AccountId: 011433970860
ContactId: e162769b-058a-4c38-a884-f8ba45e1fa6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287500 ms
Total Talk Time (AGENT): 91496 ms
Total Talk Time (CUSTOMER): 112885 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/e162769b-058a-4c38-a884-f8ba45e1fa6d_20250313T19:17_UTC.wav
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[AGENT][POSITIVE] This is easy.
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII] in customer services. How are you?
[AGENT][POSITIVE] I'm good. How are you doing?
[CUSTOMER][NEUTRAL] I'm good. I have a provider on the phone that's trying to check claim status online, but she's having problems.
[CUSTOMER][NEGATIVE] And I, I tried helping her from the guru cards but she still wasn't able to pull anything up. Is that something that y'all help with or?
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Who, who helps with that?
[AGENT][NEUTRAL] Guru cards.
[CUSTOMER][NEUTRAL] With uh she's trying she's on the online service center trying to check claim status.
[AGENT][NEUTRAL] OK, I can assist her with that. What's the policy number?
[CUSTOMER][NEUTRAL] OK, the policy number is 1423563.
[CUSTOMER][NEUTRAL] And the lady on the phone is [PII], yeah, from Rena Group of [PII].
[CUSTOMER][NEUTRAL] And I've got a callback number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. What's that number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. OK, you can send her over.
[CUSTOMER][POSITIVE] All right. Thank you, Ay.
[AGENT][POSITIVE] Mhm, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you for calling ATL. This is Ay. How can I help you?
[CUSTOMER][NEUTRAL] Hi, what was your name again?
[AGENT][NEUTRAL] Um, it's [PII], um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and I'm calling from Retina Group of [PII], and I was calling to check the claim status for a member.
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, could I get the policy number, please?
[CUSTOMER][NEUTRAL] OK, the policy number is 01423563.
[AGENT][NEUTRAL] OK. Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] First name is [PII] [PII].
[AGENT][NEUTRAL] OK. And the date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] It is [PII], and the bill amount is 2700.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file for him. Um, how was the claim submitted?
[CUSTOMER][NEUTRAL] Um, electronically.
[AGENT][NEUTRAL] What pay ID did you use?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] I was just
[CUSTOMER][NEGATIVE] It doesn't tell me to pay your ID.
[CUSTOMER][NEUTRAL] Um, the card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] It's not even on the card.
[AGENT][NEUTRAL] OK, well, the if you want to resubmit the claim, um, the correct payer ID is 60801.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] 60801
[AGENT][NEUTRAL] Yes, ma'am, and claims can also be faxed in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] Um, the fax number is [PII] and please attention it to the claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you happen to see another data service?
[AGENT][NEUTRAL] Yeah, there are other dates of services, um.
[CUSTOMER][NEUTRAL] For um [PII].
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And what are the bill charges?
[CUSTOMER][NEUTRAL] It is 1900.
[AGENT][NEUTRAL] OK, I see claims on file for that day of service but not for that amount.
[CUSTOMER][NEUTRAL] Um, cause that's what we have, the total charges was 1900.
[AGENT][NEUTRAL] OK, yeah, actually this claim, the total charges, um, is $800.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's from a different provider, looks like.
[AGENT][NEUTRAL] See who's the provider.
[CUSTOMER][NEUTRAL] It's not
[CUSTOMER][NEUTRAL] It's not man deep.
[AGENT][NEUTRAL] No, ma'am. It isn't.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] OK. I thank you again for calling APL. Have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] You too bye bye.