AccountId: 011433970860
ContactId: fd60609a-0bf8-4ba5-b86e-9034c89d564e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266160 ms
Total Talk Time (AGENT): 119952 ms
Total Talk Time (CUSTOMER): 93306 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/fd60609a-0bf8-4ba5-b86e-9034c89d564e_20250522T18:19_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] calling from product office for checking claim status.
[AGENT][NEUTRAL] OK, I could check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, my callback number is [PII].
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. The policy number is D as in Delta 41800176.
[AGENT][NEUTRAL] OK, so [PII], that's not one of our policy numbers. That is through, uh, they're called 90-degree benefits.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I can give you their information and transfer you to them or if you have the member's social I can see if they have a policy with us.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, wait a moment. I have a number. Can you please check with that?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that um alrighty what was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, uh, do you have that bill amount?
[CUSTOMER][NEUTRAL] Yes, the bill amount is 300, uh sorry.
[CUSTOMER][NEUTRAL] $219 290.
[AGENT][NEUTRAL] You said 290?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, so I will let you know, [PII], that this policy did terminate [PII]. Um, did you still want me to check to see if this claim has been received?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Was this with, is it uh Arizona arthritis uh rheumatologist?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Rheumatology Associates, yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, um, so we did receive this claim, um, of course we were unable to pay that benefit as uh the services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you need that claim number?
[CUSTOMER][NEUTRAL] May I know what is the patient's policy affected?
[AGENT][NEUTRAL] Oh, sure, um, effective date was [PII].
[CUSTOMER][NEUTRAL] Termination date is [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And can I have the claim details?
[AGENT][NEUTRAL] Uh, that claim number is 3514987.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course, did you need that receiving process date?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] So this claim was received [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, but ma'am, still we didn't receive the year before this claim, ma'am. Can you please send now to fax.
[AGENT][NEUTRAL] Sure, I can send that EIB to you. Uh, what was that fax number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm gonna read that back to you to make sure I heard that correctly. That was [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, ma'am, you're correct.
[AGENT][NEUTRAL] Alright, I will go ahead and send that now. I should get it within about 10 minutes or so. Uh, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am, that's all. May I know your name and can I have the call reference number for our call?
[AGENT][NEUTRAL] Sure, reference number would just be my first name, last initial, and today's date. Uh my name is spelled [PII]
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Of course, thanks for calling APL have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][POSITIVE] Thanks. Bye-bye.