AccountId: 011433970860
ContactId: 1a75864d-ec56-428e-928a-c958e28e4306
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279940 ms
Total Talk Time (AGENT): 113336 ms
Total Talk Time (CUSTOMER): 118092 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/1a75864d-ec56-428e-928a-c958e28e4306_20250520T19:07_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] Well
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on the claim status.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh the policy number is going to be 02552103.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, patient first name is [PII] and last name is [PII]. The date of birth is going to be [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for status. May I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Total bill.
[CUSTOMER][NEUTRAL] But the total bill is $430 even $430.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you can also check claim status via our secured portal that is [PII] and you're calling in for status of claim for data service of 22425 total bill 430. It does show that we do have that claim on file.
[CUSTOMER][NEUTRAL] And you can also check things as you know.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mhm. Yes, that's correct.
[AGENT][NEUTRAL] The receipt date was 3-10-25. It was processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That claim number is 357.
[AGENT][NEUTRAL] 484-7. That claim denied that office visits are not covered. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Are not covered
[CUSTOMER][NEUTRAL] Is there
[CUSTOMER][NEUTRAL] OK, offices are not cover uh whose plan provider plan or the patient's plan.
[AGENT][NEUTRAL] Under the patient's plan.
[CUSTOMER][NEUTRAL] OK. Uh, one second.
[CUSTOMER][NEUTRAL] Um, covered.
[CUSTOMER][NEUTRAL] May I know the patient's plan type?
[AGENT][NEUTRAL] This is their supplemental to their primary.
[CUSTOMER][NEUTRAL] OK, like H M O E P Y E P V O.
[AGENT][NEUTRAL] It is not a major medical. This is their supplemental, so it's not a PPO, HMO or any of that.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, after visits are not covered under the patient's plan, uh.
[CUSTOMER][NEUTRAL] You said it is supplement, right?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] OK, I need the patient's plan type. One second. Can you repeat that one?
[AGENT][NEUTRAL] This is a supplemental plan.
[CUSTOMER][NEUTRAL] OK what is the prime limit?
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] For appeal no timely filing. OK. What is the apple timely uh mailing address or the fax number we have to send me the bills.
[AGENT][NEUTRAL] The mailing address is [PII].
[CUSTOMER][NEUTRAL] The billing address
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the fax number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Can I get the call reference number and can you spell out your name for my documentation?
[AGENT][NEUTRAL] The call reference will be my first name [PII], which is spelled [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] OK. Thanks, [PII]. Have a nice day. Thanks for assisting me today.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great, have a great day.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] So