AccountId: 011433970860
ContactId: 089d099b-313d-4f66-bf34-0742f5fdaa4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406029 ms
Total Talk Time (AGENT): 112067 ms
Total Talk Time (CUSTOMER): 151127 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/089d099b-313d-4f66-bf34-0742f5fdaa4e_20250303T18:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office and looking on a claim status. Can you help me?
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is 1659386.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I have the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Yeah, the patient's name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] It's [PII] for $150 even.
[AGENT][NEUTRAL] Thank you. For future reference, you may visit our website at [PII] to check claim status as well.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Oh, OK. And actually I have.
[AGENT][NEUTRAL] This process.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, yeah, I have something to say for it. And actually, upon checking from the primary, it's a $50 of patient responsibility for the secondary to be covered. And we have got the payment for $50 from your side and balance $10. It's outstanding as previous representative stated, it is not covered.
[AGENT][NEUTRAL] That is correct. Please be advised that verification of coverage does not guarantee the payment of a claim. So this claim processed under claim number 3530346, the benefit amount allows $50 so any remaining balance becomes patient's responsibility.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So it's a patient responsibility. Uh, since for a claim only $50 is allowed for this policy.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. And can you fax me the EOB?
[AGENT][NEUTRAL] Yes, may I have your fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] I have [PII]. I'll fax that right over.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And may I know when we will receive it?
[AGENT][NEUTRAL] As long as it takes to transmit over. I'm sending it over now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh yes, I have one more patient to verify.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just waiting on the system, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Uh, yeah, the policy number is
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] 0 CG 0064289.
[AGENT][NEUTRAL] That is not our policy number.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Oh, so it's American Republics insurance is covered by public life?
[AGENT][NEUTRAL] American Public Life, yes, but that is not our policy number.
[CUSTOMER][NEUTRAL] Uh, no, actually, the plan is American Republic policy.
[AGENT][NEUTRAL] Do you have the social security number or I can do a name search?
[CUSTOMER][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] The patient name is [PII].
[AGENT][NEUTRAL] Can you spell it, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Lifetime.
[CUSTOMER][NEUTRAL] Last name is spelled as [PII].
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And is she the policyholder?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] She is not pulling up.
[AGENT][NEUTRAL] Do you have the social security number?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] She is not pulling up with this name and date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh sure, sir. I will check with the patient. And can you spell your name for me?
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] So, it's [PII] and [PII] is the last name.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And your name and today's date is the call reference?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're so welcome, ma'am. Thank you for calling American Public Library. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] For the information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You too as well. Thank you. Bye.