AccountId: 011433970860
ContactId: b513b4e5-d778-438f-8c21-b188e9105bf2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 337549 ms
Total Talk Time (AGENT): 138143 ms
Total Talk Time (CUSTOMER): 137680 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/b513b4e5-d778-438f-8c21-b188e9105bf2_20250516T14:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm [PII] from provider's office calling regarding claim status for a facility. Is it the correct department?
[AGENT][POSITIVE] Yes, I can check that for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, 1640661.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is 4.
[CUSTOMER][NEUTRAL] [PII] for $3,447.
[CUSTOMER][NEUTRAL] And uh you, you said your name is [PII], right?
[AGENT][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] Thank you. And so I have the information that your insurance received this claim in October last year, on [PII] and paid on [PII]. Uh, please correct me if I'm not wrong. I want to check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Yes, and I have a claim number. I wanted to ask if the information I have is correct or not.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes. What, what do I need to provide you to verify that?
[AGENT][NEUTRAL] Um, is that claim number, is that 351-7714?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I got that pulled up um what questions did you have for me?
[CUSTOMER][NEUTRAL] So we haven't received uh this claim EOB I mean the remittance, and I want to know the status of this claim, uh, how much was paid, how is it paid, and is the payment cash because we have not received this payment yet. So I want to check for the payment.
[AGENT][NEUTRAL] Sure, yeah, I can check all of that for you. So I will say that this uh claim did pay a benefit of $1,441 and if you'll give me one I can send you the EOB as well, but, um, let me check on that check information first. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I am showing this check was issued um [PII] and I am showing this check did clear on [PII], [PII].
[CUSTOMER][NEUTRAL] How it was paid?
[AGENT][NEUTRAL] It was a a check, a single check.
[CUSTOMER][NEUTRAL] For, uh, what is the check number?
[AGENT][NEUTRAL] That is 20.
[AGENT][NEUTRAL] 08124.
[CUSTOMER][NEUTRAL] 2008124. And um
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It paid you said $1,441 even. Is there any patient responsibility applied as well?
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] OK. Your insurance only paid this amount apart from this, there is no other uh
[CUSTOMER][NEUTRAL] Amount on that claim, right?
[AGENT][NEUTRAL] Correct. Well, we don't, yeah, again, we paid $1,441 that was the maximum amount payable for this policy, and again we don't say what is patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And could you confirm the pay to address for the provider that you have?
[AGENT][NEUTRAL] Of course, uh, that is [PII].
[CUSTOMER][NEUTRAL] Thank you so much. So I need the EOB, um, can you send it directly to my email because I don't know how long the fax might take. So on email, is that possible or only fax?
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEGATIVE] Unfortunately, no, I would have to do a fax, Sam.
[CUSTOMER][NEUTRAL] It's OK. I'll give you the fax number instead then whenever you're ready.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm ready when you are.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes, attention to my name, [PII].
[AGENT][NEUTRAL] [PII] OK alright I will go ahead and send that now um you should get it within about 10 minutes or so. Uh, was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] Mm, no, that is all. Thank you so much for your help. And what is the call reference number?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] That would be my first name, last initial and today's date, and so my last initial is A.
[CUSTOMER][POSITIVE] Hey, thank you so much for your help. Have a good day.
[AGENT][POSITIVE] Absolutely. Have a great rest of your day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.