AccountId: 011433970860
ContactId: 34605d04-c7d0-4c19-9942-03fcde5bf657
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 216279 ms
Total Talk Time (AGENT): 79921 ms
Total Talk Time (CUSTOMER): 63850 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/34605d04-c7d0-4c19-9942-03fcde5bf657_20250131T14:43_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from your provider's office and I need to do a claim status please.
[AGENT][NEUTRAL] OK, I can help you with that, [PII]. Can I get a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] I have in our system 02013328 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying the policy and you did say status today. What is the date of service?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[AGENT][NEUTRAL] The total charge
[CUSTOMER][NEUTRAL] $470.01.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] $470.01. 0 wait, wrong claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what who's the provider? I do show a claim here for the data service. It's not the total bill.
[CUSTOMER][NEUTRAL] Hm, OK, it's under Michigan healthcare professionals, um, you know, the.
[AGENT][NEUTRAL] OK, this is from.
[AGENT][NEUTRAL] Let me pull the image and just to make sure it wasn't a mistake on our part.
[CUSTOMER][NEUTRAL] I mean the only only part you were getting was $40 so.
[CUSTOMER][NEUTRAL] Um, yeah, the EOB from Aetna is 47001.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on a second here.
[AGENT][NEUTRAL] OK, yeah, this, uh, the claim we received is only for 22001.
[CUSTOMER][NEUTRAL] 2:20.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK, that's probably correct.
[AGENT][NEUTRAL] And it was, OK, so it was uh processed. The claim was denied, uh, the physician's office visit is not covered.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, and then the uh other charge of one cent was denied, uh, not due to sickness or injury, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, of course.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so copay is not covered under this policy, OK.
[AGENT][NEUTRAL] Yeah, the physician office copay.
[CUSTOMER][NEUTRAL] 40 OK.
[AGENT][NEUTRAL] Is there anything else I can help you? OK, to reference the call, you'll use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] And do you have a reference number today? No.
[CUSTOMER][POSITIVE] All right, I will do that thank you very much.
[AGENT][POSITIVE] You're welcome, [PII]. You have a wonderful day. Thank you for calling APO. Bye bye.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thanks bye bye.