AccountId: 011433970860
ContactId: d6acc49d-fb58-4ef5-a073-ac32be47a254
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421450 ms
Total Talk Time (AGENT): 190110 ms
Total Talk Time (CUSTOMER): 110106 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/d6acc49d-fb58-4ef5-a073-ac32be47a254_20250319T14:11_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey I was trying to verify coverage and then check a claim.
[AGENT][NEUTRAL] OK. May I have your name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII] and your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. What is the policy number please?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] And it's an older card that I've got, so, um, 997788.
[AGENT][NEUTRAL] OK, I have that as 997788. 1 moment please, [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] OK, thank you verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, how, uh, well, the patient's name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK, I have that number pulled up and you're calling to first verify um eligibility and check on a claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, uh, now this particular policy, as you stated, it's an old policy. Um, this particular policy termed as of [PII]. So let me just check real quick to see what's the date of service on the claim.
[CUSTOMER][NEUTRAL] Oh it's last year.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So let's see, let me make sure we don't have a newer number.
[AGENT][NEUTRAL] I can search for one.
[CUSTOMER][NEUTRAL] No, that's all long ago, so you said it termed, OK.
[CUSTOMER][NEUTRAL] Yeah and if you need the cardholder's name was [PII].
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] I don't know if that
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And what's that date of service?
[CUSTOMER][NEUTRAL] Um, data service is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what are the total charges billed?
[CUSTOMER][NEUTRAL] It's like $50.
[AGENT][NEUTRAL] OK, thank you. Excuse me. I do not show that claim on this particular policy, so bear with me please, [PII], let me look for an active policy for them.
[AGENT][NEUTRAL] And I provide the information to you once I'm able to obtain that.
[AGENT][POSITIVE] OK, I was able to locate an active policy for both. Let me know when you're ready for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, it is 2,030,130.
[CUSTOMER][NEUTRAL] 2,030,130
[AGENT][NEUTRAL] Yes, with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And in regards to that claim, give me one second, and you said it was bill for $50 OK.
[AGENT][NEUTRAL] Was it 1 or 2 procedure codes bill for this service date?
[CUSTOMER][NEUTRAL] Um one on that day.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and was that for procedure, can you verify the procedure code, please?
[CUSTOMER][NEUTRAL] Um, 99214.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, we received the claim and made a payment in the amount of $50.
[AGENT][NEUTRAL] I have the claim and check numbers for you when you're ready for that, [PII].
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, the claim number shows 3559579.
[AGENT][NEUTRAL] OK, check number shows 2025982.
[CUSTOMER][NEUTRAL] Can you tell if the check's been cashed or processed?
[AGENT][NEUTRAL] I can tell if it's been cleared. Yes, one moment please.
[AGENT][NEUTRAL] OK, it shows that the check has cleared as of [PII].
[CUSTOMER][NEUTRAL] Can you check another data service for me same patient?
[AGENT][NEUTRAL] I can give me 1 2nd.
[AGENT][NEUTRAL] OK, what's that date of service.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Total bill amount was 170.
[AGENT][NEUTRAL] 170 OK.
[AGENT][NEUTRAL] OK, now I did not show that that claim is on file for the patient. Let me just check to see if it's maybe in line.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] I say I can resend it with the new number too.
[AGENT][NEUTRAL] No, we don't have that in line to be processed as well. And also, Ms. [PII], you're able to check claim status by visiting our secure portal at [PII]. And if you need that EOB, you can get that from the uh website as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I was gonna say I was trying to do that and then it told me I needed a.
[CUSTOMER][NEUTRAL] A recent claim number and then couldn't I put his um or his number in but of course it was wrong so.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] Uh, no problem.
[AGENT][POSITIVE] Thank you for trying we appreciate that.
[CUSTOMER][NEUTRAL] If I can go back to it real quick.
[AGENT][NEUTRAL] OK. Yes ma'am.
[CUSTOMER][NEUTRAL] OK, so I should be able to use that 203-0130 correct?
[AGENT][POSITIVE] Correct, and I can
[AGENT][NEUTRAL] And or and or that claim number.
[CUSTOMER][NEUTRAL] Mm, they didn't take it uh let me try the claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Mhm, it keeps telling me no user was found with the information that was entered.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I appreciate you trying so what I can do, I can fax it over to you, no problem. What is your fax number, [PII]? I appreciate you trying.
[CUSTOMER][NEUTRAL] Um, OK, [PII].
[AGENT][NEUTRAL] OK, and let me just repeat that to confirm. I have that as [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I will get that you'll be faxed over to you.
[CUSTOMER][POSITIVE] OK, all right, thank you very much.
[AGENT][NEUTRAL] You're welcome, [PII]. Anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day bye.