AccountId: 011433970860
ContactId: e53d24b8-99e6-44b5-8362-20f9957c7df6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267570 ms
Total Talk Time (AGENT): 77681 ms
Total Talk Time (CUSTOMER): 77084 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/e53d24b8-99e6-44b5-8362-20f9957c7df6_20250612T18:32_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from office, uh checking for claim status.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is again?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] OK, and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 022.
[CUSTOMER][NEUTRAL] 16487 M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, the callback number [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, the patient name is uh [PII] and date of birth [PII].
[CUSTOMER][NEUTRAL] what
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] The date of service is [PII] and total charge amount is $202 even $202.
[AGENT][NEUTRAL] And the balance after primary?
[CUSTOMER][NEUTRAL] Yes, uh, the balance is, uh.
[CUSTOMER][NEUTRAL] $66.08 18 cents.
[AGENT][NEUTRAL] OK, hold on one moment please.
[CUSTOMER][NEUTRAL] What.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And you said [PII] at [PII], correct? I mean [PII] at [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK and the name of the provider's office?
[CUSTOMER][NEUTRAL] Anger, prosthetics and not res.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, I'm showing that claim processed as office visits are not covered as per the policy.
[CUSTOMER][NEUTRAL] OK. When was the claim received?
[AGENT][NEUTRAL] Uh, the claim received on [PII].
[CUSTOMER][NEUTRAL] OK. And uh may I know the date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, what is the reason?
[AGENT][NEUTRAL] Office visits are not covered per the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. What we have to do for this claim?
[AGENT][NEUTRAL] I'm sorry, say again.
[CUSTOMER][NEUTRAL] What we are good for this claim, uh, can I, uh,
[CUSTOMER][NEUTRAL] Send the bill
[AGENT][NEUTRAL] You have up to 180 days from the time the claim was processed to submit an appeal, and you must submit a letter stating the reason for the appeal.
[CUSTOMER][NEUTRAL] OK. Can I get the fax number, of the fax number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, thank you. Can I get the claim number?
[AGENT][NEUTRAL] 3,556,690
[CUSTOMER][NEUTRAL] OK. Could you spell your name and call reference number?
[AGENT][NEUTRAL] It's K E K E last initial Q and call reference number you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you for the information. Have a good day bye.
[AGENT][POSITIVE] Alright you too [PII] thanks for calling [PII] bye.
[CUSTOMER][NEUTRAL] Bye.