AccountId: 011433970860
ContactId: 281927ab-6163-4f93-a997-b74a54bb0910
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355089 ms
Total Talk Time (AGENT): 118697 ms
Total Talk Time (CUSTOMER): 140774 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/281927ab-6163-4f93-a997-b74a54bb0910_20250618T21:13_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] Yes.
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] calling from Exact Sciences Laboratories.
[AGENT][NEUTRAL] Could you spell your name for me, please?
[CUSTOMER][NEUTRAL] Uh, that is [PII].
[CUSTOMER][NEUTRAL] And your name is [PII], right?
[AGENT][NEUTRAL] No, it's [PII], but could you spell that again, please?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] OK, [PII], thank you.
[CUSTOMER][NEUTRAL] Could you please spell your name for me?
[AGENT][NEUTRAL] It is spelled [PII] and today's date will be used as the call reference.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have a callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And how may I assist you, AJ?
[CUSTOMER][NEUTRAL] Uh, with that denial and the eligibility of the patient.
[AGENT][NEUTRAL] You needing the status of a claim or eligibility.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, eligibility and then I just wanted to discuss with you as well.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] 01841211, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] And do you have a date of service?
[CUSTOMER][NEUTRAL] date of service I have is [PII].
[AGENT][NEUTRAL] And the total bill?
[CUSTOMER][NEUTRAL] $681.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, and you had a question in regards to the denial for this and the eligibility for the member?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[AGENT][NEUTRAL] For this policy, it's showing that it's still currently active with the effective date of [PII].
[CUSTOMER][NEGATIVE] don't like uh
[AGENT][NEUTRAL] And for the denial of that claim, it is showing that lab is not covered under the dismember's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, in the policy?
[CUSTOMER][NEGATIVE] This services, service is not good on the patient's policy.
[AGENT][NEUTRAL] It is showing the lab is not covered under the member's policy, correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So is it like patients, is it like patient responsibility or the provider side of?
[AGENT][NEUTRAL] That is to provide us discretion, we can't tell them how to build.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Caller reference number please.
[AGENT][NEUTRAL] At the beginning of the call I gave you call references my first name, last initial, and today's date.
[CUSTOMER][NEUTRAL] Oh yeah, yeah.
[CUSTOMER][POSITIVE] Yeah, I'm sorry for that.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] I do have one more claim.
[AGENT][NEUTRAL] Is it for the same member or different member?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK. And also you can check claim status via our secured portals that is [PII]. And may I have that next policy number, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0179 0691
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Data service and total bill.
[CUSTOMER][NEUTRAL] [PII] and the bill amount is $681.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And you're needing the eligibility for this member as well?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] For this member is showing the effective date is [PII] and currently active. And for that claim, the denial is the same where it is stating that lab is not covered under the patient's plan.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Um, thank you for the information. Have a great day.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day as well, [PII].