AccountId: 011433970860
ContactId: c787ce4c-05c9-4f3a-8d62-9967b7a87dd2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 512320 ms
Total Talk Time (AGENT): 141562 ms
Total Talk Time (CUSTOMER): 143444 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/c787ce4c-05c9-4f3a-8d62-9967b7a87dd2_20250324T22:21_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 provider for account claim status.
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 021.
[CUSTOMER][NEUTRAL] 128
[CUSTOMER][NEUTRAL] 31
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you for that, sir. And then do you have a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. There is no extension. It's a plan.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for that and then what's the date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is
[CUSTOMER][NEUTRAL] $2,815.71.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] So it looks like we did receive a claim for the state of service claim was received [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim was denied on [PII].
[AGENT][NEUTRAL] Benefits are only payable if major medical provides benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So if the claim has been paid by their major medical, then we need the explanation of benefits showing that it was paid.
[CUSTOMER][NEUTRAL] Sure. Uh, don't you receive any primary will be from our end?
[AGENT][NEUTRAL] We have not, no.
[CUSTOMER][NEUTRAL] OK. Can I have the claim number?
[AGENT][NEUTRAL] Claim number is 350-1202.
[CUSTOMER][NEUTRAL] OK. How can we send the primary?
[AGENT][NEUTRAL] It can be sent electronically via fax or mail.
[CUSTOMER][NEUTRAL] Can I have the fax number?
[AGENT][NEUTRAL] 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. Can I have the mailing address also?
[AGENT][NEUTRAL] Mailing address would be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, what is the time frame I just send it?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] What is the time frame in order to submit the primary?
[AGENT][NEGATIVE] Uh, no timely filing limit.
[CUSTOMER][NEUTRAL] OK. Could you please assist with a few more numbers?
[AGENT][NEUTRAL] Uh, yes, let me notate this account and then we can move on to the next one moment.
[CUSTOMER][NEUTRAL] Sure. Let me look whether I do have uh the numbers with me or not.
[CUSTOMER][NEUTRAL] Yes, upon checking, I do, I do have one more number with me.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][POSITIVE] Sure, sure. Take care.
[AGENT][NEUTRAL] What's the member's policy number?
[CUSTOMER][NEUTRAL] 018
[CUSTOMER][NEUTRAL] 230
[CUSTOMER][NEUTRAL] 05 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you for that data service.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII], did you say [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the build amount?
[CUSTOMER][NEUTRAL] The bill amount is $27,550 even.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, I'm not showing any claims on file for [PII].
[CUSTOMER][NEUTRAL] OK. So is the mailing address is the same as uh which you have uh stated just now?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Which is [PII].
[CUSTOMER][NEUTRAL] OK. Do you have any pay by any chance?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Thank you. And can I have the policy effective date and the termination date of the policy of the policyholder?
[AGENT][NEUTRAL] Effective date [PII].
[AGENT][NEUTRAL] This policy did terminate [PII], so the member was not active at the time of service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you able to see any other active insurances for the number?
[AGENT][NEUTRAL] I do not see any other.
[CUSTOMER][NEUTRAL] Except the primary?
[AGENT][NEUTRAL] I don't see anything else at this time.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else?
[CUSTOMER][POSITIVE] Thank you so much for assisting me. Have a great day.
[AGENT][POSITIVE] You're welcome. Have a great day.
[CUSTOMER][NEUTRAL] Nothing else. Can I get the call?
[AGENT][NEUTRAL] Call references my name with my last initials in today's date. My name again is [PII], that's [PII] Last initial is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a good day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.