AccountId: 011433970860
ContactId: 329b7b13-c2e3-4a06-8929-23554777e4e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340140 ms
Total Talk Time (AGENT): 76067 ms
Total Talk Time (CUSTOMER): 82830 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/329b7b13-c2e3-4a06-8929-23554777e4e6_20250514T17:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm not sure if I'm at the right department. I, I'm calling from a medical provider. Um, this is a secondary claim that I, it was autocross from the patient's primary, um, but I'm not sure I have the right because it says American Public Life insurance, but I don't know like what.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Type of plan this is.
[AGENT][NEUTRAL] That's OK. Um, can I get your name?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] And who are you calling from?
[CUSTOMER][NEUTRAL] Uh, I'm calling with Integrated Pain solutions.
[AGENT][NEUTRAL] OK, and do you have a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Uh, that is 01871538.
[AGENT][NEUTRAL] You said 018715.
[AGENT][NEUTRAL] 38
[CUSTOMER][NEUTRAL] 38. Yes, ma'am.
[AGENT][NEUTRAL] OK, just wanna make sure.
[AGENT][NEUTRAL] And you're wanting eligibility, correct?
[AGENT][NEUTRAL] Or claim
[CUSTOMER][NEUTRAL] Um, well, claim status, yeah.
[AGENT][NEUTRAL] OK, OK, just wanna make sure.
[AGENT][NEUTRAL] Give me one moment while I pull that up.
[AGENT][NEUTRAL] And can I get the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] Right, it looks like this policy was.
[AGENT][NEUTRAL] Effective on [PII].
[AGENT][NEUTRAL] And it lapsed on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so I have a data service that falls in between there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was autocross from the patient's primary anthem.
[CUSTOMER][NEGATIVE] To the American public life, but we have never received a payment or anything or need be or anything, so I'm not sure.
[AGENT][NEUTRAL] So did you, uh, what was the date of service?
[CUSTOMER][NEUTRAL] [PII] for $245.
[AGENT][NEUTRAL] Let me check on that for you.
[AGENT][NEUTRAL] You said [PII] correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it was for what was the provider's name again? Was it integrated?
[CUSTOMER][NEUTRAL] Pain Solutions, yes, and the provider is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do have that claim number if you would like it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 32.
[AGENT][NEUTRAL] 75.
[AGENT][NEUTRAL] 309.
[AGENT][NEGATIVE] Well, hold on, it shows that it was denied.
[AGENT][NEUTRAL] Let me find out why.
[AGENT][NEUTRAL] Office visits are not covered by this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] Alright, thank you so much. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Nope, that's it thank you.
[AGENT][NEUTRAL] I