AccountId: 011433970860
ContactId: 2dd6d75a-19a7-4367-93db-30511496bb4a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282450 ms
Total Talk Time (AGENT): 104235 ms
Total Talk Time (CUSTOMER): 92347 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/2dd6d75a-19a7-4367-93db-30511496bb4a_20250310T17:15_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Broader's office to check on a claim status.
[AGENT][POSITIVE] Sure, I can assist you with that, [PII].
[AGENT][NEUTRAL] Do I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure. Callback number is [PII] and it's going to be the direct line uh policy number.
[CUSTOMER][NEUTRAL] D as in Delta 4330.
[CUSTOMER][NEUTRAL] 2148.
[AGENT][NEUTRAL] I do apologize, but that's not pulling up a policy. Do you have the member's social?
[CUSTOMER][NEUTRAL] It's a check.
[CUSTOMER][NEUTRAL] And I do have a card copy and I have an updated member ID. Can I provide you with that?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is this the policy number or the social?
[CUSTOMER][NEUTRAL] Policy number?
[AGENT][NEUTRAL] What is this member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you. And you're calling, you said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You're calling to check the status of a claim signing for what date of service?
[CUSTOMER][POSITIVE] Great
[CUSTOMER][NEUTRAL] Baker.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] It's on [PII].
[AGENT][NEUTRAL] We received this claim [PII]. It was processed [PII]. There was no payment made on this claim, and the reason why there was no payment made on this claim, [PII], is because anesthesia benefits are based on the benefits allowable under the surgery benefits. Please send the surgery charges for this date of service. Both benefits can be considered so that both benefits can be considered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. May I know what type of document you need us to process this claim?
[AGENT][NEUTRAL] We need the
[AGENT][NEUTRAL] The services for the surgery itself.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Could you please repeat that?
[AGENT][NEUTRAL] The surgery, the surgery UB or the surgery 1500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like the claim number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, I, I do have that I need for that. And could you please spell out your name?
[AGENT][NEUTRAL] [PII], and today's date is the reference.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, could you please provide the fax number to send the medical record?
[AGENT][NEUTRAL] The fax number will be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII] that's [PII].
[CUSTOMER][NEUTRAL] And the last
[CUSTOMER][NEUTRAL] OK. And could you please also provide the claim's mailing address?
[CUSTOMER][NEUTRAL] To the claim.
[AGENT][NEUTRAL] It'll be to American public life.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]. [PII], so it's gonna be American Public Life Claims Department.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Thank you so much for that. And what is the time if any limit to submit an appeal?
[AGENT][NEGATIVE] There's no timely filing?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] And could you please
[CUSTOMER][NEUTRAL] No. And before ending up the call, could you please provide the call reference number?
[AGENT][NEUTRAL] We don't provide those Simon, however, you can use my name and today's date as a reference.
[CUSTOMER][POSITIVE] Thank you. Thank you so much for providing that information. Have a wonderful day. Bye for now.
[AGENT][POSITIVE] Thanks for calling APO. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Right.