AccountId: 011433970860
ContactId: 2c47278a-adb9-4734-b3b7-375f0c101387
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353019 ms
Total Talk Time (AGENT): 149530 ms
Total Talk Time (CUSTOMER): 129876 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/2c47278a-adb9-4734-b3b7-375f0c101387_20250509T16:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, good afternoon, [PII]. My name is [PII]. Excuse me, calling on behalf of Methodist Medical, trying to see if I can request an EOB.
[AGENT][POSITIVE] OK, I can help you with an EOB for a claim. Um, Miss [PII], may I please get your callback number just in case the call is disconnected and you're so welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yep
[CUSTOMER][NEUTRAL] Thank you. Direct dial [PII].
[AGENT][NEUTRAL] OK, and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] It is [PII] is the last name. Date of birth uh [PII]. Well, you know what, the patient says [PII] uh date of birth [PII]. Member ID is 02035009, excuse me.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] Thank you. This is an old claim from [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright thank you and do you have the claim number?
[CUSTOMER][NEUTRAL] Uh, I don't. Like, you mean like from the EOB?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right from the.
[CUSTOMER][NEUTRAL] Yeah, I see it in into our system, but I just can't pull it.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, alright, what is the date of service and the charge amount?
[CUSTOMER][NEUTRAL] It is data service [PII] billed amount of $691 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then what were the charges after the primary paid?
[CUSTOMER][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Uh, well, we just have you all as primary. As American Public Life Insurance Company, we don't have any other insurance listed.
[AGENT][NEUTRAL] OK, alright, this is a uh a uh supplement policy, but I'm gonna try to pull it with that first amount that you gave me, so it's gonna be just quick hold while I look up this claim and I'll be right back with you, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. I appreciate it.
[AGENT][POSITIVE] You're very welcome. No problem.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi Miss [PII], did you say that [PII] is the um patient or is it somebody else on his policy?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] It's, it's [PII], but we have [PII] as the uh subscriber. I'm guessing [PII] is the child on the policy.
[AGENT][NEUTRAL] OK. OK.
[AGENT][POSITIVE] OK, that helps me. Thank you so much. It's gonna be a brief hold again. Thank you, ma'am.
[CUSTOMER][NEUTRAL] Sure, you're welcome. OK, thanks. You are on hold.
[AGENT][NEUTRAL] OK, I do have the claim pulled up now. um, can you please give me your fax number and I'll fax this EOB over to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Thank you. It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then let me go ahead and give you the claim number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome. It's 304-437-9.
[AGENT][NEUTRAL] And the claim was denied because we need the explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] OK, OK, thank you. And then do you all have access to who the primary insurance carrier should be?
[AGENT][NEUTRAL] Uh, let me look and see if he has any active policies because this policy is no longer active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] I can look on the group and see who their primary is now.
[CUSTOMER][NEUTRAL] OK. Oh, gotcha. Yeah, that was, it's like.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But I don't know if that's who it was in [PII].
[CUSTOMER][POSITIVE] OK. Yeah, no, I appreciate.
[AGENT][POSITIVE] But we can start there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] At least they'll give you a place to start at and hopefully we'll.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Hopefully it'll work for you. It says it's um the the um primary major medical is National General.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then is there an ID number associated with that?
[AGENT][NEUTRAL] No, it's just our, our ID number which would be the um.
[CUSTOMER][NEUTRAL] OK. Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 020
[AGENT][NEUTRAL] The 203, no his um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 203-500-009.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Thank you. I appreciate it. And then is there a reference number that is assigned to the call, like a call reference?
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Yes ma'am, you can use my name and today's date and I'm going to put you on a quick hold while I get this EOB faxed over to you.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] While we're on the phone together. You're welcome. It's gonna be a brief hold.
[CUSTOMER][POSITIVE] Thank you.