AccountId: 011433970860
ContactId: 1e1bb06e-c59f-4702-a982-67a843e766d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 481910 ms
Total Talk Time (AGENT): 130834 ms
Total Talk Time (CUSTOMER): 195200 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/1e1bb06e-c59f-4702-a982-67a843e766d2_20250513T17:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] OK. Hi, this is [PII] calling to check on uh claim status. The first initial and my last name is [PII].
[AGENT][NEUTRAL] OK, I can verify claim status for you, [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Sure. Oh, that would be.
[CUSTOMER][NEUTRAL] 02300838.
[AGENT][NEUTRAL] OK, thank you one moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah. Sure.
[CUSTOMER][NEUTRAL] Yeah, that would be [PII].
[AGENT][NEUTRAL] Thank you. And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and you say you're calling for a claim status correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] That would be [PII]. And the bill charges of $425 even.
[AGENT][NEUTRAL] And do you have the balance after primary is process the claim?
[CUSTOMER][NEUTRAL] Mm mm mm uh.
[CUSTOMER][NEUTRAL] No, I do see this claim was submitted to American Public Life as a primary, so yes.
[AGENT][NEUTRAL] OK, uh, this call is secondary only, and you said [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] And I'm sorry, how do you spell out your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect, thank you so much for that.
[AGENT][POSITIVE] Alright, you're welcome.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] So the provider's office Mercy Go Health urgent cash.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] You said urgent uh East Mercy urgent care?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, what's the tax ID number?
[CUSTOMER][NEUTRAL] That would be [PII].
[AGENT][NEUTRAL] OK, I show a claim it says East Mercy East Ambulatory Services.
[CUSTOMER][NEUTRAL] Ambulatory.
[AGENT][NEUTRAL] And the claim process is needing primary EOB.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, this claim was denied on?
[AGENT][NEUTRAL] Uh, this claim process on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so do you have the information like who's the primary for this number?
[AGENT][NEUTRAL] Alright, you have to contact the member. The policy they have with us is secondary online.
[CUSTOMER][NEUTRAL] OK, what would be the client's mailing address? Is it the same as the one we submitted?
[AGENT][NEUTRAL] Uh, yes, it should be [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] What would be the timely firing limit?
[AGENT][NEGATIVE] Uh, there is no timeline.
[CUSTOMER][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK. So I'm ready for the claim number whenever you're ready.
[AGENT][NEUTRAL] Uh, sure, claim number is 3413813.
[CUSTOMER][NEUTRAL] OK, one quick moment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, uh, so just have to generate a reference number for this number. I have one more claim to look up for another member. So would you be able to help me with that as well, please?
[AGENT][NEUTRAL] Uh, sure, give me one moment.
[AGENT][NEUTRAL] OK, and what is that policy number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And the call reference number, is it going to be the same for the entire call?
[AGENT][NEUTRAL] Uh, we don't give reference numbers. If you like, you may use my name in today's date.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Why not.
[CUSTOMER][NEUTRAL] OK, so I'm ready with the next ID which is.
[CUSTOMER][NEUTRAL] 02300.
[CUSTOMER][NEUTRAL] 830.
[CUSTOMER][NEUTRAL] One moment, one moment, I'm sorry.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK. Uh, so, I'm sorry, that is for the same number actually, so.
[AGENT][NEUTRAL] OK, uh, data service and amount of the charge?
[CUSTOMER][NEUTRAL] Mm sorry.
[CUSTOMER][NEUTRAL] Uh, that would be [PII] for the build amount of $430 even so when this claim was submitted as primary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Uh, show that claim process as well as needing the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, and this was denied on?
[AGENT][NEUTRAL] Uh, this was processed on.
[CUSTOMER][NEUTRAL] This is.
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] What would be the claim number? Does it end with 1753?
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And even if we submit the.
[CUSTOMER][NEUTRAL] You will be from the primary now also the claim would be processed right?
[AGENT][NEUTRAL] I'm sorry, say again.
[CUSTOMER][NEUTRAL] Yeah, even if you submit the claim now, it's been like more than 365 days or it's been more than a year. So even if you submit the claim with the primary, you'll be, will the claim be processed and paid.
[AGENT][NEGATIVE] Yes, like I said, we don't have time uh timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much for that. And just another small piece of information which will be needed, that would be, so for American Public Life, that is actually uh a secondary for the members.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We are secondary.
[CUSTOMER][NEUTRAL] OK. So you'll be secondary for all the members. So, is that correct?
[AGENT][NEUTRAL] Yes, this is a secondary policy only.
[CUSTOMER][POSITIVE] Perfect. Uh, thank you so much for that, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And yeah, happy rest of your day. Bye-bye.
[AGENT][POSITIVE] Alright, you too. Thanks for calling APL. Bye.
[CUSTOMER][NEUTRAL] Yeah.