AccountId: 011433970860
ContactId: b5a479d5-ba53-4743-aa66-7c767a9881b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497809 ms
Total Talk Time (AGENT): 168763 ms
Total Talk Time (CUSTOMER): 180155 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/b5a479d5-ba53-4743-aa66-7c767a9881b2_20250527T18:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, ma'am. My name is [PII]. I'm calling from the provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it would be [PII]. Extension would be [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. It would be 101622818. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yes, ma'am. The first name is [PII], last name is
[CUSTOMER][NEUTRAL] [PII] and the date of birth would be on [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. What was the date of service for this claim, [PII]?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. The date of service would be on [PII] and the bill amount would be $237 even.
[AGENT][NEUTRAL] OK, that was [PII] for $237.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Was this from uh Gastro Health?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] I understand, ma'am. Could you just provide me the claim number, the received date, and the denied date for this one?
[AGENT][NEUTRAL] Of course that claim number is 3592.
[AGENT][NEUTRAL] 740.
[CUSTOMER][POSITIVE] Thank you for that, ma'am.
[AGENT][NEUTRAL] Mhm this claim was received [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[CUSTOMER][POSITIVE] OK, thank you, ma'am. And I do have this 2 more cleans with me, ma'am, if you can assist me with them.
[AGENT][NEUTRAL] Are they for the same member?
[CUSTOMER][NEUTRAL] Uh, let me verify that, ma'am. Oh no, ma'am, this would be for different members.
[AGENT][NEUTRAL] OK, if you'll give me one moment, um, I'll let you know when I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] Sure, ma'am.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, I appreciate your patience, [PII]. You can go ahead and give me that next policy number.
[CUSTOMER][NEUTRAL] Yes, ma'am. It would be 026-03938 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for this number, please?
[CUSTOMER][NEUTRAL] Yes, ma'am. First name is [PII], last name is [PII], and the date of birth would be on [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that and then uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yes, ma'am. It would be on [PII] with the total bill amount of $2,862 even.
[AGENT][NEUTRAL] OK, one moment, was this for the same, uh, provider [PII] or was this a different provider?
[CUSTOMER][NEUTRAL] It's for the same provider, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] OK, I am not showing that we received this claim, [PII].
[CUSTOMER][NEUTRAL] I understand, ma'am. Could you just provide me the mailing address and payer ID to resubmit this claim, ma'am?
[AGENT][NEUTRAL] Of course that uh mailing address is [PII].
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And that is in [PII] City, [PII].
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] 8950.
[CUSTOMER][POSITIVE] Yes, thank you, ma'am.
[AGENT][NEUTRAL] Of course, and then that payer ID is 0801.
[CUSTOMER][NEUTRAL] 0801. Is it just four digits, ma'am?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Thank you for that, ma'am. And could you provide me with this patient's effective dates, ma'am?
[AGENT][NEUTRAL] Of course
[AGENT][POSITIVE] Yes, this policy is effective day, one moment.
[AGENT][NEUTRAL] That was [PII] and it is currently active.
[CUSTOMER][NEUTRAL] [PII]. Thank you, ma'am. That will be it, ma'am and
[CUSTOMER][NEUTRAL] Yes, shall I go ahead and provide you with the next member's ID, ma'am?
[AGENT][NEUTRAL] Uh, one moment please.
[CUSTOMER][NEUTRAL] Sure, ma'am.
[AGENT][NEUTRAL] OK, uh, yes, you can go ahead and give that to me.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. It would be 02465331. M as in [PII] in Lima, [PII] 8.
[AGENT][NEUTRAL] OK and then uh what was the name and date of birth for this number please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, my first name is [PII]. Last name is [PII]. Date of birth would be on [PII].
[AGENT][NEUTRAL] OK and then uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Yes, ma'am. It would be on [PII] with the total charges of $358 even.
[AGENT][NEUTRAL] 258. OK, thank you one moment.
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII], we were unable to pay a benefit as this policy provides no benefits for the treatment of conditions other than a sickness or an injury.
[CUSTOMER][NEUTRAL] Yeah, no college.
[CUSTOMER][NEUTRAL] I understand, ma'am. Thank you for that information. Could you provide me with the information for the claim number, received date, and the denied date, ma'am?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course that claim number is 359-093-5.
[AGENT][NEUTRAL] And then this claim was received [PII].
[AGENT][NEUTRAL] And it was processed [PII].
[CUSTOMER][POSITIVE] Thank you, ma'am. And yes, ma'am, that would be it for today. Thanks for your assistance, ma'am, and I really hope you have a great day ahead.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Sure, you're very welcome.
[AGENT][POSITIVE] You too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye, ma'am.