AccountId: 011433970860
ContactId: 3c9496f3-2b7d-4922-bd06-60076d1dfb8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199889 ms
Total Talk Time (AGENT): 82555 ms
Total Talk Time (CUSTOMER): 79638 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/3c9496f3-2b7d-4922-bd06-60076d1dfb8a_20250107T14:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I am calling from um
[CUSTOMER][NEUTRAL] Kendall Anesthesia Associates in regards to a claim that we have filed, I need to uh to get some additional information please.
[AGENT][POSITIVE] I'll be happy to help you with the claim status, [PII]. Do you have a policy number or claim number?
[CUSTOMER][NEUTRAL] I do have the policy number. It is 02182415.
[AGENT][NEUTRAL] And may I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII], um.
[CUSTOMER][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. And may I have a date of service or claim number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And total bill amount?
[CUSTOMER][NEUTRAL] $10,472.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] check claim status as well. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like this processed under.
[AGENT][NEUTRAL] Claim number 3536464 in which we are asking for the primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK, so the denial that I have for um invalid principal diagnosis is not correct.
[AGENT][NEUTRAL] Let's see if there's multiple diagnosis on this claim. One moment.
[AGENT][NEUTRAL] On this one it looks like it is asking for.
[AGENT][NEUTRAL] The detailed EOB.
[CUSTOMER][NEUTRAL] OK, OK, we were just a little confused because the um denial that we received states missing and completed valley diagnosis, so.
[CUSTOMER][NEUTRAL] That was just a little confusing. Do you show who is listed as primary or who you're, um, do you have any COP information?
[AGENT][NEUTRAL] We only have that COB information once the claim is submitted.
[CUSTOMER][NEUTRAL] OK, OK, alright, I can uh I'll get in touch with the patient. Can I get a reference number please?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII] Last initial is [PII] along with today's date. [PII], is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] I know that's gonna be all. Thank you so much.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.