AccountId: 011433970860
ContactId: dc3d1033-2d73-451c-ad58-d61b79dabc48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157919 ms
Total Talk Time (AGENT): 54605 ms
Total Talk Time (CUSTOMER): 87707 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/dc3d1033-2d73-451c-ad58-d61b79dabc48_20250128T14:32_UTC.wav
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[AGENT][POSITIVE] And thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, my name is [PII] and I'm calling from the provider's office, and I'm calling to check um the eligibility benefits for a patient.
[AGENT][POSITIVE] I'm sure, [PII] I can assist you with benefits. Um, first, I'll need a good callback number.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Now, I need the policy number, please.
[CUSTOMER][NEUTRAL] Um 01580974.
[AGENT][NEUTRAL] And just let me advise you that verification of coverage does not guarantee payment of claims. Um, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, I have the patient as being the subscriber's daughter.
[CUSTOMER][NEUTRAL] Uh, [PII] is [PII] with the birth date of [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing the effective date on this policy was [PII] and the policy is still active. And for a list of all the benefits and a fee schedule, I can fax that over to you.
[CUSTOMER][NEUTRAL] Um, no, that's OK. I actually had submitted a claim for her on [PII], and it did come back denied, stating that she was unable to locate any coverage that you were unable to locate any coverage for her.
[AGENT][NEUTRAL] OK. Yeah, I'm showing her on the policy and the policy is still active.
[CUSTOMER][NEUTRAL] OK, well, when I talked to the, when I talked to the patient, the father, he, I don't know if he had to call or I, I'm not sure, but anyway, I'm just calling to see if that claim is still in your system and if it can be reprocessed or if I need to resub it.
[AGENT][NEUTRAL] You would need to resubmit it. I'm not showing it in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and that is the correct policy number that I gave you, right? The 015809974 for her to use? OK, OK.
[AGENT][NEUTRAL] Yes, ma'am. And yeah, and verify her name and date of birth one more time.
[CUSTOMER][NEUTRAL] Um, I have her, the, the last name is [PII] First name is [PII]
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] With the date of birth of [PII].
[AGENT][NEUTRAL] Yes, ma'am. She's on the policy.
[CUSTOMER][NEUTRAL] OK, I'll resub it and I have your payer ID is 60801.
[AGENT][POSITIVE] Yes, ma'am, that's correct.
[CUSTOMER][POSITIVE] Alright, perfect, very good I'll get it resubmitted then thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's everything you have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.