AccountId: 011433970860
ContactId: c75bc860-140f-4e0f-b06f-a3b0d3dd183d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 623320 ms
Total Talk Time (AGENT): 163872 ms
Total Talk Time (CUSTOMER): 143942 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/c75bc860-140f-4e0f-b06f-a3b0d3dd183d_20250530T13:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office. I'd like to check the status of a couple of claims, please.
[AGENT][NEUTRAL] Yeah, I can help you with claim status, [PII]. Can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] My direct callback number is [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, D as in David, 43302323.
[CUSTOMER][NEUTRAL] You know what, it says policy number and medical ID number. Which one should we use to file the claim?
[AGENT][NEUTRAL] Uh, that one is, since it's um.
[AGENT][NEUTRAL] This is a 90 degree.
[AGENT][NEUTRAL] Number, so I mean that is the correct policy number.
[AGENT][NEUTRAL] Um, give me just a moment to see how I can, uh, search for her because claims will go through INA for 90 degrees, so give me just a moment.
[CUSTOMER][NEUTRAL] And this patient is a male, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] What state
[CUSTOMER][NEUTRAL] What state the patient lives in?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] And what is his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's not it.
[AGENT][NEUTRAL] Give me just a moment, there's a few.
[AGENT][NEUTRAL] And I'm gonna check on.
[AGENT][NEUTRAL] Uh, I'm not able to pull him up because that is a 90 degree benefit, um, so it's through us, but that it goes through IMA.
[AGENT][NEUTRAL] Um, give me just a moment and let me find their number for you.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So it doesn't bill through you?
[AGENT][NEUTRAL] It goes through IMA first.
[AGENT][NEUTRAL] So when you're filing a claim, you'll file it through IMA.
[AGENT][NEUTRAL] Would you like me to verify the address for that? Oh, go ahead.
[CUSTOMER][NEUTRAL] OK, and the card, the.
[CUSTOMER][NEUTRAL] No, it says that's where I submitted it, IMA Inc [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And it, and, and the telephone number is the number I called that's listed on the card.
[AGENT][NEUTRAL] Right, and did you click option 2?
[CUSTOMER][NEUTRAL] Yes, I followed the directions on number I called to.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So you'll want to call IMA?
[AGENT][NEUTRAL] And it's going to be [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] It should be option one.
[CUSTOMER][NEUTRAL] I wonder why that that number is nowhere on the insurance card.
[AGENT][NEUTRAL] I don't know. Um, sometimes if they have other insurance through us, we can look them up, um, but since this, um, it's, I, I wasn't able to locate him in our system with that, um, birth date.
[AGENT][NEUTRAL] It, it only goes through them, so it's only for hospital indemnity plans.
[CUSTOMER][NEUTRAL] Let me ask you this. Do you see the insured name is [PII]?
[AGENT][NEUTRAL] OK, I can look it up that way.
[CUSTOMER][NEUTRAL] Because he's a spouse.
[AGENT][NEUTRAL] Do you have her social? That might be easier.
[CUSTOMER][NEUTRAL] No, it says [PII]. It says policy 02584680.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see if it works for her.
[AGENT][NEUTRAL] Yeah, cause there's a lot of [PII] to go through.
[AGENT][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], um, let me start again, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I am able to see them. I don't know why I wasn't able to find it through him.
[AGENT][NEUTRAL] Um, can you verify, oh wait, I think I have his date of birth. You said.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me check on that.
[AGENT][NEUTRAL] All right, I'm not showing any claims through him yet. Uh, that could just mean that IMA received it and they haven't sent it through to us yet.
[AGENT][NEUTRAL] Because I'm not seeing any claims with his name on it.
[CUSTOMER][NEUTRAL] So this is the question I have. OK, so here's the question that I had in the beginning. On the card it says her name, it says policy number you were able to locate it by the policy number I gave you. My question is, do we file the claims through the policy number or the medical ID number?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because you couldn't find him under the medical ID number that starts with the [PII].
[AGENT][NEUTRAL] You'll want to put it under that policy number.
[CUSTOMER][NEUTRAL] I'm wondering, should I resubmit to the policy?
[CUSTOMER][NEUTRAL] OK, that's what I thought.
[AGENT][NEUTRAL] Yeah, so the, the 258-4680.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there a group number?
[AGENT][NEUTRAL] The group number is 70052.
[CUSTOMER][NEUTRAL] And what was your name, please?
[AGENT][NEUTRAL] [PII], last initial [PII]
[CUSTOMER][NEUTRAL] You give call reference numbers?
[AGENT][NEUTRAL] We don't do call reference numbers, but you can use my name and last initial and today's date.
[CUSTOMER][POSITIVE] Thank you so much. I'll resubmit both claims. Have a wonderful day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] Bye.