AccountId: 011433970860
ContactId: 2aa48ea3-5ac7-40b8-b38e-d825bb1dd264
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 549640 ms
Total Talk Time (AGENT): 131066 ms
Total Talk Time (CUSTOMER): 150281 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/2aa48ea3-5ac7-40b8-b38e-d825bb1dd264_20250407T17:21_UTC.wav
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[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello, did you hear me?
[AGENT][NEUTRAL] Yes, hold for a second, please.
[CUSTOMER][POSITIVE] Oh, sure. Take your time.
[AGENT][NEUTRAL] Can you hear me? Oh, thank you.
[AGENT][POSITIVE] OK, sorry about it.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] No issues, no issues.
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check a claim status.
[AGENT][NEUTRAL] May I please have a callback number and then the policy number?
[CUSTOMER][NEUTRAL] 8. Sure. It's [PII]. Of policy number is 02465058.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] First name is [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for status. May I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Sure, it's [PII] for the bill amount is uh
[CUSTOMER][NEUTRAL] 403-580.01.
[AGENT][NEUTRAL] That's $403,580.01.
[CUSTOMER][NEUTRAL] Yes, right. Uh-huh.
[AGENT][POSITIVE] Thank you, and I can assist you with that. I'm pulling it up for you now.
[CUSTOMER][POSITIVE] No issues, take your time. I'll wait.
[AGENT][NEUTRAL] OK, I'm not seeing a claim for that total bill.
[CUSTOMER][NEUTRAL] Oh, could you tell me the effective and term date of the policy?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is showing that the policy is currently active with the effective date of [PII].
[CUSTOMER][NEUTRAL] [PII]. May I get the mailing address?
[AGENT][NEUTRAL] Yes, and do you know if this was a facility bill or a physician bill?
[CUSTOMER][POSITIVE] Uh, it's a hospitable.
[AGENT][NEUTRAL] OK. Do you know if that is the correct amount?
[CUSTOMER][NEUTRAL] It's UB 04.
[CUSTOMER][NEUTRAL] Correct. What do you mean correct bill amount, right?
[AGENT][NEUTRAL] Yes, I'm needing the correct total bill charge for this claim.
[CUSTOMER][NEUTRAL] Yeah, it's, yeah, it is 403580.01.
[CUSTOMER][NEUTRAL] I just said it.
[AGENT][NEUTRAL] Let me pull this image up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And while I'm pulling the image up I'll go ahead and give you the mailing address as well. That mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] 24
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Make it be ready?
[AGENT][NEUTRAL] Yes, the electronic payer ID is 60801.
[CUSTOMER][NEUTRAL] Time referring to send this.
[AGENT][NEGATIVE] No timely filing.
[CUSTOMER][NEUTRAL] OK. And I have another one more claim. Could you help me with that too, please?
[AGENT][NEUTRAL] Is it for the same member or a different member?
[CUSTOMER][NEUTRAL] Could you tell me the call reference number, sir?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Different member and uh could you tell me the call reference for this claim so we can move to the next one.
[AGENT][NEUTRAL] Yes, the call reference is my first name [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] [PII] and T. Just give me a minute. I'll just post my notes from here, uh, so that we will move to the next one. Give me aa. Thank you so much for the patience.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] And the next one is.
[CUSTOMER][NEUTRAL] Uh, it's for different, uh,
[CUSTOMER][NEUTRAL] Member ID that is 024.
[CUSTOMER][NEUTRAL] 86619
[CUSTOMER][NEUTRAL] [PII], are you there?
[CUSTOMER][NEUTRAL] Amen?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][POSITIVE] Oh thank you.
[AGENT][NEUTRAL] You're welcome and that policy number is 02486619 and may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yup, why not. The patient's first name is uh [PII], last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Uh, it's so uh [PII] for the bill amount, uh.
[CUSTOMER][NEUTRAL] Give me a minute. It's $9,846 even.
[AGENT][NEUTRAL] OK, could you repeat that total again, please?
[CUSTOMER][NEUTRAL] Yup, why not? Just a minute, it's uh.
[CUSTOMER][NEUTRAL] $9,846 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so for that claim, you will have to contact the insured in regards to that claim.
[CUSTOMER][NEUTRAL] Uh, may I know the reason why you want to contact because we receive a correspondence from your side to stated need of a primary or you will be with the claim number of.
[CUSTOMER][NEUTRAL] 352-687-5
[AGENT][NEUTRAL] Yes, and then we received that that claim in with that claim number is 3546718 and it stated that it denied that it was already paid to the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 354
[CUSTOMER][NEUTRAL] Oh, may I get the details or, uh, in that we need to, may I know the reason why it's
[CUSTOMER][NEUTRAL] Got paid to the insured?
[AGENT][NEUTRAL] It's based off of who we received the claim from first.
[AGENT][NEUTRAL] So if the claim came in from the insured, then the payment would go to the insured.
[AGENT][NEUTRAL] So that's why I stated that you would have to contact the insured in regards to that claim.
[CUSTOMER][POSITIVE] Oh, OK, thank you, bye bye.
[AGENT][POSITIVE] You're welcome. Is there anything else I can assist you with today?