AccountId: 011433970860
ContactId: 3c13498b-7ecd-4e97-ad88-a312f96a200d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 685309 ms
Total Talk Time (AGENT): 187817 ms
Total Talk Time (CUSTOMER): 176726 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/3c13498b-7ecd-4e97-ad88-a312f96a200d_20250203T20:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from office checking on payment status.
[AGENT][NEUTRAL] OK, and what was your name again, please?
[CUSTOMER][NEUTRAL] [PII]. And can you also spell your name, please?
[AGENT][NEUTRAL] Uh, yes, it's [PII]
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you and what is uh your callback number please just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Is it the American Public Life Insurance?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, thank you. And the callback number is [PII].
[AGENT][NEUTRAL] Thank you. And what is the patient's name?
[CUSTOMER][NEUTRAL] First name is [PII].
[CUSTOMER][NEUTRAL] Last name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what's the patient's policy number?
[CUSTOMER][NEUTRAL] 1130252 M as in Mike L as in Lima 5.
[AGENT][NEUTRAL] OK, and that was 1130252 ML5.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And what's the patient's uh name? I'm sorry, date of service?
[CUSTOMER][NEUTRAL] It's on [PII].
[AGENT][NEUTRAL] OK, let me pull in this policy real quick.
[CUSTOMER][NEUTRAL] For the
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, and what is the charge amount?
[CUSTOMER][NEUTRAL] $1,173 even 1173.
[AGENT][NEUTRAL] Thank you. And then what is the amount after the primary paid their part?
[CUSTOMER][NEUTRAL] I think American Public Life is the primary.
[AGENT][NEUTRAL] Mm, OK, what is the name of the facility that you're calling from?
[CUSTOMER][NEUTRAL] Holy Cross Medical Group.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I pull up this claim for you, Ms. [PII], and I'll be right back.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], this, this is [PII] back with you again.
[AGENT][NEGATIVE] I looked on the data service that you gave me of [PII] and I do not find a claim on file.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, did you find a member?
[AGENT][NEUTRAL] Yes, I found the member but I did not find the claim on file.
[CUSTOMER][NEUTRAL] Uh, actually, it was resubmitted on [PII].
[CUSTOMER][NEUTRAL] For the bill amount you did check, right, for the bill amount, uh, $1,173 even, right?
[AGENT][NEUTRAL] OK, do you have, um, a claim number?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, I don't find the claim on file correct.
[CUSTOMER][NEUTRAL] So there is no claim on file there?
[CUSTOMER][NEUTRAL] OK. May I know the policy effective and term date of this member?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The effective date is [PII] and the
[AGENT][NEUTRAL] Policy term on [PII].
[CUSTOMER][NEUTRAL] [PII] of
[AGENT][NEUTRAL] Yes, but I do see an active policy. Let me see if it's on this other policy that is active because the policy number.
[CUSTOMER][NEUTRAL] 2000.
[CUSTOMER][NEUTRAL] Uh sorry?
[CUSTOMER][NEUTRAL] May I know
[CUSTOMER][NEUTRAL] Sorry, but uh the
[AGENT][NEUTRAL] The policy number.
[AGENT][NEUTRAL] What? Go ahead.
[CUSTOMER][NEUTRAL] The effective date is [PII], right? And term date is [PII].
[AGENT][NEUTRAL] 17.
[CUSTOMER][NEUTRAL] 70
[CUSTOMER][NEUTRAL] So the number is not active for the data service?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Not on that policy, but I do have an active policy.
[CUSTOMER][NEUTRAL] Uh, can you tell me that
[AGENT][NEUTRAL] I will check
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm, mm mm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Miss, um, I've found the
[AGENT][NEUTRAL] I found it looked on the policy for the data service 116 of 2024 and the amount that you've given me and I do not find a claim on file on that policy number.
[CUSTOMER][NEUTRAL] Yes, uh, I know, I do know that, uh, but may I know the effective date?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It is [PII] and the policy is active.
[CUSTOMER][NEUTRAL] OK, so it is active for the data service, right? May I know the time and finding limit?
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][NEUTRAL] Timely filing limit for this claim.
[AGENT][NEUTRAL] We do not have one.
[CUSTOMER][NEUTRAL] May I have the claim's mailing address?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Can you spell the uh
[AGENT][NEUTRAL] Yes, it's OK [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And state also same right.
[AGENT][NEUTRAL] OK. It's just OK.
[CUSTOMER][NEUTRAL] Can you repeat the ZIP code again?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] It's [PII], Oklahoma. OK. [PII], right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] May I know the payer ID?
[AGENT][NEUTRAL] Yes, it's 60801.
[CUSTOMER][NEUTRAL] May I know the fax number?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] 3.
[CUSTOMER][NEUTRAL] May I have the call reference number?
[AGENT][NEUTRAL] Yes, you can use my name. It's [PII]
[AGENT][NEUTRAL] And today's date.
[CUSTOMER][NEUTRAL] OK, we can submit the claim through fax. Is it possible?
[AGENT][POSITIVE] Yes, yes, you can.
[CUSTOMER][NEUTRAL] Thank you. And we have to send the primary also?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] If there
[CUSTOMER][NEUTRAL] Uh, may I know,
[AGENT][NEUTRAL] You'll need
[CUSTOMER][NEUTRAL] Is it primary or?
[AGENT][NEUTRAL] You'll need
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] No, we're secondary, we're secondary gap insurance.
[CUSTOMER][NEUTRAL] May I know what is the primary insurance?
[AGENT][NEUTRAL] I don't have that.
[CUSTOMER][NEUTRAL] Is it Blue Cross uh settle?
[AGENT][NEUTRAL] I, I don't have the primary.
[CUSTOMER][POSITIVE] Thank you, thank you for assisting me. Have a great day.
[AGENT][POSITIVE] You too you have a blessed one thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye bye.