AccountId: 011433970860
ContactId: e66ee1f1-790e-4877-895f-19f325594a63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314959 ms
Total Talk Time (AGENT): 136453 ms
Total Talk Time (CUSTOMER): 96526 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/e66ee1f1-790e-4877-895f-19f325594a63_20250220T14:26_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. I need to check on a claim, please.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a call back number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] And what is the policy number of the member that you're inquiring claim status for?
[CUSTOMER][NEUTRAL] It is 02353101.
[AGENT][NEUTRAL] Can you verify that patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure, it's [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can I have, and you're calling to verify benefits and eligibility for [PII], correct? for inpatient or outpatient, [PII]?
[CUSTOMER][NEUTRAL] No, I'm calling to check status on a claim.
[AGENT][NEUTRAL] What's the date of service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] There was a payment of $1,107.26 made on this claim.
[CUSTOMER][NEUTRAL] [PII] and when was that?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, when was that?
[AGENT][NEUTRAL] Yes, this was some processed [PII].
[AGENT][NEUTRAL] Let me see when the check was if the check was cashed.
[AGENT][NEUTRAL] This check was cashed [PII].
[CUSTOMER][NEUTRAL] Can you tell me um where it was mailed to or?
[AGENT][NEUTRAL] What was your full balance for the claim?
[CUSTOMER][NEUTRAL] So the full balance of the claim was $5,532.59.
[AGENT][NEUTRAL] So this is not a hospital bill?
[CUSTOMER][NEUTRAL] No, it's not a hospital bill.
[AGENT][NEUTRAL] What is your, what is the procedure code? Because I'm not showing a claim on file.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So I have J.
[AGENT][NEUTRAL] Other than the hospital.
[CUSTOMER][NEUTRAL] J 1335.
[CUSTOMER][NEUTRAL] NS 9494.
[CUSTOMER][NEUTRAL] The claim was sent on yeah that wouldn't have been us because we have called um.
[CUSTOMER][NEUTRAL] [PII] and they said the claim wasn't on file and we mailed it to [PII].
[CUSTOMER][NEUTRAL] Ok [PII].
[AGENT][NEUTRAL] Give me your date of service again.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] See, I'm not showing a claim on file for [PII]. It's just a hospital bill that I see for this patient.
[CUSTOMER][NEUTRAL] Is that the correct address to send it to?
[CUSTOMER][NEGATIVE] Because this is like the 3rd time we're sending it and you guys keep saying you're not getting it.
[AGENT][NEUTRAL] Correct, so we can't if it's not in the system, then we have not received it. So you said you sent it to [PII]?
[AGENT][NEGATIVE] [PII]? No, that's not correct.
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEGATIVE] It's, that's not the correct address. That's why we don't have it that no that address has been changed for years.
[CUSTOMER][NEUTRAL] OK, what is the uh what is it?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII]. That's [PII]. That's [PII]. And [PII], we have a fax number as well. I think I suggest that you fax it so that way we can get it because you've been calling about it for several times.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, what's the fax number?
[AGENT][NEGATIVE] And no one has corrected gave you the correct address. I'm not sure why they wouldn't have gave it to you.
[AGENT][NEUTRAL] Um, the fax number is [PII]. That's [PII] attention claims department.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Alright perfect thank you so much. I appreciate it.
[AGENT][NEUTRAL] And [PII], give me that bill amount.
[CUSTOMER][NEUTRAL] 5000.
[CUSTOMER][NEUTRAL] $532.59. 5532.59.
[AGENT][POSITIVE] Thank you, I need to make sure that I could make that a note.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][NEUTRAL] So you do have the correct address and the fax number, correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] Alrighty, well done.
[AGENT][POSITIVE] Thanks for calling ATL and you have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thanks. Goodbye.