AccountId: 011433970860
ContactId: ceca52a5-311f-461f-9142-6b25a3c287b6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298420 ms
Total Talk Time (AGENT): 124116 ms
Total Talk Time (CUSTOMER): 151078 ms
Interruptions: 7
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/ceca52a5-311f-461f-9142-6b25a3c287b6_20250313T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from MESCs to check on a claim status.
[AGENT][NEUTRAL] OK, you said your name is [PII], is that correct?
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][POSITIVE] Uh, that's right.
[AGENT][NEUTRAL] And you have one claim that you're needing to check status on, is that also correct?
[CUSTOMER][NEUTRAL] I do have 3 claims for the same member.
[AGENT][POSITIVE] Yes, I can help you with all of those and what is your callback number, please?
[CUSTOMER][NEUTRAL] Can you help me with all of this and what's your call back number please? Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] direct line. If you don't mind, can I get your name again? Sorry, I missed your name.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you will use my name along with today's date [PII] as your call reference number for each one.
[CUSTOMER][NEUTRAL] You will use my name along with the date of date change your call reference number for each one. Sure, thank you. And I provide for you will be the information I provide will be your verification of benefits and not a guarantee of payment and lastly if you do have the claims on file and you need a copy of the. Got it.
[AGENT][NEUTRAL] And also any information that I provide for you will be, yes sir, any information I provide will be a verification of benefits and not a guarantee of payment and lastly if we do have the claims on file and you need a copy of any of the explanation of benefits.
[AGENT][NEUTRAL] Can they print them. I'm so sorry, Chan, but I can't, yes, so there's some background noise that's echoing back and where I can't hear you.
[AGENT][NEUTRAL] But we do have a portal if we have the claim on file that you can check claim status, I'm sorry, and print the EOB by going to [PII].
[CUSTOMER][NEUTRAL] Uh, sorry for that.
[AGENT][NEUTRAL] And what is your patient's policy number, please?
[CUSTOMER][NEUTRAL] Mm. Got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy number is 023893887.
[AGENT][NEUTRAL] 893-87. Is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the first date of service and total bill amount for him please?
[CUSTOMER][NEUTRAL] I think total bills are.
[CUSTOMER][NEUTRAL] Data Services.
[CUSTOMER][NEUTRAL] [PII] for the bill amount of $520 even.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And you said it was 6:25 is the data service, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, there is no claim on file for him for this state of service.
[CUSTOMER][NEUTRAL] OK, there is no claim on file for him for the state of service.
[CUSTOMER][NEUTRAL] Got it. Can I have the policy effective on termination date?
[AGENT][NEUTRAL] Policy is active. There is no termination date. The effective date is [PII].
[CUSTOMER][NEUTRAL] Policy is active. There is no termination date and effective date is [PII].
[AGENT][NEUTRAL] Now on these, if, if you're going to be filing a claim with APO we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] Now on the you're going to be filing a claim with you we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim. Mm. Got it, [PII]. Can I go to the next data service policy number?
[AGENT][POSITIVE] Mhm. I'm ready.
[CUSTOMER][NEGATIVE] Next, next date of service is [PII] for the bill amount of $24 even, sorry, for the bill amount of $76 even.
[AGENT][NEUTRAL] And it's also for the same data service, 625?
[CUSTOMER][NEUTRAL] And it's also for the same date of August That's right.
[AGENT][NEUTRAL] No, sir, this claim is not on file either.
[CUSTOMER][NEUTRAL] that claim is not on file either. got it. Can we on to the last claim when you are ready?
[AGENT][NEUTRAL] Yes, sir. Next day the service.
[CUSTOMER][NEUTRAL] OK. Next to the service. Next data services, same data service, [PII] for the bill amount of $149 even.
[AGENT][NEUTRAL] Right, so there is no claim on file for that amount either.
[CUSTOMER][POSITIVE] for that amount. Got it. Thank you so much for your patiencely assisting me, [PII]. Have a great rest of your day. Stay safe. Take care. Bye-bye.
[AGENT][POSITIVE] Well, you're very welcome. Yes, sir, is there any, I hope you do too. And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] is there anything else I can help you with? No, that's all for the day.
[AGENT][POSITIVE] OK, well then, thank you again for calling APO have a great afternoon.
[CUSTOMER][POSITIVE] Again for calling you have a great afternoon. Bye bye.