AccountId: 011433970860
ContactId: 20ce977c-2ea3-4b3c-82cb-e7c923b5fb47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 949270 ms
Total Talk Time (AGENT): 223019 ms
Total Talk Time (CUSTOMER): 331716 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/20ce977c-2ea3-4b3c-82cb-e7c923b5fb47_20250306T13:58_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] How you doing man?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Hi, hello?
[AGENT][NEUTRAL] I'm sorry, what's your name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah. Hi, this is [PII] calling from provider. Yeah, I need an
[AGENT][NEUTRAL] And how can I help you?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I need a climb sheet of.
[AGENT][NEUTRAL] OK, I can help you, [PII]. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, the policy number is gonna be.
[CUSTOMER][NEUTRAL] 02120
[CUSTOMER][NEUTRAL] 25 MLH.
[AGENT][NEUTRAL] 0212025
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] ML8
[CUSTOMER][NEUTRAL] One moment, one moment, right. I'll.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah. Can I tell you the policy number?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, the policy number is 02120.
[CUSTOMER][NEUTRAL] 25 MLH.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, the callback number is.
[CUSTOMER][NEUTRAL] [PII] of [PII].
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thanks a lot.
[CUSTOMER][NEUTRAL] I'm something
[CUSTOMER][POSITIVE] I'm so glad I guess with you.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Spell the patient's first and last name for me please.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The person's first name is [PII].
[AGENT][NEUTRAL] Spell the patient's first and last name, please?
[CUSTOMER][NEUTRAL] Yeah. The first name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] And the last name, can I say the last name?
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] Yeah. The last name is [PII].
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][POSITIVE] [PII] thank you.
[AGENT][NEUTRAL] And you're checking for a medical claim status?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the patient's date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, it's on [PII].
[AGENT][NEUTRAL] Thank you for that information and what is the date of service and the total charge?
[CUSTOMER][NEUTRAL] Yeah, [PII] is the date of service.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] Wait
[CUSTOMER][NEUTRAL] Yeah, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, the total amount is gonna be $425 and even.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the name of the provider?
[CUSTOMER][NEUTRAL] 99
[CUSTOMER][NEUTRAL] Yeah, the provider name is gonna be.
[AGENT][NEUTRAL] Or the practice name.
[CUSTOMER][NEUTRAL] Yeah, right Medical card PC.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, so the claim was received [PII].
[AGENT][NEUTRAL] Processed
[CUSTOMER][NEUTRAL] Yeah, one moment. Ja.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Processed on the same date, that is correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And we need a copy of the major medical explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah, is of benefits, right?
[AGENT][NEUTRAL] From the primary and then I have the claim number when you're ready.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] So you need the no benefit from the primary insurance, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So which is the primary insurance?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] You definitely wanna check with your patient, but our records show Florida Blue.
[CUSTOMER][NEUTRAL] You have the
[CUSTOMER][NEUTRAL] You have that?
[AGENT][NEUTRAL] Our records indicate Florida blue, but you also want to check with your patient to verify who the primary insurance carrier is.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, you had that it's the Blue Cross, right?
[AGENT][NEUTRAL] Florida [PII].
[CUSTOMER][NEUTRAL] Yeah, OK, so.
[CUSTOMER][NEUTRAL] So, go, go ahead.
[AGENT][NEUTRAL] So the claim number is 3553879.
[CUSTOMER][NEUTRAL] Yeah. And then
[AGENT][POSITIVE] And any other questions I can help out with today?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, mm, should they pro if this claim was denied or not.
[AGENT][NEUTRAL] OK, can you hear me OK?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, earlier I said that the claim was denied.
[AGENT][NEUTRAL] For the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Primary explanation of print.
[CUSTOMER][NEUTRAL] So what's the dinner date?
[CUSTOMER][NEUTRAL] His name was [PII] right?
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] One moment.
[AGENT][NEUTRAL] Any other questions I can help out with today, [PII]?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] I believe.
[CUSTOMER][NEUTRAL] Yeah, I had a question. One moment. I am taking notes about it.
[AGENT][NEUTRAL] OK, I'm gonna place you on a brief hold, OK?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Anything else?
[CUSTOMER][NEUTRAL] Yeah, I had a question. One moment. So I'm taking notes about on it.
[CUSTOMER][NEUTRAL] So, could you please provide me the primary insurance name?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Spell me?
[AGENT][NEUTRAL] [PII], the state [PII].
[CUSTOMER][NEUTRAL] Could you please tell me that?
[AGENT][NEUTRAL] The state, [PII].
[AGENT][NEUTRAL] The second word is blue, the color blue.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Stay for the blue, right?
[AGENT][NEUTRAL] So the primary insurance carrier is [PII].
[CUSTOMER][NEUTRAL] [PII], yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII] has doesn't, doesn't have any insurance on the name of [PII] Blue.
[AGENT][NEUTRAL] OK, that's what we show, sir.
[AGENT][NEUTRAL] So then you could reach out to your patient to confirm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah. Could you please provide me the effective date?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] The policy effective date is [PII]. The policy is active.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Is it correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yeah, [PII]. That's correct?
[AGENT][NEUTRAL] Any other questions I can assist with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, uh, still as an active or?
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] Currently active?
[CUSTOMER][NEUTRAL] Uh, one moment. Uh, could you please provide me the member ID?
[AGENT][NEUTRAL] It's the number that you gave me when you called.
[CUSTOMER][NEUTRAL] Who who.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Member ID please.
[CUSTOMER][NEUTRAL] For the primary member ID.
[AGENT][NEUTRAL] The member ID said.
[AGENT][NEUTRAL] I don't have any information for the primary carrier.
[CUSTOMER][NEUTRAL] Yeah, I need the primary member ID.
[AGENT][NEUTRAL] OK, you provided the policy number for APL that's our policy number.
[CUSTOMER][NEUTRAL] And what you do?
[AGENT][NEUTRAL] The 2120.
[CUSTOMER][NEUTRAL] On you.
[AGENT][NEUTRAL] 2175474
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] So are you asking for the Florida Blues uh policy number or APL?
[CUSTOMER][NEUTRAL] Could you please provide me the Florida memberlu member ID?
[AGENT][NEUTRAL] OK sir, we do not have their information.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] You didn't have that. How you only have that.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] I need the member ID of Florida Blue.
[AGENT][NEUTRAL] OK, we do not have their policy number, sir. You'll have to get that information from the patient.
[AGENT][NEUTRAL] You're speaking with American Public Life, so I can only give you information for American Public Life.
[CUSTOMER][NEUTRAL] Very
[CUSTOMER][NEUTRAL] Yeah, OK. Can you please provide me the mailing address? to to submit the to submit the primary UB.
[AGENT][NEUTRAL] American Public Lives mailing address?
[AGENT][NEUTRAL] OK, it's the same address that the claim was mailed to, which is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] Are you are you speaking with me?
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] and then?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] City, right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII] that's correct?
[AGENT][NEUTRAL] [PII]. That is correct.
[CUSTOMER][NEUTRAL] Yeah. Could you please provide me the fax number to provide the primary UOB?
[AGENT][NEUTRAL] 8877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 94
[CUSTOMER][NEUTRAL] 365
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 94
[AGENT][NEUTRAL] 23
[AGENT][NEUTRAL] Attention claims.
[CUSTOMER][NEUTRAL] Yeah, one moment. Uh, can I
[CUSTOMER][NEUTRAL] Can I confirm the fax number?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]. That's correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. So what is the timing filing limit?
[AGENT][NEGATIVE] To submit the primary EOB there's no timely.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No time is available.
[CUSTOMER][NEUTRAL] So how many days from the end of service?
[AGENT][NEUTRAL] What do you mean?
[CUSTOMER][NEUTRAL] Timely filing limit.
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] So could you please provide me the claim number?
[AGENT][NEUTRAL] Let me get that for you again.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 355.
[AGENT][NEUTRAL] 387 9.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK. Could you please provide me the reference number for this call and your name?
[AGENT][NEUTRAL] My name and today's date, [PII], [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Could you please, could you please spell spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] First initial last name is [PII]
[CUSTOMER][NEUTRAL] Yeah, and the reference number is today's date and your name and today's date, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So that's all.
[AGENT][POSITIVE] All righty. Thank you for calling APLit. Have a good day.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Right.