AccountId: 011433970860
ContactId: d6d248f0-b081-4352-8989-4086c403f509
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402429 ms
Total Talk Time (AGENT): 96560 ms
Total Talk Time (CUSTOMER): 184187 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/d6d248f0-b081-4352-8989-4086c403f509_20250403T14:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling from provider's office in regards to a mutual patient to check on a few claims and check eligibility.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims and eligibility. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII]. Last name initials [PII].
[AGENT][NEUTRAL] Thank you. And may I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][POSITIVE] Yes ma'am, [PII]. Happy Thursday.
[AGENT][NEUTRAL] OK. All right. And uh you're calling from which facility for meditation?
[CUSTOMER][NEUTRAL] Sure, I'm calling from Miami Hematology and Oncology Associates.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, give me one little second, go on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] Let me go back to [PII] policy ID number is 01638489 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] OK, thank you. And um what is the date of birth for Miss [PII] for Ms. [PII]?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][POSITIVE] Perfect. All right. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] OK, so [PII] and the total amount is 13386.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That could be wrong. Give me one second. Let me double check this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Be.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, for this one it's [PII]. Sorry, I was right.
[CUSTOMER][NEUTRAL] Mm we have to find out.
[CUSTOMER][NEUTRAL] Which I do have
[AGENT][NEUTRAL] OK. And the amount is the 133. 86?
[CUSTOMER][NEUTRAL] OK, sorry, no, they, I don't know why they send it to me like this, but so the total amount for that data service is 900.
[AGENT][NEUTRAL] No
[CUSTOMER][NEUTRAL] No sorry, $974.06.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, let's see.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, here it is. OK. The, the remaining balance was 13386, which we did send the payment for 13386. Uh this was processed on [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Do you need the claim number or the check number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I uh.
[CUSTOMER][NEUTRAL] OK alright let me see something.
[CUSTOMER][NEUTRAL] um
[CUSTOMER][NEUTRAL] so I think that's, you know, yeah.
[CUSTOMER][NEUTRAL] Yeah let me.
[CUSTOMER][POSITIVE] Actually found your portal. Let me take a check something here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So you do have this is funny they OK.
[CUSTOMER][NEUTRAL] This is coming back as paid.
[CUSTOMER][NEUTRAL] I'm looking at this one. Can you do me a favor? Can you look at, OK, let me have the claim number for this for the [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] Yes, um, claim number 3547305.
[CUSTOMER][NEUTRAL] And it did pay 13386.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Let me look.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, I'm gonna have to call to see which of the payers.
[CUSTOMER][NEUTRAL] Because once the patients.
[CUSTOMER][POSITIVE] and it is amazing.
[CUSTOMER][NEUTRAL] OK, so, and I believe the one that they're looking at is the office visit which is CPT code 99213.
[AGENT][NEUTRAL] OK. Um, yeah, the office visit is not covered under this policy.
[CUSTOMER][NEUTRAL] OK, no office visits are covered, am I correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Because, OK, so I believe that's what it is because the way they sent it over to me on my end.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, I got it here because let me see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, rampage.
[CUSTOMER][NEUTRAL] Dispute it's the office visits, yeah, because I also have the same for [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My billing department just sent me half of the statement, so that's why when I looked it over.
[AGENT][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK, but they are paid, it's the balances that the patient is paying. OK, can I get a reference number?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] We don't have reference numbers you can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Sure, that is.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] My name is [PII] and last name is [PII]
[CUSTOMER][NEUTRAL] Your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] Mhm. Yes, [PII] mhm.
[CUSTOMER][POSITIVE] Thank you so much I appreciate it.
[AGENT][POSITIVE] You're welcome. Is there anything else? You as well. Well, thank you for calling. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] You have a good day.
[CUSTOMER][POSITIVE] No ma'am thank you you too.
[CUSTOMER][NEUTRAL] Bye bye.