shows that we received something from the group to to lapse it, uh, to lapse this it it's called a lapse report, um, and that's the only thing that doesn't show a date that it lapsed, so I'm not, uh.
[AGENT][NEUTRAL] I don't see when it lapsed. I'm just showing that it, it is lapsed, so I don't know the date that it lapsed.
[AGENT][NEUTRAL] So it could be [PII] because that's because your date of service, your date of service is in January, so um I'm guessing it might have been [PII] that it lapsed but I don't, I don't actually see the date that it lapsed. That's not available to me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, you are saying that [PII], uh, it was, uh, term you are trying it, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's the only thing, yes, that's the only thing I can guess is because they're, they're showing it, uh, the, the system is showing the policy is being lapsed and if your policy, if your data services in January, that's the only thing that I can see that it, it would, would have lapsed on that date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, got it. Uh, do you have any other insurance information other than this?
[AGENT][NEUTRAL] No, I'm sorry, this is the only information that we have for this individual.
[CUSTOMER][NEUTRAL] OK. Could you please spell out your name?
[AGENT][NEUTRAL] It's [PII], and we'll use that today's date as a reference.
[CUSTOMER][NEUTRAL] OK, got it. Could you please fax me the UV of this place?
[AGENT][POSITIVE] Yes, I'll be glad to. What is your um fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] [PII]. OK, I'll be glad to do that.
[CUSTOMER][NEUTRAL] Yeah, attention to me.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] OK, I will do that. Is there anything else I can help with?
[CUSTOMER][POSITIVE] Yeah, I got all the information. Thank you for assisting. Have a great day. Bye-bye.
[AGENT][POSITIVE] OK, thanks for contacting AP have a good.