AccountId: 011433970860
ContactId: c2b35539-a2b7-493a-81d7-9e87a411bf7f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260380 ms
Total Talk Time (AGENT): 87210 ms
Total Talk Time (CUSTOMER): 153689 ms
Interruptions: 5
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/c2b35539-a2b7-493a-81d7-9e87a411bf7f_20250409T19:10_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from the office. I just want to discuss upon a claim denial. Could you please help me?
[AGENT][NEUTRAL] I can help, I can help with the claims, and what's that policy number, please?
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] Sorry, what do you want? The callback number?
[AGENT][NEUTRAL] I can help with it. I, yes, I can help with the claim. What is the um policy number, please?
[CUSTOMER][NEUTRAL] OK, the policy number is D as in Delta 46802083.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, let's see if we can't find it by their name, um.
[AGENT][NEUTRAL] How do you spell the last name, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, that is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Thank you. And the first name?
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] I'm, I'm sorry, you said what was the first name again, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII], thank you. And [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. And is this for a dental or a medical claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Male.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I also have a claim number if you want I can provide you that as well.
[AGENT][NEUTRAL] Yes, and what is that claim number, please?
[CUSTOMER][NEUTRAL] The claim number is 3561416.
[AGENT][NEUTRAL] Thank you. Just let me check and see what we have here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this is for a data service of [PII], is that correct?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][POSITIVE] Yes, that is correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ma.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So this is a a limited benefit.
[CUSTOMER][NEUTRAL] So my question on this claim, yes.
[AGENT][NEUTRAL] Yes, and, and what, what is your question?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As like this claim is denied for non-covered charges, so I just want to know that like the charges are not covered under the provider specialty or the under the patient plan.
[AGENT][NEUTRAL] Yes, the, under the patient's plan.
[AGENT][NEUTRAL] The only covered tests are an MRI, a CAT scan, or a, um,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, thyroid uptake test, uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] CT scans, uh, PET scan.
[CUSTOMER][NEUTRAL] OK, so these, so we have.
[AGENT][NEUTRAL] Yeah. Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So these services are not under the member plan. So can we build this claim to the member as you, OK, how do you spell out your good name?
[AGENT][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] My name is [PII]. The first letter of my last name is [PII], and we'll use that in today's date as a reference. The only thing I can tell you, um, uh, [PII], is that we can't, we, we can't pay it. So whether you bill the patient or not is, is entirely up to you guys.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, thank you for this wonderful option that is all for today. Have a great day bye.
[AGENT][POSITIVE] OK, thanks for contacting UTL have a very good day.
[CUSTOMER][NEUTRAL] OK.