AccountId: 011433970860
ContactId: e7fb97d9-7246-4f9a-ad1e-6ee89186493a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294540 ms
Total Talk Time (AGENT): 101969 ms
Total Talk Time (CUSTOMER): 91033 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/e7fb97d9-7246-4f9a-ad1e-6ee89186493a_20250226T13:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from Pror of checking on claim status.
[AGENT][NEUTRAL] OK, I can assist you, [PII] What's the policy number?
[CUSTOMER][NEUTRAL] 02492946
[AGENT][POSITIVE] And a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] is the direct line.
[AGENT][NEUTRAL] Thank you and what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] and they did up this [PII].
[AGENT][NEUTRAL] OK, thank you for that information and you say stated that you're checking up status a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] For what date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the toe build?
[CUSTOMER][NEUTRAL] It's $4,251 even.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, so this claim was received [PII], processed [PII]. Um, the policy termed [PII], so no payment was made as the date of services after the policy termination date. I'm showing a claim number of 3545582.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And you can also check claim status on our online service center Max at [PII]. And did you have any other questions I can help out with today?
[CUSTOMER][NEUTRAL] [PII], could you verify the effective date of the member?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. I move the next one start on you?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Shall I move the next member?
[AGENT][POSITIVE] OK, I could do one more.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I can also help you set up an account if you would like.
[CUSTOMER][NEUTRAL] Yes, uh, can I put it in the next member ID?
[AGENT][NEUTRAL] That policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 019
[CUSTOMER][NEUTRAL] 122
[CUSTOMER][NEUTRAL] 66
[CUSTOMER][NEUTRAL] M as in Michael, L as in Lima, number 7.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] and the date of [PII].
[AGENT][NEUTRAL] And what is the data service and total charge?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You did have so this.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's [PII], 2024 and the bill amount is $34,495.76.
[AGENT][NEUTRAL] [PII], 34,495.76.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And we're requesting a copy of the major medical explanation.
[AGENT][NEUTRAL] Of benefits one moment, let me give you the date that the claim was received and paid or processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Receipt date is [PII]. It was processed on the [PII] under claim number 3551063.
[CUSTOMER][NEUTRAL] OK, [PII], you, uh, you have any primary you'll receive or not of. We already sent on a primary OB on [PII] and then the mailing address is [PII].
[AGENT][NEGATIVE] I do not show the ELB received for this state of service at this time.
[CUSTOMER][NEUTRAL] Mm OK. OK. Can I, uh, could you verify the fax number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, we can send it on this uh fax number. Can I get that attention?
[AGENT][NEUTRAL] Claims
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, [PII]. Thank you. Thank you for the information.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. If no other questions, have a good day, [PII]
[CUSTOMER][POSITIVE] Have a good day bye bye.
[AGENT][NEUTRAL] Uh-huh, bye-bye.