AccountId: 011433970860
ContactId: 2a934bc9-8627-4930-b4a0-352f233b97e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310299 ms
Total Talk Time (AGENT): 116729 ms
Total Talk Time (CUSTOMER): 154644 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/2a934bc9-8627-4930-b4a0-352f233b97e8_20250429T19:52_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. This is [PII] from Doctor [PII]'s office. How are you doing?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] Good, good, good. Thank you. Yeah, I need to check um claim status.
[AGENT][NEUTRAL] OK, I can help you with that. Could I get a callback number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and the policy number you're calling on?
[CUSTOMER][NEUTRAL] It's 01994118 MLA.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And the patient's name.
[CUSTOMER][NEUTRAL] First name uh [PII], last name [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you did say status. What is the date of service?
[CUSTOMER][POSITIVE] And they do service.
[CUSTOMER][NEUTRAL] It's uh [PII] total amount is $1000.
[CUSTOMER][NEUTRAL] We submit the claim through um United Healthcare. United Healthcare applied that to her deductible and on [PII], that was uh 4 to.
[CUSTOMER][NEUTRAL] American public.
[AGENT][NEUTRAL] OK, and you just say [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I do not show we have a claim on file.
[CUSTOMER][NEUTRAL] You don't have anything yet?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, do you have the member as an active? Probably it's not active anymore.
[AGENT][NEUTRAL] No, the policy is no longer active. It looks like this policy did cancel on [PII]. So if and when received, it would deny as non-covered due to policy cancellation.
[CUSTOMER][NEUTRAL] it was
[CUSTOMER][NEUTRAL] So what's cancel one.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] OK, that is good to know. That's no point me to send anything anymore.
[CUSTOMER][NEUTRAL] Let me see, hold on, and what about um.
[CUSTOMER][NEUTRAL] Let me see, hold on a second.
[CUSTOMER][NEUTRAL] I gave you the 199118 ML 8 hold on and I have another number in here.
[AGENT][NEUTRAL] Mhm. 1994118.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that is the one I, I, I'm pulling up at this time.
[CUSTOMER][NEUTRAL] Mhm, yeah, 0199411AMLA mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have another member ID in here.
[AGENT][NEUTRAL] OK, what is that?
[CUSTOMER][NEUTRAL] It is 02458642 MLA.
[CUSTOMER][NEUTRAL] I don't know if she maybe got confused with the number.
[AGENT][NEUTRAL] OK, let me look here. November. Now this one was active at the time, so let me see 92524.
[CUSTOMER][NEUTRAL] And that was the start date [PII]. Mhm.
[AGENT][NEUTRAL] And the total bill.
[CUSTOMER][NEUTRAL] It's the same as the same uh data service, the same patient.
[AGENT][NEGATIVE] I didn't get it the first time. What is the what is the total bill?
[CUSTOMER][NEUTRAL] OK. OK. So it is 1000.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show that this claim was received. It looks like, let me pull it up here, 35.
[CUSTOMER][NEUTRAL] So the correct um it's 02458 mhm.
[AGENT][NEUTRAL] I show a payment was made of $612.04 to the provider.
[CUSTOMER][NEUTRAL] OK, so they pay the 612. Do you have the day when the check was sent out?
[AGENT][POSITIVE] Yes, let me get that for you.
[CUSTOMER][POSITIVE] Please, thank you.
[AGENT][NEUTRAL] Uh, it looks like this claim, uh, processed and paid out on [PII]. Check would have mailed out [PII].
[CUSTOMER][NEUTRAL] Yeah it was a long time ago and I don't see that on patient's account.
[AGENT][NEUTRAL] OK. It looks like the check has not cleared, so I can do a request for a stop payment and reissue.
[CUSTOMER][NEUTRAL] Yeah, that's weird. Mhm.
[CUSTOMER][NEUTRAL] Yeah, but because I don't see that.
[AGENT][NEUTRAL] OK, I can do a request for a stop payment and reissue.
[CUSTOMER][NEUTRAL] And you say that it's not clear yet. Mhm.
[CUSTOMER][NEUTRAL] OK request to stop payment.
[CUSTOMER][NEUTRAL] Andre, OK.
[CUSTOMER][NEUTRAL] And what's your name again please?
[AGENT][NEUTRAL] My name is [PII] And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] It's just that [PII]. So how many that will take to process?
[AGENT][NEUTRAL] Uh, that will be reprocessed and pay within 24 hours.
[CUSTOMER][POSITIVE] 0 20 OK, now I'm gonna put that on file. OK, perfect. Thank you, have a wonderful day.
[AGENT][POSITIVE] You're welcome you have a wonderful day yourself and thank you for calling APL bye bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm bye bye.