AccountId: 011433970860
ContactId: 10d40a7c-efc0-4795-9884-dad904a26eac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268119 ms
Total Talk Time (AGENT): 112354 ms
Total Talk Time (CUSTOMER): 70670 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/10d40a7c-efc0-4795-9884-dad904a26eac_20250130T15:40_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] Yes, ma'am. I don't know if I have the right number or not. I was calling to try to um check the status of the claim.
[AGENT][NEUTRAL] OK, may I have your name and a callback number?
[CUSTOMER][NEUTRAL] Um, it's [PII], initial [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], may I please have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, it is.
[CUSTOMER][NEUTRAL] 022.
[CUSTOMER][NEUTRAL] 30028.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth? Go ahead.
[CUSTOMER][NEUTRAL] Sure. And what was your
[CUSTOMER][NEUTRAL] Um, it's [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You were asking what was my name?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that is [PII] and that is spelled [PII]
[AGENT][NEUTRAL] [PII] last initial of [PII] and then today's date will be used as the call reference.
[CUSTOMER][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] You're welcome, and may I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] 9124.
[CUSTOMER][NEUTRAL] $552.
[AGENT][NEUTRAL] And I did pull that claim up for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So for that claim it does show that we received it on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 351.
[AGENT][NEUTRAL] 2896. It shows that that claim processed and it denied.
[AGENT][NEGATIVE] That this member was not eligible at that time of service.
[CUSTOMER][NEUTRAL] OK, do you have their effective dates?
[AGENT][NEUTRAL] Their effective date is showing [PII].
[AGENT][NEUTRAL] Let me pull.
[AGENT][NEUTRAL] Now with this policy, this is an indemnity policy, which is normally a weekly benefit. So if that benefit was not paid for that week, they were not eligible at that time.
[AGENT][NEUTRAL] So it looks like the member did not have that benefit at the time of that service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you said what did you say? What type of plan?
[AGENT][NEUTRAL] It's an indemnity policy, which is a limited benefit.
[CUSTOMER][NEUTRAL] Limited benefits.
[CUSTOMER][NEUTRAL] [PII], is that A [PII] N [PII] T [PII]?
[AGENT][NEUTRAL] Indemnity is I N D E M N I T Y.
[CUSTOMER][NEUTRAL] Oh, I was a little backwards on that.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] OK, so it's a limited benefit that's paid weekly?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. And is there, so is there an ending date on that policy or it just, it was just for that week?
[AGENT][NEUTRAL] It shows that it was for that week, but let me see if this policy is currently active.
[AGENT][NEUTRAL] No, the policy actually turned in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you, do you have a date because this is [PII].
[AGENT][NEGATIVE] Yes, it shows that it ended on [PII], but during that week they did not have benefits.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Oh, that is it.
[AGENT][POSITIVE] Well, I do wanna thank you so much for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you, bye.
[CUSTOMER][NEUTRAL] Bye bye.