AccountId: 011433970860
ContactId: bc1f28b6-1237-4621-b138-20bfc2863b08
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 468859 ms
Total Talk Time (AGENT): 139649 ms
Total Talk Time (CUSTOMER): 199220 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/bc1f28b6-1237-4621-b138-20bfc2863b08_20250505T15:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yes, hi, good morning. I'm calling from the provider's office. I would like to check to see if you guys have a claim for one of our patients, please.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, first, could I get your name and a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Of course it's [PII] The nature for my last name is [PII].
[CUSTOMER][NEUTRAL] The phone number here is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] The policy number that I have is 14793.
[AGENT][NEUTRAL] OK. No one's coming up under that number. Um, do you have the social, the social security number?
[CUSTOMER][NEUTRAL] No, I have the name and the date of birth.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me see if I have a copy of the card just in case because.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, you never know, if they have multiple copies.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Obviously the card that I have here the 147 is the group number. Let me see.
[CUSTOMER][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Do you see where it says um outpatient certificate number?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No, that car only have.
[CUSTOMER][NEUTRAL] The name of the patient and the group number.
[AGENT][NEUTRAL] OK. I can look them up by that name.
[CUSTOMER][NEUTRAL] Let me see the.
[CUSTOMER][NEUTRAL] You, you can look it up by the name on the day of birth.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, what's the last name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And the first name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, I see.
[CUSTOMER][NEUTRAL] And his driving license, he has a second name.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Yeah, so far, no one's coming up.
[CUSTOMER][NEUTRAL] I found the cer I have the er what are you looking the um certified number?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yes, certificate number.
[CUSTOMER][NEUTRAL] That is the number that you, yes, I found it here. OK, it's 024.
[CUSTOMER][NEUTRAL] 24
[CUSTOMER][NEUTRAL] 707 M like Mary, L like Larry, number 7.
[CUSTOMER][NEUTRAL] And the number 8 for says outpatient benefits certificate. The difference is only.
[AGENT][NEUTRAL] OK, and verify his date of birth one more time. I think I found him.
[CUSTOMER][NEUTRAL] Of course, [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. That's his policy number and we just need the um numeric portion, the part after the letter M. We don't need that portion.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And what's the date of service and bill charges on the claim?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] The original amount bill was.
[CUSTOMER][NEUTRAL] $7290.38.
[AGENT][NEUTRAL] OK, you said that was for [PII]?
[CUSTOMER][POSITIVE] That is correct, yes.
[AGENT][NEUTRAL] OK. I'm not showing that claim on file. Um, do you know how it was submitted?
[CUSTOMER][NEUTRAL] No, I imagine that you don't have it if we have the policy number incorrect, you probably don't have it. My question is, how can I submit that claim? Should I send it by mail?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Should I put the copy of the original EOB send it to the primary insurance? I need that information, please, if you don't mind.
[AGENT][NEUTRAL] I'm sure when you file the claim with us, um, is this, are you filing a claim from a doctor's office or from a facility, from a hospital?
[CUSTOMER][NEUTRAL] For a for a facility it's diagnostic center.
[AGENT][NEUTRAL] OK. Yes, ma'am. Well, you would need to uh file a claim on the 1500 along with the EOB from the primary insurance company and you can fax us the information. You can send it through mail or you can send it through the pair ID.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, perfect. Can I have the fax number just in case?
[AGENT][NEUTRAL] Yes, ma'am. The fax number is 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 377.
[CUSTOMER][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942-3 um by mail just in case I would like to have all that information sorry to that I ask you too many questions.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, no, ma'am. I can help you. Um, the mailing address is [PII].
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And you said that the one that I have to use on this case is that ending in in ML 8, right?
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][POSITIVE] Thank you so much. Can I have a reference number for this call?
[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] My last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's all. Thank you so much. I really appreciate your help, [PII].
[AGENT][POSITIVE] Oh, no, no problem, [PII]. I thank you for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] that