AccountId: 011433970860
ContactId: c54a1cf6-88af-4a6e-b5a3-5d50c4210741
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 274000 ms
Total Talk Time (AGENT): 109848 ms
Total Talk Time (CUSTOMER): 62053 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/c54a1cf6-88af-4a6e-b5a3-5d50c4210741_20250124T16:19_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi good morning I was calling in regards to claim status.
[AGENT][NEUTRAL] Uh, sure. I can assist you with claim status. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] [PII], excuse me, [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Miss. No?
[CUSTOMER][NEUTRAL] Yes, uh, policy number is 01848513.
[AGENT][NEUTRAL] Thank you. One moment, let me pull this information.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, Miss. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, uh, this is for.
[CUSTOMER][NEUTRAL] [PII], uh, total charge is.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] $304.80.
[AGENT][NEUTRAL] OK, that was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, OK.
[AGENT][NEUTRAL] And I need to let you know that for the future, you can check claim status online through our website at [PII] and that's just optional.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Alright, let me pull this ER one moment.
[AGENT][NEUTRAL] All right. OK, here it is. OK, it looks like we processed the claim on [PII] and um part of it was denied and part of it is needing the explanation of benefits from the primary insurance. So the office visits are not covered under this policy, so that part was denied. And the office treatments are considered, um, but we need the explanation of benefits from the primary insurance to continue the processing of this claim.
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][NEUTRAL] Can you provide me with the claim number please?
[AGENT][NEUTRAL] Yes, the claim number is 352-568-0.
[CUSTOMER][NEUTRAL] OK, and also, um, can we fax this over or does it have to be mailed in?
[AGENT][NEUTRAL] You can fax it or you can mail it. Um, the fax number is [PII].
[CUSTOMER][NEUTRAL] OK, I'm just gonna repeat that to confirm it is [PII]?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, we'll fax this over and do you provide reference reference numbers?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you would like, Miss [PII], do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, can I get your name one more time please?
[AGENT][NEUTRAL] Sure. That's [PII], last initial [PII].
[CUSTOMER][POSITIVE] Got it. OK, thank you so much for your help today.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.