AccountId: 011433970860
ContactId: 0fdc69dc-928e-4581-9840-7bc68e960706
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285369 ms
Total Talk Time (AGENT): 90899 ms
Total Talk Time (CUSTOMER): 158248 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/0fdc69dc-928e-4581-9840-7bc68e960706_20250128T15:04_UTC.wav
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[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII], this is [PII] calling from provider's office. I'm looking for a claim denial information for a member.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] That's [PII] and it's a direct line.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, the policy number is 01.
[CUSTOMER][NEUTRAL] 829
[CUSTOMER][NEUTRAL] 093 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for status of a claim?
[CUSTOMER][NEUTRAL] Yeah, actually this claim was initially denied for primary explanation of benefit, and we had submitted the primary explanation of benefit through mail on [PII]. So I just wanted to make sure, like, have you received the primary explanation of benefit, uh, has the claim been reprocessed?
[AGENT][NEUTRAL] May I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Yeah, date of services for [PII] with the total bill $724 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So for that claim, it does look like we received it on [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] That claim number is 354-4428. It shows that it processed and it made a payment in the amount of $75.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so it was been paid on [PII], right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And could you let me know how was this claim paid?
[AGENT][NEUTRAL] Via check.
[CUSTOMER][NEUTRAL] Check payment, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, was it a single payment or a bulk payment?
[AGENT][NEUTRAL] It is a single payment and are you ready for the check number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That check number is 20.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 19
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 976.
[CUSTOMER][NEUTRAL] 976, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, could you let me know the check date as well? Yeah, I know that, yeah.
[AGENT][NEUTRAL] That would be [PII].
[CUSTOMER][NEUTRAL] OK, just a second.
[CUSTOMER][NEUTRAL] So, has it, has this check been cashed?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] If I'm not able to verify that, I will have to send a check verification.
[CUSTOMER][NEUTRAL] And do you have any passion across?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And I'm not able to verify, so I will have to send a check verification and it can take up to 24 to 48 hours.
[CUSTOMER][NEUTRAL] 8658.
[CUSTOMER][NEUTRAL] Got it. And uh before that, could you just let me know the where was the check mailed to? Uh, sure, it's [PII].
[AGENT][NEUTRAL] You will have to verify that mailing address with me.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] So you are applying for the check later, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, and it will be taking 24 to 48 hours.
[AGENT][POSITIVE] Yes, that would be correct.
[CUSTOMER][NEUTRAL] So will there be any like escalation number or will it only be the call reference number?
[AGENT][NEUTRAL] The car reference will be my first name, [PII], which is spelled [PII] last initial of [PII] in today's date.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Got it. Uh, thanks a lot, [PII]. Thanks for the help.
[AGENT][NEUTRAL] You're welcome. Is there anything else that I can assist you with today, Java?
[CUSTOMER][NEUTRAL] Uh, uh, that would be it. And [PII], my name is [PII].
[AGENT][NEUTRAL] [PII], sorry about that.
[CUSTOMER][POSITIVE] Yeah, that's fine. Uh, so thanks a lot for the help.
[AGENT][POSITIVE] You're welcome. And thank you so much for calling American Public Life, [PII]. Have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.