AccountId: 011433970860
ContactId: ededa71d-00ce-4264-81aa-056572bc5d2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1011760 ms
Total Talk Time (AGENT): 183547 ms
Total Talk Time (CUSTOMER): 345740 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/ededa71d-00ce-4264-81aa-056572bc5d2e_20250321T15:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling you from the provider office. I want to claim status of a patient.
[AGENT][NEUTRAL] All right, [PII], I'm happy to check on the claim status of a patient. What's the policy number?
[CUSTOMER][NEUTRAL] It is 02501744 ML 8.
[AGENT][POSITIVE] Thank you. And do you have a good callback number?
[CUSTOMER][NEUTRAL] Yeah, I have it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you. And then what's the date of service?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII].
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Not showing any, go ahead.
[CUSTOMER][NEUTRAL] Oh, I so.
[CUSTOMER][NEUTRAL] Yeah, so, well.
[CUSTOMER][NEUTRAL] Can you say it again what you said?
[AGENT][NEUTRAL] I don't show any claims on file for that date of service.
[CUSTOMER][NEUTRAL] Yeah, I want uh general claims it doesn't that.
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Uh, what you said, are you sure you're seeing a claim on file?
[AGENT][NEUTRAL] No claim on file.
[CUSTOMER][NEUTRAL] Uh, no claim on file. OK, but it is billed as, uh, like secondary to APL.
[AGENT][NEUTRAL] We are APL and we are the secondary.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so you are, uh, you're saying there is no claim on file.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, gonna move to the next question.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] No, no, different number.
[AGENT][NEUTRAL] OK, I'm ready for the policy number when you are.
[CUSTOMER][NEUTRAL] Yeah, it is 01.
[CUSTOMER][NEUTRAL] 951-054
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Name of the patient, date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Name is [PII] with the date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the build amount?
[CUSTOMER][NEUTRAL] $1,319.
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] OK, so can we move to the next one?
[AGENT][NEUTRAL] Mhm. Go ahead when you're ready.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so patient ID is.
[CUSTOMER][NEUTRAL] [PII] ML 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is [PII] with the date of birth of.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Not showing any claims on file for [PII].
[CUSTOMER][NEUTRAL] No on the.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so can we move to the next one.
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] 717
[CUSTOMER][NEUTRAL] 40.
[CUSTOMER][NEUTRAL] 85
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] No claims on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] OK, that's OK, we go to the next one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 67.
[CUSTOMER][NEUTRAL] 872 2
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No claims on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] Mhm OK, so can we move to the next one?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mm, uh, yeah, but it's ID is a little bit different like 60801.
[AGENT][NEUTRAL] That's our payer ID.
[CUSTOMER][NEUTRAL] Uh huh. OK, so let me just open the document because they feel it wrong here, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and document they also write 60,810. Can you verify it through the member name, date of birth, address or phone number?
[AGENT][NEUTRAL] And what's the member's name?
[CUSTOMER][NEUTRAL] Member name is
[CUSTOMER][NEUTRAL] OK, let me spell it because it is different. [PII]
[CUSTOMER][NEUTRAL] And last name is [PII].
[AGENT][NEUTRAL] Can you just spell it, please.
[CUSTOMER][NEUTRAL] [PII] sorry, [PII]
[AGENT][NEUTRAL] Alright, I'm gonna read this back phonetically to make sure I copied it down right. The last name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] No, no, no.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it's [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the first name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, no. [PII], uh wait, [PII].
[AGENT][NEUTRAL] Why is
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then, what is the patient's date of birth?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] The service is 6-13-2024.
[AGENT][NEUTRAL] OK. No claims on file for this patient. Would you like the policy number?
[CUSTOMER][NEUTRAL] Mm yeah.
[AGENT][NEUTRAL] Policy number is 02337095.
[CUSTOMER][NEUTRAL] 023370-95, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Oh, OK, can we move to the last question now?
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] 134 8.
[CUSTOMER][NEUTRAL] 86
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's the bill about?
[CUSTOMER][NEUTRAL] Mm let me check it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, it is $1490.
[AGENT][NEUTRAL] Is there an amount after the primary?
[CUSTOMER][NEUTRAL] Yeah, it is $148.43.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, we don't have a claim on file for that bill amount.
[CUSTOMER][NEUTRAL] OK, let me just check it again. Maybe there's a diff there are the difference for the uh bill amount.
[AGENT][NEUTRAL] I show one claim on file for a charge amount of 1150.
[AGENT][NEUTRAL] For that age of service.
[CUSTOMER][NEUTRAL] OK, let me open it completely.
[CUSTOMER][NEUTRAL] OK, can I, like, can I verify the procedure code so maybe it will be easy for me to find.
[AGENT][NEUTRAL] What's the procedure code?
[CUSTOMER][NEUTRAL] And there are three procedure codes 78452.
[CUSTOMER][NEUTRAL] 93015.
[CUSTOMER][NEUTRAL] A 9502.
[AGENT][NEUTRAL] We don't have any claims for those procedure codes.
[CUSTOMER][NEUTRAL] Mhm, OK, so no claim on file for that one.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So, like, can you spell your name?
[AGENT][NEUTRAL] My name is spelled [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK [PII] got you.
[AGENT][NEUTRAL] Anything else I can check on for you?
[CUSTOMER][NEUTRAL] OK, what does that work?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] No, uh, I want to call her phone number.
[AGENT][NEUTRAL] Call references my name with my last initial in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much sir for your assistance today.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Mhm you too bye bye.
[AGENT][NEUTRAL] Bye bye.