AccountId: 011433970860
ContactId: c93b033f-2f93-485b-9191-f16ac21a44a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295600 ms
Total Talk Time (AGENT): 142266 ms
Total Talk Time (CUSTOMER): 69612 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/c93b033f-2f93-485b-9191-f16ac21a44a2_20250509T16:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Court
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling from Memorial Healthcare, and I'm calling about a claim.
[CUSTOMER][NEGATIVE] That I've submitted we haven't received anything on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, I can check on that claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes I do. It is 02230098.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, do you have that billed out?
[CUSTOMER][NEUTRAL] Um, the total charge was.
[CUSTOMER][NEUTRAL] 46,850 and we are billing you guys a copay and deductible of 17,330.
[AGENT][POSITIVE] Got it. OK, thank you for that one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], do you have uh y'all's tax ID?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, I do believe I've found it.
[AGENT][NEUTRAL] Looks like there were 3 procedure codes. Does that sound right to you?
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][NEUTRAL] OK, alrighty, yep, so we did pay a benefit, we paid a benefit of $138.30. Let's take a look here.
[AGENT][NEGATIVE] The only thing we were unable to pay uh was um procedure code 99213 as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] OK, and when did you guys pay this?
[AGENT][NEUTRAL] Sure, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so this check was received [PII] and it was processed [PII]. If you'll give me one moment, I'll take a look at when that uh check was issued.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I've got that claim number if you need it as well, [PII].
[CUSTOMER][NEUTRAL] Yep, go ahead.
[AGENT][NEUTRAL] OK, that is 3549496.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then I do have that check number as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is 2021962.
[CUSTOMER][NEUTRAL] And can you tell me where it was paid to?
[AGENT][NEUTRAL] Of course I am showing that the check was issued [PII], uh, and has not cleared, so I can go ahead and get this voided and reissued. The address we have is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, alright, so I will go ahead and get this voided and reissued. uh, did you need a copy of this EOB or anything, [PII]?
[CUSTOMER][NEUTRAL] Um, yes, we do.
[AGENT][NEUTRAL] OK, do you have a fax number?
[CUSTOMER][NEUTRAL] Yep it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, I will go ahead and get that sent to you now. I should get it within about 10 minutes or so. Uh, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, was there a reference number for this call?
[AGENT][NEUTRAL] Oh sure, that would just be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] And then today's great. OK, thank you so much, [PII].
[AGENT][POSITIVE] Yes ma'am, you're welcome. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Bye-bye.