AccountId: 011433970860
ContactId: 409b3c66-1137-4c30-a645-e9353d555007
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283779 ms
Total Talk Time (AGENT): 88556 ms
Total Talk Time (CUSTOMER): 214612 ms
Interruptions: 4
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/409b3c66-1137-4c30-a645-e9353d555007_20250123T22:36_UTC.wav
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[CUSTOMER][NEUTRAL] And the last thing is made, I mean.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] at Arlington Physicians and
[AGENT][NEUTRAL] Oh hi.
[CUSTOMER][NEUTRAL] And I was calling, I think I might have pushed the wrong button, but I was calling uh regarding a claim.
[AGENT][NEUTRAL] Uh, needing to check on a claim?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, uh, who did you say you were with? I'm sorry.
[CUSTOMER][NEUTRAL] your
[CUSTOMER][NEUTRAL] Arlington physicians, Doctor [PII] mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK thank you um can I get a good call back number from you really quick in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII] direct line.
[AGENT][NEUTRAL] Alright thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am. 02506269.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] efficiency, um, you know, more cost.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the insured?
[CUSTOMER][NEGATIVE] [PII] [PII]. Things are getting more expensive. You're not making.
[AGENT][NEUTRAL] Alright, thank you for that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] And also
[CUSTOMER][NEUTRAL] Uh, date of service was [PII] and the amount of just one second, $470 and it looks like that uh Aetna just paid on it on the [PII].
[AGENT][NEUTRAL] OK, do you know what the remaining balance was?
[CUSTOMER][NEUTRAL] Or pay their portion.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] It's OK if not.
[CUSTOMER][NEUTRAL] Looks like I'm new at this so just uh uh uh.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] I guess 126. 38 is the balance after Aetna? OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No worries.
[AGENT][NEUTRAL] OK, so this was, I'm sorry, this was [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Or to get this rule permanently through, there have been a few concerns raised, right.
[AGENT][NEUTRAL] Uh, this was for [PII], correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, it doesn't we have not received a claim for that date of service.
[CUSTOMER][NEUTRAL] Alright, let me make sure I've got, um, is the mailing address electronic, uh, payer ID is 60801?
[AGENT][NEUTRAL] Correct, um, and I've got our mailing address and fax number too if you'd like.
[CUSTOMER][NEUTRAL] Uh, is it [PII] [PII]?
[AGENT][NEUTRAL] That's it, yes.
[CUSTOMER][NEUTRAL] Alright, fax number [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] think
[CUSTOMER][NEUTRAL] Alright, well, I wonder why, well, it's probably too soon, uh, the [PII], that was, uh, that was a week ago.
[AGENT][NEUTRAL] Did y'all just send it recently?
[CUSTOMER][NEUTRAL] Uh, well, I guess Aetna automatically submits it.
[CUSTOMER][NEUTRAL] I guess
[AGENT][NEUTRAL] Oh, usually it's the providers, but I mean I don't know that's possible I guess.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 00, I, oh, OK, uh, let's see, no, we haven't, uh, submit it is ready to submit wait a minute, what is this?
[AGENT][NEUTRAL] All we really need for this kind of policy is the EOB from other primary, so Aetna like just showing what they paid.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, from Aetna.
[CUSTOMER][NEUTRAL] Huh, yeah, because I'm getting an error so secondary electronic claims transmission option is not selected for insurance American Public Life. Uh, oh stop. If the payer attaches secondary electronic claims, please select second. Well, we did have secondary claims, uh, options in the, OK, right, I'll just mail it, um, but you'll need the EOB from Aetna.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Got it, uh, yeah, I'll just do that.
[AGENT][NEUTRAL] I know sometimes the simplest options turn out to be the most complicated.
[CUSTOMER][NEUTRAL] Yeah, exactly. All right. And, and [PII], do you spell your name [PII] or [PII]?
[AGENT][POSITIVE] I do, yes, it's OK.
[CUSTOMER][POSITIVE] Ah, just like mine. All right, cool. All right.
[AGENT][POSITIVE] That's so rare. Well, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] I know because I
[CUSTOMER][NEUTRAL] No, just a reference number and we're done.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, yeah, my reference number would just be my first name, last initial and today's date, uh, so my last initial is A.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Got it. All right, [PII], thank you very much and you have a good evening. OK, bye-bye.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Yeah, thanks for calling APL you too thank you bye bye.
[AGENT][NEUTRAL] All right