AccountId: 011433970860
ContactId: ca4dd895-072b-483f-af04-18655c4a52c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246889 ms
Total Talk Time (AGENT): 100061 ms
Total Talk Time (CUSTOMER): 69236 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/ca4dd895-072b-483f-af04-18655c4a52c1_20250121T15:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I'm calling to check on a medical claim that we sent.
[AGENT][NEUTRAL] OK, I can help you. What's your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the patient's policy number?
[CUSTOMER][NEUTRAL] I have here.
[CUSTOMER][NEUTRAL] That's gonna be.
[CUSTOMER][NEUTRAL] That's gonna be 02352722 ML 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you said you're checking claim status, [PII]?
[CUSTOMER][NEUTRAL] Yes, it was for um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, this was [PII].
[CUSTOMER][NEUTRAL] The charges were 1,257 even.
[AGENT][NEUTRAL] OK, is this a facility charge or professional?
[CUSTOMER][POSITIVE] Professional.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I do not show that claim received.
[CUSTOMER][NEUTRAL] Mm, we mail it out.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] On [PII], is that too early?
[CUSTOMER][NEUTRAL] It's like I'm around a month.
[AGENT][NEUTRAL] Yeah, we can't gauge when you leave it when it leaves your office how long it'll take to get here. I would think it would have been here by now, but I don't show that we've received it yet. Um, I also show that this policy.
[AGENT][NEUTRAL] Actually, this policy is no longer active as of [PII]. Let me give you the current policy number and I'll look under that number. The current policy number is 2473332.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what were the procedure codes on the claim? Is it surgical codes?
[CUSTOMER][NEUTRAL] It's the surgical code 29846?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I do see it under this policy number.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] Received [PII], processed [PII], it was denied. Uh, the maximum benefit per day is exhausted, um, so it appears we received another claim for this date of service and it was paid prior to this one and it also exhausted the benefit.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, I see.
[AGENT][NEUTRAL] I have that claim number if you would like.
[CUSTOMER][NEUTRAL] That's all.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] That number is 352-1296.
[CUSTOMER][POSITIVE] 352-1296. Thank you so much for your help.
[AGENT][NEUTRAL] Alright, anything else I can assist with today [PII]?
[CUSTOMER][POSITIVE] That's gonna be all. Have a nice day.
[AGENT][POSITIVE] All right, and you can also, you can also check your status on our online service center at [PII]. And if no other questions, thanks for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.