AccountId: 011433970860
ContactId: 41a53fc4-322d-4f2e-9819-f4fa21758174
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 698830 ms
Total Talk Time (AGENT): 246616 ms
Total Talk Time (CUSTOMER): 158931 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/41a53fc4-322d-4f2e-9819-f4fa21758174_20250421T16:36_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is how may I help you?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Be office to check on a claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Yeah, it is 02317301, M as in Mike, L as in Lima, number 8.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you, one moment and thank you for verifying that information.
[AGENT][NEUTRAL] May I have a date of service?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is [PII] and the bill amount is $792.57.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This processed under claim number 3554113. No benefits are payable. Looks like the office visit, they do not have office visit benefits, and for the second line, it looks like the primary insurance paid in full.
[AGENT][NEGATIVE] So, no benefits were payable. This claim processed and denied on [PII].
[CUSTOMER][NEUTRAL] OK, so the patient has no offices benefits, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] On the 2nd line item it is paid.
[CUSTOMER][NEUTRAL] Primary paid more than 2 year allowed amount, right?
[AGENT][NEUTRAL] The primary insurance paid in full.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] And can you spell your name?
[AGENT][NEUTRAL] [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] OK, and I have 2 more claims for this number. Could you help me with that?
[AGENT][NEUTRAL] For the same person?
[CUSTOMER][NEUTRAL] Yeah, same number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Next data service.
[CUSTOMER][NEUTRAL] So the date of service.
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] And total bill amount?
[CUSTOMER][NEUTRAL] It is $1,339.20.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] This processed under claim number 3541416.
[AGENT][NEUTRAL] It looks like a benefit amount of $50 processed and paid to the provider.
[AGENT][NEUTRAL] And this processed on [PII].
[CUSTOMER][NEUTRAL] OK, and it's page 3 of your check.
[AGENT][NEUTRAL] It was a single check?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 201
[CUSTOMER][NEUTRAL] On the check number?
[AGENT][NEUTRAL] 2018475.
[CUSTOMER][NEUTRAL] OK. So it is 20184758?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I'll check issue date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and it is cashed or not?
[AGENT][NEUTRAL] I would have to send it over to finance to verify if it has cashed or not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and may I know the pay to address?
[AGENT][NEUTRAL] One moment, I'll pull that up.
[AGENT][NEUTRAL] Slow, sleep, snoring and sinus, [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Is that the correct address?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Actually, we did not receive the UOB, so could you please fax the UOB?
[AGENT][NEUTRAL] May I have a fax number?
[CUSTOMER][NEUTRAL] Yeah, one moment.
[CUSTOMER][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII]. I'll fax it right over.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And also could you please send the inquiry it is cash or not.
[AGENT][NEUTRAL] OK, I would have to send that over to the finance department and once they verify that, then I can send that over.
[CUSTOMER][NEUTRAL] OK, and another time or one time for this one.
[AGENT][NEUTRAL] Um, turnaround time could be, could be anywhere from 24 to 48 hours on that cash check.
[CUSTOMER][NEUTRAL] So we need to follow up on next day, right? Tomorrow.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] One moment, I'm faxing over the EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] you know
[AGENT][NEUTRAL] Let me send this over to finance. One moment.
[AGENT][NEUTRAL] OK, may I have your next date of service?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[CUSTOMER][NEUTRAL] And the bill amount $1,339.20.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] This one processed under claim number 35141.
[CUSTOMER][NEUTRAL] I I
[AGENT][NEUTRAL] 3541412.
[AGENT][NEUTRAL] And there's
[CUSTOMER][NEUTRAL] One moment ma'am. Could you repeat one more time? 35.
[AGENT][NEUTRAL] 3541412.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this one processed to the provider benefit amount was $50. This one processed on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so single check or bulk check?
[AGENT][NEUTRAL] Single check
[AGENT][NEUTRAL] One moment, I'll pull up the check number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Check number is 2018472.
[AGENT][NEUTRAL] Would you like me to send that to finance?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Once they return, whether or not it had processed and cleared, I can fax those over to you as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the pay to address same, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I faxed that EOB for claim number 3541412 and the previous claim 3541416. Once I get the clarification if the check is clear, then I can fax that over to you as well.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. So the initial claim we discussed, right, so in that one patient does not have office visits. But in this both claims, uh, so it is the office visit only, right? But this both are paid.
[AGENT][NEUTRAL] It looks like office treatment. This looks like treatment in the office.
[AGENT][NEUTRAL] It was not an actual office visit.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So the first one is office treatment in the office, right?
[AGENT][NEUTRAL] Correct. It was office visit. [PII], 99214. Those are office visits.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] do that.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] So the call reference number is the same right for the entire call.
[AGENT][POSITIVE] That, that is correct.
[CUSTOMER][POSITIVE] OK, thank you so much for assistance. Have a nice day.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.