AccountId: 011433970860
ContactId: d2b09f9d-f366-4bf1-ae3c-e7dc3433a3df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379679 ms
Total Talk Time (AGENT): 162176 ms
Total Talk Time (CUSTOMER): 127581 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/d2b09f9d-f366-4bf1-ae3c-e7dc3433a3df_20250522T15:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for contacting ATM. My name is [PII]. How may I help you?
[AGENT][POSITIVE] Hello, thank you for contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII]. I'm calling from Emi Clinic. I need to check claim status. Hope you can assist me.
[AGENT][POSITIVE] Yes, I can help with the same steps. I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] [PII] Last name [PII].
[AGENT][NEUTRAL] OK, thank you. Um, [PII], what is the policy number that we're looking at today?
[CUSTOMER][NEUTRAL] I'm sorry, could you repeat it? Your policy is very low.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, I'm sorry, I'm, I'm not able to hear you very well. What is the policy number that, that, uh, we're uh looking at today?
[CUSTOMER][NEUTRAL] Uh, member ID number is D for Delta 45401602.
[AGENT][NEUTRAL] OK, thank you. And how do you spell the patient's last name, please?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][POSITIVE] Thank you, and their first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And, and [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I appreciate that. Thank you. While I'm looking that up, if I could just have a callback number please in the event that we're disconnected.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's 90 day like.
[AGENT][POSITIVE] OK, I do appreciate that. Thank you. Uh, [PII]'s, uh, the, the, um,
[AGENT][NEUTRAL] The claim that we're looking for, is this for medical or is it for um
[AGENT][NEUTRAL] Or is it for dental or?
[CUSTOMER][NEUTRAL] Medical, medical.
[AGENT][NEUTRAL] Thank you. And what date of service are you looking for for [PII]?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sorry, it's [PII] for the charge amount of $1,654 even.
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] Uh, it doesn't look like I have her, um, claim, and so let me, let me see if I can't find where we should send this to because it looks like that.
[AGENT][NEUTRAL] Uh, I don't have it, but the claims are supposed to go to a company called IMA, so it doesn't look like we have received the claim for this. Um, what I can do is I can tell you, uh, the, the claim will need to be submitted again, and what I can do is I can tell you where to submit it again but I'm afraid I don't have a copy of it.
[AGENT][NEUTRAL] So it was never sent to us, let me put it that way.
[CUSTOMER][NEUTRAL] Uh, so, you don't receive the claim?
[AGENT][NEUTRAL] No, we, we never received the claim, um, but, uh, if you like, I can tell you where to send it.
[CUSTOMER][NEUTRAL] I'm sorry, I didn't get you. Your voice is too low. Please, can you repeat it?
[AGENT][NEUTRAL] Oh, I'm sorry. Can, can you hear me, can you hear me a little better now?
[CUSTOMER][POSITIVE] Yeah, yeah, a little better now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, um, the, we never received your claim, [PII], but I can tell you where to send it.
[AGENT][NEUTRAL] Um, we, we never received it, so I don't, I don't have it on file, but if you like, I can give you the address of where to send it to.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yes, please. Yes, please.
[AGENT][NEUTRAL] Um, OK, the company is called IMA. That's I for Ida.
[AGENT][NEUTRAL] M for Mary
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] A for alpha,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the PO box address.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the name of the city is [PII], that's [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and that the state abbreviation is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code for that is [PII]. And if you would like the payer ID, I can give you that as well.
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] OK, the, the payer ID is.
[AGENT][NEUTRAL] 64
[AGENT][NEUTRAL] 556.
[CUSTOMER][NEUTRAL] Thank you. And also, can I know the coverage um effective date please?
[AGENT][NEUTRAL] Yes, her
[CUSTOMER][NEUTRAL] Eligibility date claim.
[AGENT][NEUTRAL] Yes, the, the, uh, the policy went into effect on March, excuse me, on [PII], and it is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and coverage is still active, right?
[AGENT][POSITIVE] That is right, yes.
[CUSTOMER][NEUTRAL] OK, thank you. Can I have a call reference number please?
[AGENT][NEUTRAL] Yes, my name is [PII].
[AGENT][NEUTRAL] The first letter of my last name is [PII].
[AGENT][NEUTRAL] And we're gonna use that today's date as our reference.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So yeah, uh it's [PII]
[AGENT][NEUTRAL] That's right, yes. Uh, my name is [PII] as well.
[CUSTOMER][POSITIVE] OK, great. Nice to talk.
[CUSTOMER][POSITIVE] Thank you so much for assisting me. Have a great day.
[AGENT][POSITIVE] OK, well thank you for contacting AP have a good.