AccountId: 011433970860
ContactId: 14d02df1-accc-4e8a-b8dc-fa202d4ac336
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 518690 ms
Total Talk Time (AGENT): 157969 ms
Total Talk Time (CUSTOMER): 138950 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/14d02df1-accc-4e8a-b8dc-fa202d4ac336_20250519T18:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm calling from provider's office. I'm checking for claim status.
[AGENT][NEUTRAL] OK, I can help you with claim status. May I please get your name and your callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] my extension direct line.
[AGENT][NEUTRAL] Thank you, [PII]. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and Ms. [PII]'s policy number please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Policy number is 109.
[CUSTOMER][NEUTRAL] 323-026
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, we've got one too many digits in there. Can you repeat the policy number for me?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] One moment, I have just now closed my ID card.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] Yeah, that is 109.
[CUSTOMER][NEUTRAL] 323
[CUSTOMER][NEUTRAL] 026.
[AGENT][NEUTRAL] OK, let me pull that up.
[AGENT][NEUTRAL] OK, is that an APL policy?
[CUSTOMER][NEUTRAL] Yeah, this is uh this is for Cigna.
[AGENT][NEUTRAL] No, we're not Cigna.
[CUSTOMER][NEUTRAL] American public, public life.
[AGENT][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Do you see a policy number for American Public Life?
[CUSTOMER][NEUTRAL] I can see Cigna's uh policy number back of the card. I can see American Pub, Public Life.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, do you have the member's social?
[AGENT][NEUTRAL] And I'll try to pull the policy in that way.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Fortunately I do not have so I have my birth address.
[AGENT][NEUTRAL] OK. Can you spell the, and you spell the member's first name [PII]?
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][NEUTRAL] OK, how do I spell the last name?
[CUSTOMER][NEUTRAL] And the last name is
[CUSTOMER][NEUTRAL] Yes. Uh, the last name spelled as [PII].
[AGENT][NEUTRAL] OK, let me see if I can find her by her name real quick.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I believe I have her.
[AGENT][NEUTRAL] And what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Date of service is [PII] for the charge amount of
[CUSTOMER][NEUTRAL] $7300.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, we have built a claim as primary.
[AGENT][NEUTRAL] OK alright and what is the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] Atlantic Surgery Center.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look at this claim for us and I'll be right back, [PII].
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding for me, [PII] so looking on data service of [PII].
[AGENT][NEUTRAL] I do not find a claim on file for Atlantic Surgery Center for Ms. [PII].
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yeah, I'm sorry, actually my mic was on mute. Uh, I'm a little bit confused actually.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, because uh when I see the member ID card, it shows us the Cigna's ID card, and when I look at the back of the card, it shows us the payer ID 62308.
[CUSTOMER][NEUTRAL] Uh, for American public life.
[CUSTOMER][NEUTRAL] Is the number active for the rate of service with you?
[AGENT][POSITIVE] Yes, yes, hold on and I'll get over there and I'll give you the effective date and the policy number and I'll also give you the claim information so you can submit the claim.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please go ahead, please.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] She does have an active policy with us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the effective date of her, yes, the effective date of her policy is [PII].
[CUSTOMER][NEUTRAL] Effect your date?
[AGENT][NEUTRAL] The policy is current.
[AGENT][NEUTRAL] The payer ID number to send the claims to?
[AGENT][NEUTRAL] It's 60801.
[AGENT][NEUTRAL] The member's policy number.
[AGENT][NEUTRAL] is 230-4274.
[CUSTOMER][NEUTRAL] 2304274, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Oh, I see you are a third party for signal as per the, uh, note mentioned for this account.
[AGENT][NEUTRAL] We are the secondary.
[CUSTOMER][NEUTRAL] So are you the primary for this number?
[AGENT][NEUTRAL] No, we're the secondary.
[CUSTOMER][NEUTRAL] Oh, who is the primary, who is the primary reason?
[AGENT][NEUTRAL] It sounds like you have Cigna as the primary. Cigna is the major medical. We're not major medical.
[CUSTOMER][NEUTRAL] After the signa directly then. OK.
[CUSTOMER][POSITIVE] OK, thanks for the information. I'll call the Cigna and get the information from there.
[AGENT][NEUTRAL] You
[AGENT][POSITIVE] OK. All right. Well, you're very welcome. Is that everything I can help you with today?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, well, you have a wonderful week and thank you for calling APL. Bye-bye, sir.
[CUSTOMER][POSITIVE] Thank you.