AccountId: 011433970860
ContactId: b69eccda-6226-4ccc-bc8e-e3bbf02ee0ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541960 ms
Total Talk Time (AGENT): 134844 ms
Total Talk Time (CUSTOMER): 121416 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b69eccda-6226-4ccc-bc8e-e3bbf02ee0ee_20250204T18:07_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] calling from [PII]. I'm sorry, what was your name?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Oh, OK, thank you. I'm calling to check the status of a medical claim please.
[AGENT][NEUTRAL] Yeah, sure, I can assist you with claim status. May I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, 993-835-940.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this a social?
[CUSTOMER][NEUTRAL] Um, no.
[AGENT][NEUTRAL] Yeah. Yeah, it's too long to be one of our policy numbers. Uh, do you have the copy of the card?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It's 993-835-940. I do have a social. Can you look it up by social?
[AGENT][NEUTRAL] OK, now
[AGENT][NEUTRAL] I can bear with me just a second, let me pull up the system so.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What's the name?
[CUSTOMER][NEUTRAL] [PII] last um date of birth is [PII].
[AGENT][NEUTRAL] OK, perfect, yes, thank you and may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, the data services for [PII] for $249.02.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] Uh, let's see here.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Procedure code 99214990715.
[CUSTOMER][NEUTRAL] 90471 and then 3078 F as in Frank and then 3074 F as in Frank.
[AGENT][POSITIVE] All right, thank you. OK. All right. Here it is.
[AGENT][NEUTRAL] Yeah, I'm waiting on the EOB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII], and um we send a benefit amount of $75. Um, the $75 is for the um office visit, and that is the maximum benefit for that date of service.
[CUSTOMER][NEUTRAL] OK, um, wait a minute, I got something. Let me think that's it for that data service.
[CUSTOMER][NEUTRAL] Yeah, I have an EOB right here but it's not.
[CUSTOMER][NEUTRAL] Wait a minute, it's not that date of service though.
[CUSTOMER][NEUTRAL] Um, check number and EOB is for 95. I have a um EOB for [PII], and [PII]. I don't have an EOB for um.
[CUSTOMER][NEUTRAL] For the other one for that this day the service.
[AGENT][NEUTRAL] The 95, you need a copy to be sent to you by fax?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, what's the fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I don't, I mean if they send a payment we haven't received it yet.
[AGENT][NEUTRAL] Um, yeah, we did send this check out on the [PII]. It may be on the way because this is too um early, the [PII], let me see exactly when it left the building.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Monday, so went out, no, that wasn't a Monday. That was a Friday, so it went out on the [PII] in the mail. It's [PII]. It's been 6 days, more than likely you will get it next either this the end of this week or the beginning of next week, um, but I can send you a copy. Do you mind holding for me while I send this copy out to you? Let me know, OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Miss. [PII]. Can I send that over to you. Should be there in a few minutes. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes, can you give me the, um, the claim number?
[AGENT][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] OK, so the claim number is 3555692.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mrs. [PII]?
[CUSTOMER][POSITIVE] That'd be all. I appreciate it.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day. Good afternoon.
[CUSTOMER][POSITIVE] Yes ma'am alright thanks bye bye.
[AGENT][POSITIVE] You're welcome.