AccountId: 011433970860
ContactId: db05a23d-4918-4e98-9546-a15cfdc276d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 677979 ms
Total Talk Time (AGENT): 158598 ms
Total Talk Time (CUSTOMER): 124425 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/db05a23d-4918-4e98-9546-a15cfdc276d2_20250505T15:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII], and I'm calling from Atlanta Health. This call may be monitored, recorded for quality purposes, and I was calling, uh, regarding a claim.
[AGENT][NEUTRAL] OK, and I can help you with the claim status. Can I please um get the spelling of your first name?
[CUSTOMER][NEUTRAL] Yes, that's [PII]
[AGENT][NEUTRAL] Thank you and then one more time, can you please give me the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Alinna Health.
[AGENT][POSITIVE] And may I please get your callback number just in case the call gets disconnected I can call you right back.
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yes, that's [PII], that's [PII].
[CUSTOMER][NEUTRAL] 3999.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look up that patient real quick.
[AGENT][NEUTRAL] OK, and then may I please have the date of service and the charge amount?
[CUSTOMER][NEUTRAL] Yes, that's [PII] $384.70.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up that claim for you, Miss [PII], and I'll be right back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 384.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me I have the claim pulled up for you now.
[AGENT][NEUTRAL] The claim number is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 351-405-5
[AGENT][NEUTRAL] Was paid $50.
[AGENT][NEUTRAL] With check number 2006474 after the $50 was paid it maxed out for the calendar year.
[CUSTOMER][NEUTRAL] OK. Um, I wanna, it was breaking up, so I wanna make sure I have the information correct. So you did say the claim number was 3514055?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And you said, you said it paid $60 or $50?
[AGENT][NEUTRAL] 550.
[CUSTOMER][NEUTRAL] OK, 50.
[CUSTOMER][NEUTRAL] And that 2006474, was that a check number?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] I didn't catch what that number was OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And then you said after that, that's when it maxed out, correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] And then, uh, did it leave any patient responsibility?
[AGENT][NEUTRAL] We don't give patient responsibility we allow the providers to determine that.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Do you know which line that it paid?
[AGENT][NEUTRAL] Yes, let me look back at it real quick.
[CUSTOMER][NEUTRAL] Uh, hold on one second.
[AGENT][NEUTRAL] It paid on procedure number 99213.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, could you also let me know when this claim was received?
[AGENT][NEUTRAL] Yes ma'am, let me look that up.
[AGENT][NEUTRAL] We received the claim on [PII] and processed it on [PII].
[AGENT][NEUTRAL] And the check.
[CUSTOMER][NEUTRAL] OK. Do you know, um,
[CUSTOMER][NEUTRAL] OK go ahead.
[AGENT][NEUTRAL] The check did clear the bank on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what was gonna be my next question if you knew if it had cleared.
[AGENT][POSITIVE] Oh yes ma'am.
[AGENT][POSITIVE] Great minds think alike.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Do we have that?
[CUSTOMER][NEUTRAL] And then also, can I just get your name again?
[AGENT][NEUTRAL] My name is [PII]. It's [PII]
[CUSTOMER][NEUTRAL] OK. Well, thank you, [PII], that's all I have for today. Um, also, can I get a copy of this EOB?
[AGENT][NEUTRAL] Yes, what's your fax number and I'll send it to you.
[CUSTOMER][NEUTRAL] Yes, that's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, alright, I'm gonna put you on a quick hold while I send this over to you and I'll be right back with you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Why is such a stuck like that?
[AGENT][NEUTRAL] Come on, load.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding for me.
[AGENT][NEUTRAL] [PII], I have that.
[AGENT][NEUTRAL] Its way to you now.
[CUSTOMER][NEUTRAL] OK. And then also, could we just confirm where that payment went to the address?
[AGENT][POSITIVE] Yes ma'am let me um get this in here real quick.
[AGENT][NEUTRAL] Look it up real quick.
[AGENT][NEUTRAL] Let me go back to it.
[AGENT][NEUTRAL] It went to Alina Health Systems [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Well, thank you to that's all I have for today and I hope you have a great Monday.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Well, thank you and I hope you have a good rest of your week also. Thank you for calling APL today.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.