AccountId: 011433970860
ContactId: 412429ea-e972-480f-bcae-4acc4bc46921
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437309 ms
Total Talk Time (AGENT): 139552 ms
Total Talk Time (CUSTOMER): 186569 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/412429ea-e972-480f-bcae-4acc4bc46921_20250609T13:52_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII] calling from provider office regarding claim status.
[AGENT][NEUTRAL] What is your name?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. And what's your name?
[AGENT][NEUTRAL] I'm so sorry, can you spell that for me again, please?
[CUSTOMER][NEUTRAL] [PII]. What's your name?
[AGENT][NEUTRAL] OK. My name is [PII], that's [PII] Last initial is [PII].
[AGENT][NEUTRAL] OK, and what is your callback number please?
[CUSTOMER][NEUTRAL] OK. Yup.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What is the policy number please? Thank you.
[CUSTOMER][NEUTRAL] Policy number is 01989386.
[AGENT][NEUTRAL] OK. I have it as 01989386. Thank you very much. Verify the patient's name and date of birth. Thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just providing.
[CUSTOMER][NEUTRAL] So [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you very much for the information. Excuse me, I have that member pulled up and again, you're calling for claim status. What is that date of service and the charge amount please, total charge amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. This is the date of service and total bill charges is showing.
[CUSTOMER][NEUTRAL] Uh, uh, just a moment. There is showing 0. $48,539.65.
[AGENT][NEUTRAL] OK, that is [PII].
[AGENT][NEUTRAL] [PII] and that's for $48,539.65. OK, one moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] And who is the billing provider?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] GCU
[CUSTOMER][NEUTRAL] Medical Center.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you say this is $48,539.65. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So, uh, in this claim, there is, uh, one thing only. So it has been paid as primary payer as Santara and uh showing, uh, the
[CUSTOMER][NEUTRAL] Co-payment
[CUSTOMER][NEUTRAL] Amount left for the secondary payer APL.
[CUSTOMER][NEUTRAL] Uh, 5
[CUSTOMER][NEUTRAL] $162.50 even.
[CUSTOMER][NEUTRAL] And there is
[CUSTOMER][NEUTRAL] Uh, sorry, just a moment. I'm checking.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. So the copayment amount.
[CUSTOMER][NEUTRAL] has been left $560.50 even.
[CUSTOMER][NEUTRAL] For American Public Life Insurance Company.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I did not show a claim on file for a total charge of $48,539.65 for that date range.
[CUSTOMER][NEUTRAL] So, do you have any claim on file on the date of service?
[AGENT][NEUTRAL] I do, however, it's not for the bill amount that you, I'm sorry.
[CUSTOMER][NEUTRAL] 4:30. Yeah.
[CUSTOMER][NEUTRAL] Yeah, $38,427.40. Do you have?
[AGENT][NEUTRAL] I do have.
[CUSTOMER][NEUTRAL] Yeah. So please uh provide me the status on this because uh there is uh maybe the late charges is included in this claim so that.
[AGENT][NEUTRAL] I'm sorry. So,
[CUSTOMER][NEUTRAL] I have provided that one.
[AGENT][NEUTRAL] OK, so $38,427.40. You want the claim status for that, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, the claim was received and we are requesting the explanation of benefits from the primary insurance provider. Once we received the claim.
[AGENT][NEUTRAL] I'm sorry, the EOB, we will continue processing this claim.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] OK. On which address do you need? Mailing address I need?
[AGENT][NEUTRAL] OK, it will be mailed to APO claims PO Box.
[CUSTOMER][NEUTRAL] me, just a moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So, yeah, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Only the uh primary care you'll be needed or anything else needed with this along with the document.
[AGENT][NEUTRAL] We only need the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me, let me provide you with the claim number as well.
[CUSTOMER][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] OK, and just provide me.
[AGENT][NEUTRAL] OK, the claim number shows 354-5805.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This is 7 days only.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. So [PII], what is the option for alcohol?
[AGENT][NEUTRAL] We do not use my reference numbers of you. You can use my name and today's date. Anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, it's fine. [PII]
[AGENT][POSITIVE] That is correct, please.
[CUSTOMER][NEUTRAL] And today date, [PII]. Time is also or only the date is appropriate for you?
[AGENT][NEUTRAL] Just today's date. If you need the time, it is [PII] central time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You are welcome, [PII]. Thank you so much for calling APL. Have a good day. Thank you. Take care.
[CUSTOMER][POSITIVE] Bye-bye. Take care. Bye-bye.
[AGENT][NEUTRAL] Bye.