AccountId: 011433970860
ContactId: 32692d0a-03ac-4f62-a1b3-490e4f98acd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385750 ms
Total Talk Time (AGENT): 165652 ms
Total Talk Time (CUSTOMER): 119662 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/32692d0a-03ac-4f62-a1b3-490e4f98acd7_20250220T18:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you today? My name is [PII].
[AGENT][NEUTRAL] Hi, [PII]. Actually, my name is [PII]
[CUSTOMER][NEUTRAL] Oh, OK. I'm sorry. All right. Well, I'm calling to, yeah, um, I'm calling to check on a claim status.
[AGENT][NEUTRAL] That's OK. How can I help you?
[AGENT][NEUTRAL] OK, you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Um, well, for a patient, I have like 5 planes.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] So you have 1 patient for 5 days of service?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, and [PII], you will use my name that I gave you along with today's date as your call reference number. Also [PII], any information that I provide for you today will be a verification of benefits and not a guarantee of payment. And lastly, if we do have the claims on file and you need a copy of the explanation of benefits, you may print that by going to our portal at [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so what is your patient's policy number, please?
[CUSTOMER][NEUTRAL] It's gonna be 00235064.
[CUSTOMER][NEUTRAL] It's under the name of [PII].
[AGENT][NEUTRAL] OK, so one of the numbers, again, no, so don't give me that information yet, [PII]. You said 00235064?
[CUSTOMER][NEUTRAL] And they
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, sir, that's not a valid policy number.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Let me check the patient's ID card. um, give me a moment.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, right.
[CUSTOMER][NEUTRAL] Is this American plan admin, right?
[AGENT][NEUTRAL] No, sir. This is American Public Life Insurance.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Ah, public life.
[AGENT][NEUTRAL] Yes, sir. Did you call the wrong company?
[CUSTOMER][NEUTRAL] Give me a second, maybe. Yes. Uh, I do apologize but no problem. I, I, I, I also have, I also have, yeah, because I, I was calling to the, to the wrong number, but give me just a second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. That's OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, so I have this another patient. This should be.
[CUSTOMER][NEUTRAL] All right. Um, all right. So this number is [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And how many days service for this number do you have?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the same thing applies. Any information that I provide would be a verification of benefits and not a guarantee of payment. What is the patient's name, please, and their date of birth, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] All right. First date of service was on [PII] for $158.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, [PII], this claim was received. One moment, I'll provide you that information.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And this claim was received on.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] I'm getting ahead of the computer.
[CUSTOMER][POSITIVE] No problem. Take your time.
[AGENT][NEUTRAL] OK, so this claim was received on [PII] and it was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3,504,580.
[AGENT][NEGATIVE] This claim was denied.
[AGENT][NEUTRAL] And the denial remark states these services were rendered after coverage was terminated.
[AGENT][NEUTRAL] [PII], this policy termed as of 7-1-2024.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][POSITIVE] Yes, sir. No, yes, that is correct. [PII]. I'm sorry, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem. Alright, um.
[CUSTOMER][NEUTRAL] Well, I think that's uh all because the next claim is for uh data service per patient was not covered, um.
[CUSTOMER][NEUTRAL] So, yeah, no, I, I think.
[AGENT][NEUTRAL] No, I'll be happy to check if you need a claim number, if you need a claim number, if we did receive it like we did this one, but yes, sir, this policy did term is a 7-12024, and there is no other coverage with us beyond that time.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Alright, well.
[CUSTOMER][POSITIVE] OK, no problem. I think that it's uh everything what I need now and the only thing is that the reference number, that's all.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you. All right. I hope you have a wonderful day, OK?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] I hope you do too, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yeah. Take care. Bye bye.
[AGENT][NEUTRAL] You too. Bye-bye.