AccountId: 011433970860
ContactId: 187bd516-580a-4727-bd31-6ae55c34c225
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353799 ms
Total Talk Time (AGENT): 108527 ms
Total Talk Time (CUSTOMER): 95949 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/187bd516-580a-4727-bd31-6ae55c34c225_20250403T19:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] This call may be uh.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] calling from provider's office. How are you doing today?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][POSITIVE] I'm doing good. Thank you for asking. It's for claim status. Can you please help me out?
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] Yeah, it will be [PII] direct line.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Yeah, before we proceed, this call may be recorded for quality and training purpose. Would you like to continue?
[AGENT][NEUTRAL] Yes, may I have the policy number?
[CUSTOMER][NEUTRAL] Yes, just one.
[CUSTOMER][NEUTRAL] 02458549 ML 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth will be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $197 even.
[AGENT][NEUTRAL] And you're calling in for status of claim for this member you can also check claim status via our secured.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Portal that is secured. [PII] and I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] OK, but mm they're asking a claim number on the portal. I do not have it.
[AGENT][NEUTRAL] You will be able to pull it up by the member's patient account number as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Just a moment.
[CUSTOMER][NEUTRAL] Uh, may I know how to search the, the patient account number?
[AGENT][NEUTRAL] You need to know how to do what with the patient account number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, just a moment, I'm just checking.
[AGENT][NEUTRAL] And are you ready for the status of the claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so for this claim, it does look like we received it in twice. The first time we received it was [PII]. It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 354.
[AGENT][NEUTRAL] 983 8. The claim processed and denied that.
[CUSTOMER][NEUTRAL] 983 8.
[CUSTOMER][NEUTRAL] 3549838, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And would you like for me to continue?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] That claim process and denied office visits are not covered. Then we did receive it again on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 356.
[AGENT][NEUTRAL] 3555. That claim denied as a duplicate of the previous submitted claim.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, Ohhan?
[CUSTOMER][NEUTRAL] Uh, just a moment, I'm just looking.
[CUSTOMER][NEUTRAL] 354.
[CUSTOMER][NEUTRAL] 9838, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] But I was unable to pull the claim.
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEGATIVE] But I'm unable to pull the claim via portal.
[AGENT][NEUTRAL] OK, I just gave you the status of that claim.
[CUSTOMER][NEUTRAL] But I need the EOB, right?
[AGENT][NEUTRAL] May I have a fax number and I can submit it to you because it should be able to be pulled up that's the claim number.
[CUSTOMER][NEUTRAL] OK. It will be 702.
[CUSTOMER][NEUTRAL] 835.
[CUSTOMER][NEUTRAL] 1020.
[AGENT][NEUTRAL] OK, and is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, I have a few more claims.
[AGENT][NEUTRAL] Same member or different member?
[CUSTOMER][NEUTRAL] Yeah, it's a different number.
[AGENT][NEUTRAL] May I have that policy number please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 018949.
[CUSTOMER][NEUTRAL] 36 ML 8.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?