AccountId: 011433970860
ContactId: 40266971-c279-4918-b217-9432518b5b36
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268769 ms
Total Talk Time (AGENT): 102598 ms
Total Talk Time (CUSTOMER): 105385 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/40266971-c279-4918-b217-9432518b5b36_20250305T19:59_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] Um, hi, my name is [PII] calling from Broader's office to check for the claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Sure. Policy number, I have it's 0017, it's 01072146.
[CUSTOMER][NEUTRAL] Can I get your name one more time please?
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII]
[AGENT][NEUTRAL] And I have [PII].
[CUSTOMER][POSITIVE] Yes, that is right.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] That's [PII], uh, the callback number it is [PII].
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] Data service it is for [PII].
[AGENT][NEUTRAL] [PII] of [PII].
[CUSTOMER][NEUTRAL] It's November [PII].
[AGENT][NEUTRAL] Can I have the total bill amount?
[CUSTOMER][NEUTRAL] $2820 even.
[AGENT][NEUTRAL] Thank you. For future reference you may visit our website at [PII] to check claim status as well. This processed under claim number 3546511. Looks like no.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Payments were made, the per occurrence max was met.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Prior to this claim being received, so no benefits were payable.
[CUSTOMER][NEUTRAL] Oh, so that means like the primary paid more than the $20 amount, is it?
[AGENT][NEUTRAL] No, it means the benefit on this policy.
[AGENT][NEUTRAL] was maxed prior to this claim being received.
[CUSTOMER][NEUTRAL] OK, so it's like uh the.
[CUSTOMER][NEUTRAL] And if its maximum exhausted, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Can you help me out, uh, is it for the, uh, visit uh the units?
[AGENT][NEUTRAL] No, it's a dollar amount. The benefit amount allows $500 per occurrence.
[CUSTOMER][NEUTRAL] OK. And uh when was it, ma'am?
[AGENT][NEUTRAL] It was met prior to the claim being received.
[CUSTOMER][NEUTRAL] Can you also help me out with the claim number, uh, prior claim number?
[AGENT][NEUTRAL] It's a different provider. I cannot give you that information.
[CUSTOMER][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] Can you provide me that date of service or?
[AGENT][NEUTRAL] Your date of service, [PII].
[CUSTOMER][NEUTRAL] No, the one which was uh paid before this date of service with the, the, no, OK, that's fine. Does this patient has any other insurance?
[AGENT][NEUTRAL] I cannot.
[AGENT][NEUTRAL] I cannot
[CUSTOMER][NEUTRAL] Apart from this?
[AGENT][NEUTRAL] We are their secondary plan.
[CUSTOMER][NEUTRAL] OK, got it. Um, and the claim has been processed as a secondary itself, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you so much for all this information. Can you help me out with the call 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?
[CUSTOMER][NEUTRAL] Uh, one last thing, um.
[CUSTOMER][NEUTRAL] The dollar amount was for, uh, is it annual or monthly basis?
[AGENT][NEUTRAL] It's per occurrence, which means per condition.
[CUSTOMER][POSITIVE] Thank you so much. That will be all for the day, and you may have a great day ahead. Bye for now.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Sure.