AccountId: 011433970860
ContactId: d9dbf938-0864-44d4-a834-e28b3d2401b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 850789 ms
Total Talk Time (AGENT): 213382 ms
Total Talk Time (CUSTOMER): 177433 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/d9dbf938-0864-44d4-a834-e28b3d2401b8_20250620T19:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, this is [PII] calling from the private office.
[AGENT][NEUTRAL] How can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, I want the claim status of the patient.
[AGENT][NEUTRAL] Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. It's [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Yeah, it's 02440118.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yeah. The first name is [PII] and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Yeah, just a moment, please.
[CUSTOMER][NEUTRAL] Yeah, can I tell the, take the service in the middle?
[AGENT][NEUTRAL] OK, and what is that?
[CUSTOMER][NEUTRAL] Yeah. It's number 20, 2024 and the bill amount is $719. 45 cents.
[AGENT][NEUTRAL] I'm sorry, you said [PII]?
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEGATIVE] OK, you're breaking up. One, I'm sorry, one more time.
[CUSTOMER][NEUTRAL] Yeah, it's November 20224. You got it?
[AGENT][NEUTRAL] So [PII] 2020 [PII]?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][POSITIVE] OK, I'm so sorry.
[AGENT][NEUTRAL] Alright, I'm showing that we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 354-7692.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And it looks like we paid $174.45 towards this claim.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It's 145.
[AGENT][NEUTRAL] 1
[CUSTOMER][NEUTRAL] Could you please repeat again?
[AGENT][NEUTRAL] $174.45.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, is there any reason?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Is there any code has been denied or something like that.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like there was only one.
[AGENT][NEGATIVE] Um, piece of durable medical equipment that was not covered. Um, it didn't meet the definition, but I'm unable to see which one of them they were. It just shows that it was durable medical equipment, but there was 1234. There were 6 of them and only 1 of them was denied.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, so just some be.
[AGENT][NEUTRAL] What was that?
[CUSTOMER][NEUTRAL] Actually, patient has no, yeah, there's no DME coverage, right?
[AGENT][NEGATIVE] Wait, you're, you're breaking up. I'm sorry. What, what did you say?
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, is anyone there?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah. Hello? Can you hear me?
[AGENT][NEUTRAL] OK. Yes, um, what did you ask?
[CUSTOMER][NEUTRAL] Yeah, that, there is no DMA coverage, right?
[AGENT][NEGATIVE] Uh, there is, but only one of the 6 wasn't, didn't meet the definition.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] It looks like 5 of them were paid.
[CUSTOMER][NEUTRAL] Yeah, could you please tell the EFT number for me?
[CUSTOMER][NEUTRAL] For the paid
[AGENT][NEUTRAL] What number did you want?
[CUSTOMER][NEUTRAL] EFT number or the check number for the payment details.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The check number is 2021319.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, sure. Thanks for that. For the same patient, I have another claim. Could you please assist with me that?
[AGENT][NEUTRAL] OK, give me just one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is the other data service?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Alright, it looks like we received this claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 357-8394.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] And we paid $149.52.
[CUSTOMER][NEUTRAL] Yeah, and the check ID number?
[AGENT][NEUTRAL] 203.
[AGENT][NEUTRAL] 4134.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Is the
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] Is there any denial for the code?
[AGENT][NEGATIVE] Um, only one was denied.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] It looks like uh A 7038 was the one that got denied because it did not meet the definition of durable medical equipment.
[CUSTOMER][NEUTRAL] Is patient responsibility for the claim?
[AGENT][NEUTRAL] We don't determine patient responsibility that's up to the provider.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] Yeah, sure. Thanks for that.
[CUSTOMER][NEUTRAL] Just a moment, please.
[CUSTOMER][NEUTRAL] Yeah, I have another 2 claims. Will you please assist me with that?
[AGENT][NEUTRAL] OK, is it with the same patient or a different different patient? OK, give me just one moment.
[CUSTOMER][NEUTRAL] For different patient
[CUSTOMER][POSITIVE] Different place. Yeah, that's right.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And what is the next policy number?
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] Yeah, it's 023-37056.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, the first name is [PII] and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] And do you have the claim number, the date of service?
[CUSTOMER][NEUTRAL] A service.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] It's [PII] and the billing amount is $283. 38 cents.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][POSITIVE] Sure. Take your time.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] Of [PII] correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm not showing anything for that data service.
[CUSTOMER][NEUTRAL] Mhm. And, just a moment, please.
[AGENT][NEUTRAL] And you have another claim for the same patient?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, and what is the next date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] I'm not showing anything for that date of service as well.
[CUSTOMER][NEUTRAL] Uh, that, there is no claim on file?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Sure. Thanks for that.
[CUSTOMER][NEUTRAL] Assemblies.
[AGENT][NEUTRAL] Is it for the same patient?
[CUSTOMER][NEUTRAL] Yeah, for the same patient, I have another claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I tell the details of?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, just one please mhm.
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, let me look.
[AGENT][NEUTRAL] I'm not showing a claim for [PII] either.
[CUSTOMER][POSITIVE] OK, sure. Thanks for that.
[CUSTOMER][NEUTRAL] Yeah, can I get your card and your good name, please?
[AGENT][NEUTRAL] OK, so we don't have call reference numbers. You can use my name and last initial in today's date, so [PII] in today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, sure. Thanks for that.
[CUSTOMER][POSITIVE] Thank you. Have a good day. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Have a great day to