AccountId: 011433970860
ContactId: e442e623-76e4-4ece-bd5b-f60e1afe4a31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 398609 ms
Total Talk Time (AGENT): 168368 ms
Total Talk Time (CUSTOMER): 165031 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/e442e623-76e4-4ece-bd5b-f60e1afe4a31_20250106T21:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I am trying to find uh some information regarding a claim.
[AGENT][NEUTRAL] OK. You said your name is [PII]?
[CUSTOMER][NEUTRAL] No, it's [PII]. I'm sorry, [PII] and actually I'm looking to get a remit.
[AGENT][NEUTRAL] [PII]. OK, [PII].
[AGENT][NEUTRAL] OK, so are you calling on behalf of the group or the agent broker's office?
[CUSTOMER][NEUTRAL] Um, I'm calling on behalf of the provider's office.
[AGENT][NEUTRAL] OK, so when you say remit, do you mean an explanation of benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. And what's the policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well let's see what did they put down the the subscriber ID they put down originally is Delta 46802085.
[CUSTOMER][NEUTRAL] Let me pull up cause I think it was something different.
[AGENT][NEGATIVE] Mhm it should start with a 0.
[CUSTOMER][NEUTRAL] On their insurance card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Yeah, I kind of figured they messed that up again.
[CUSTOMER][NEUTRAL] Um, the policy number is 025557007.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] It's gonna be [PII] and that's direct dial.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name again?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] First initial last name is [PII] and you'll use my name in today's date as reference for today's call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. What's the patient's name and date of birth, [PII]?
[CUSTOMER][NEUTRAL] Uh, patient's name, oh, I don't know if I can pronounce that. [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and what's the data service of her claim, and I can help out with the ELB?
[CUSTOMER][NEUTRAL] Um, let's see, what did they tell me?
[CUSTOMER][NEUTRAL] My office manager call so I'm not, well, it's the only data service they have, so I guess that's easy. [PII].
[AGENT][NEUTRAL] And do you know what the procedure codes on the claim are?
[CUSTOMER][NEUTRAL] Uh, I have [PII] and 36415.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And while I'm looking at the claim, you do know that you can download a copy of the explanation because it's automatically mailed, um, the next business day from processing, so that would have been [PII], and it is available on our online service center. I can give you that address and then help you set up the account to download the ELB. Looks like we issued a payment of, OK, of $50. Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, that'd be great
[CUSTOMER][NEUTRAL] 50 $50? Yeah.
[CUSTOMER][NEUTRAL] Cause I, I have the amount and the check number, but I never, I don't know if they threw it away or what. They couldn't find the remit that came with it. I kind of figured.
[AGENT][NEUTRAL] No, it's attached to the check.
[AGENT][NEUTRAL] Yeah, it's attached to the check yeah so let me give you the um online service center address.
[AGENT][NEUTRAL] Um, it's secured [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So it's [PII]? Or did I miss a letter in there?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[CUSTOMER][NEUTRAL] So just the six letters.
[AGENT][NEUTRAL] [PII]. So secured. [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and then you need to log in?
[AGENT][NEUTRAL] Uh, not creating an account, you need to click the new user tab to the right.
[CUSTOMER][NEUTRAL] Well, well, I, I created an account but we couldn't figure out how to get a copy of the remit.
[AGENT][NEUTRAL] OK, so I can help you with that. Give me a second.
[CUSTOMER][NEUTRAL] Sure, because I think, I think the 22 issues one wanted either the um claim number which obviously if we don't have the remit we don't know what it is, uh, or the other I think one of the last 4 of the subscriber and I don't have the subscribers social security number.
[AGENT][NEUTRAL] OK, um, I think there's a quick search.
[CUSTOMER][NEUTRAL] Cause this person's uh
[AGENT][NEUTRAL] Using the patient's first name, the date of service.
[AGENT][NEUTRAL] And date of birth, so I'll give you the claim number do you wanna go ahead and jot this number down?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 958 5.
[AGENT][NEUTRAL] And [PII], what's the tax identification number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so you create an account, are you logged in?
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so then what you're going to do is go to the claims dashboard.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have either quick access or if I don't have the claim number.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, use the quick access because you have the patient's name. Do you have the patient's date of birth?
[AGENT][NEUTRAL] And then the claim number that I gave you, or did I give you that number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, you get it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 39585
[CUSTOMER][NEUTRAL] Patient's first name, uh, do you own uh.
[CUSTOMER][NEUTRAL] Date of birth [PII].
[CUSTOMER][NEUTRAL] And that would be it. Now is it just to double check, so if I don't have the claim number there's still no way I can do this, correct?
[AGENT][NEUTRAL] Well, if you don't have the yeah because we're the other way to search you will need the social of the primary card holder.
[CUSTOMER][NEUTRAL] Which I don't have
[AGENT][NEUTRAL] Right, so yeah, so you more than likely would call us for the claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To do the quick search.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Let's see, the only other.
[CUSTOMER][NEUTRAL] OK, you have it down below.
[CUSTOMER][POSITIVE] OK, sounds good. That's what I needed. Thank you very much, [PII]. I appreciate it.
[AGENT][POSITIVE] You, you're welcome, [PII]. Any other uh issues I can assist with today?
[CUSTOMER][NEUTRAL] No, ma'am, that was it.
[AGENT][POSITIVE] OK, well, thank you for calling ATL. Have a good day, [PII].
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Uh-huh, bye-bye.