AccountId: 011433970860
ContactId: f491f638-6de6-4492-8cf1-4e615a51e5b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 287420 ms
Total Talk Time (AGENT): 86433 ms
Total Talk Time (CUSTOMER): 105788 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/f491f638-6de6-4492-8cf1-4e615a51e5b8_20250207T19:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from provider's office to check on the claim status.
[AGENT][NEUTRAL] Yeah, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, sir, can I gotta get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's 01887351 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] All right, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh, the first name is [PII] and the last name is [PII], [PII]
[AGENT][NEUTRAL] OK. Do you have the date of birth? Mhm.
[CUSTOMER][NEUTRAL] And the date of birth is, yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It's [PII], and the total charge is $4,195 even.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] And can you please spell out your name for documentation?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, [PII], I'm sorry, what was the name of the provider's office?
[CUSTOMER][NEUTRAL] The provider's office is Pediatrics Medical Group of Florida Incorporation.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so I did find this claim, [PII], uh, we were unable to pay a benefit as office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] So, can I get the claim status for this claim?
[AGENT][NEUTRAL] The status, uh, it has been denied office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK, one moment.
[CUSTOMER][NEUTRAL] So, OK. So, can I get this EOB through fax for reference because we received an EOB that's stating that information is in notification. So the UOB is gettinging different.
[AGENT][POSITIVE] Yeah, I can send that back to you.
[AGENT][NEUTRAL] I can fax it to you. uh, what's that fax number for you?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] 954
[CUSTOMER][NEUTRAL] 333354 3
[AGENT][NEUTRAL] OK, I'm going to read that back to make sure I heard that correctly. That was [PII].
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, and I just put this to your attention.
[CUSTOMER][NEUTRAL] Uh, to the counter number which is 493643.
[AGENT][NEUTRAL] I'm sorry, could you repeat that number?
[CUSTOMER][NEUTRAL] 493643.
[AGENT][NEUTRAL] Got it. OK. Alrighty. I will send that to you now. Should get it here in maybe 1015 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] Uh, can I get the call reference number?
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. uh so my last initial is A.
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[CUSTOMER][POSITIVE] Yeah, thank you so much for your wonderful assistance. Have a happy weekend.
[AGENT][POSITIVE] Of course. Thank you, you too. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.