AccountId: 011433970860
ContactId: eb01427f-1906-4cbc-93ba-8e762e924f05
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285390 ms
Total Talk Time (AGENT): 126260 ms
Total Talk Time (CUSTOMER): 60304 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/eb01427f-1906-4cbc-93ba-8e762e924f05_20250217T13:42_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. This is [PII] calling from provider's office check on a claim status.
[AGENT][NEUTRAL] Did you say that your name is [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yes, it's correct.
[AGENT][NEUTRAL] OK, [PII]. And what is your, I'm very sorry, [PII], but I'm having a hard time hearing you. There is a lot of noise in your background.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Give me a second
[CUSTOMER][NEUTRAL] Uh, is it OK, ma'am?
[AGENT][NEUTRAL] No, sir, not really, but we'll do the best we can. What is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And that you said that you have one claim to check status on, is that correct?
[CUSTOMER][POSITIVE] Yes, it's correct.
[AGENT][NEUTRAL] OK. What is that member's policy number?
[CUSTOMER][NEUTRAL] It's uh 02433298 ML 8.
[AGENT][NEUTRAL] OK, thank you, [PII]. One moment while I get the member's information pulled up, please.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth, please?
[CUSTOMER][NEUTRAL] Sure. The patient name is um
[CUSTOMER][NEUTRAL] Ms [PII] [PII], and the date of birth is uh [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is your date of service and total build amount, please, [PII]?
[CUSTOMER][NEUTRAL] With the data service is number 4, [PII] and the total charges $48,672.30.
[AGENT][NEUTRAL] 30 cents.
[CUSTOMER][POSITIVE] Yes, it's correct.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, [PII], so this claim was received, the received date on this claim was [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3551587.
[AGENT][NEUTRAL] And this claim was denied. The reason for the denial states please provide copies of the explanation of benefits from your primary insurance carrier.
[AGENT][NEUTRAL] This is a supplemental policy to the primary insurance.
[CUSTOMER][NEUTRAL] OK. Can I get your fax number?
[AGENT][NEUTRAL] The claim fax number is going to be [PII] attention claims.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] What was the timely?
[AGENT][NEGATIVE] There is no timely filing limit?
[AGENT][NEUTRAL] And [PII], if you need a car.
[CUSTOMER][NEUTRAL] Can I get your call reference number?
[AGENT][NEUTRAL] Yes, but first, if you need a copy of this explanation of benefits, you may print that by going to our portal at [PII], and now that you have the claim number, you should be able to print that explanation of benefits. For our call reference number, you will use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you, and providing the information. I love good day, bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] I hope you have a nice day, [PII], if that's all I can help you with, thank you again for calling APL.