AccountId: 011433970860
ContactId: 01c71acf-8405-4b6c-8e25-a8828e401905
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 632619 ms
Total Talk Time (AGENT): 151245 ms
Total Talk Time (CUSTOMER): 206872 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/01c71acf-8405-4b6c-8e25-a8828e401905_20250124T20:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. I'm calling from the provider's office to check on the claim status. I apologize for that.
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII] and the policy number is 024.
[CUSTOMER][NEUTRAL] [PII] [PII] and number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, Patient's first name is [PII]. It's [PII] and the last name is [PII].
[CUSTOMER][NEUTRAL] And the date of birth is for [PII].
[AGENT][NEUTRAL] And may I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] The data services for [PII] with the bill amount of $542 even.
[AGENT][POSITIVE] Thank you, and you can also check claim status via our secured portal that is [PII] and I'm pulling it up for you now.
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for that claim, it does show that we received it on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 352.
[AGENT][NEUTRAL] 8612.
[AGENT][NEUTRAL] A process and it denied that office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] OK, I understand.
[CUSTOMER][NEUTRAL] Let's uh.
[AGENT][NEUTRAL] And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Uh yes, I do have a few more claims with me, ma'am.
[AGENT][NEUTRAL] OK, may I please have the next policy number?
[CUSTOMER][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] And for this one, can you like fax us a copy of you before this one, ma'am?
[AGENT][NEUTRAL] May I have the fax number?
[CUSTOMER][NEUTRAL] Yes, it would be [PII].
[CUSTOMER][NEUTRAL] And you can use my name for attention.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I will get the request submitted over for you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK, uh, shall I provide you with the next member's ID?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yes, it would be [PII] [PII] and the number [PII].
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, first name is [PII]. Last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Day of service and total bill.
[CUSTOMER][NEUTRAL] Yes, data services for [PII] with a total bill amount of $14,500 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And that is for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm not seeing a claim on file for that total bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, so it's a no claim on file, ma'am.
[AGENT][NEUTRAL] I'm not seeing one, but I'm gonna pull it up to see if I can find the member by its name.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm not finding a claim on file for that date of service.
[AGENT][NEUTRAL] For this member.
[CUSTOMER][NEUTRAL] OK, ma'am. I understand.
[CUSTOMER][NEUTRAL] There's no problem, ma'am. I'll submit a new claim. Could you provide me with the payer ID and mailing address to submit the claim to?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Because the policy number that you gave me is actually an old policy number.
[AGENT][NEUTRAL] So I'm trying to find out which one is the correct policy number that it could be listed under.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] OK, so for this member, this member is not active with us they haven't been active with us since [PII].
[CUSTOMER][NEUTRAL] OK, so he's not active since [PII], is that right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Uh 2.
[CUSTOMER][NEUTRAL] And there's no other policies with him right now, is that right?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, could you provide me with the specific date of the policy was terminated on?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Thank you for that, ma'am and yes that would be it for this one and I have one last thing with me if you can help me with that.
[AGENT][NEUTRAL] May I have that policy number?
[CUSTOMER][NEUTRAL] Yes, give me one second. OK, the policy number would be 023.
[CUSTOMER][NEUTRAL] 371-13 Mike Lima number 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes. First name is
[CUSTOMER][NEUTRAL] [PII]. Last name is [PII].
[CUSTOMER][POSITIVE] Thank you for the same and
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][NEUTRAL] May I have the date of service and total bill?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] Total bill amount is $3,045.
[AGENT][NEUTRAL] And that's 3,045.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not seeing a claim for that total bill charge.
[CUSTOMER][NEUTRAL] I understand ma'am. We submit a new thing. Could you provide me the
[CUSTOMER][NEUTRAL] Uh, can you please verify if this member is activity for this data service?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Could you provide me with the effective dates for this patient?
[AGENT][NEUTRAL] Yes, it is showing that the effective date is [PII] and currently active.
[CUSTOMER][NEUTRAL] OK, thank you for that, ma'am. And what would be the time you filing for us to submit a new claim?
[AGENT][NEGATIVE] We have no timely filing.
[CUSTOMER][NEUTRAL] OK, thank you for that. And what would be the payer ID and mailing address for this?
[AGENT][NEUTRAL] The electronic payer ID is [PII].
[AGENT][NEUTRAL] 801.
[AGENT][NEUTRAL] And the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, could you provide me with the zip code once more?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Thank you for that, ma'am, and that would be it. Could you please provide me the call reference number for this?
[AGENT][NEUTRAL] The call reference will be my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you for that, ma'am. You've been a great help and I hope you have a great day ahead. Bye-bye.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life. You have a great day as well.
[CUSTOMER][POSITIVE] Thank you bye bye.