AccountId: 011433970860
ContactId: 0b7c549e-65ad-413b-9f77-78c6bd173c6e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 588500 ms
Total Talk Time (AGENT): 196341 ms
Total Talk Time (CUSTOMER): 155348 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/0b7c549e-65ad-413b-9f77-78c6bd173c6e_20250217T19:33_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] Hi, this is [PII]. I'm calling on behalf of provider checking claim status on the recorded line. Can I have your name again, please?
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] Very good. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] Yes, ID number I have is
[CUSTOMER][NEUTRAL] 0216289
[AGENT][NEUTRAL] And that's 0216289?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, we're missing a number.
[CUSTOMER][NEUTRAL] 0216289 you said it's not the complete ID?
[AGENT][NEGATIVE] Yes, we're missing a number.
[CUSTOMER][NEUTRAL] Can we do a name search?
[AGENT][NEUTRAL] Yes, may I have the first and last name, please?
[CUSTOMER][NEUTRAL] Yes. Patient first name I have is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Last name is [PII].
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] You want the date of birth as well?
[AGENT][NEUTRAL] Not right now. I'm pulling the name up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can go ahead and give me the date of birth now please.
[CUSTOMER][NEUTRAL] OK. The date of birth I have is [PII].
[AGENT][POSITIVE] Thank you. [PII].
[AGENT][NEUTRAL] [PII], it's 621-89.
[CUSTOMER][NEUTRAL] 621.
[CUSTOMER][NEUTRAL] 62189.
[CUSTOMER][NEUTRAL] OK, 621-89. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And you're calling in for status of claim for this member. May I please have the date of service and total bill?
[CUSTOMER][POSITIVE] Yes, the deal of service I have is
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. The bill amount is $2,191.
[AGENT][NEUTRAL] Thank you and you can also check claim status via our secured portal that is [PII]. I'm pulling that information up for you now.
[AGENT][NEUTRAL] And that's for $2,191?
[CUSTOMER][NEUTRAL] 2 $191 yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not seeing that total bill amount.
[AGENT][NEUTRAL] Yes, I'm not seeing that total bill that you're giving me for that date of service.
[CUSTOMER][NEUTRAL] OK, so that means there's no claim on file.
[AGENT][NEUTRAL] Yes, for that total bill.
[CUSTOMER][NEUTRAL] OK. Can I have the policy effective date for this patient.
[AGENT][NEUTRAL] The policy affect the data showing 214 of 22 and currently active.
[CUSTOMER][POSITIVE] You too. Thank you. And the time of filing you mean?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] The fee schedule?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] OK, so I did pull the image up that we received in. It looked like there's two claims.
[AGENT][NEUTRAL] In the system.
[AGENT][NEUTRAL] And it actually totals more than 2,191.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But that's the amount that you all have listed on the bill.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The total charge for this claim is actually $4,513.
[CUSTOMER][NEUTRAL] Uh, can you tell me the procedure code?
[AGENT][NEUTRAL] It is, we received the claim for the date of service of [PII].
[AGENT][NEUTRAL] And also,
[AGENT][NEUTRAL] The procedure codes, there's several, so there's 10.
[AGENT][NEUTRAL] On one page.
[AGENT][NEUTRAL] And 8 on the other.
[CUSTOMER][NEUTRAL] Uh, can you just tell me the procedure code? I just want to check if this, uh, same procedure code that we're looking for. That is not just want to make sure that, uh, we are looking in the right claim.
[AGENT][NEUTRAL] I have D 0350.
[AGENT][NEUTRAL] D 2391.
[AGENT][NEUTRAL] D1110.
[AGENT][NEUTRAL] D 1206.
[AGENT][NEUTRAL] These are the claims that we received in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's the claim that I'm looking for.
[AGENT][NEUTRAL] Yes, and again, the total bill charge is incorrect on the claim. So the total amount is showing $4,513.
[CUSTOMER][NEUTRAL] OK, and the claim was complete process or still under review?
[AGENT][NEUTRAL] That claim was processed. It was received on [PII]. It was processed on [PII]. That claim number is showing 35.
[AGENT][NEUTRAL] 39121.
[AGENT][NEUTRAL] It processed and it made a payment in the amount of $41.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the issue date of the payment on [PII].
[AGENT][NEUTRAL] Yes, and would you like the check number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] The check number is 20.
[AGENT][NEUTRAL] 19
[AGENT][NEUTRAL] 831.
[AGENT][NEUTRAL] It does show that the $35 was applied to the member's deductible and then the patients owe $119.
[CUSTOMER][NEUTRAL] OK, and it's a single check?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. and the check was sent to which address?
[AGENT][NEUTRAL] You will have to verify that address based off of the claim that we received in.
[CUSTOMER][NEUTRAL] OK, let me give you this. Uh, the first one, the address I have is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] The check if C still outstanding.
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] So for this I will have to send that over to have them to verify if the check had cleared the bank or not. I'm not able to pull that up in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you fax us a copy of your?
[AGENT][NEUTRAL] Yes, may I have that fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you please keep attention my name?
[AGENT][NEUTRAL] And that is [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And I will get that submitted over to you. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, that's all for today. Thank you so much for your help and you have a wonderful day.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life. You have a great day as well.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you bye.