AccountId: 011433970860
ContactId: 4a28a635-4c3e-44a0-8ab8-5d053d0f5662
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288179 ms
Total Talk Time (AGENT): 93596 ms
Total Talk Time (CUSTOMER): 71543 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/4a28a635-4c3e-44a0-8ab8-5d053d0f5662_20250107T21:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. Who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Hi [PII] and how can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I was trying to follow up on uh claims, please.
[AGENT][POSITIVE] Absolutely I can help you with that. But first we're having phone issues. Can I get a callback number in case I lose you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect and the policy number?
[CUSTOMER][NEUTRAL] Yes, that is 02010665.
[AGENT][NEUTRAL] OK, and the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect and the data service for the claim?
[CUSTOMER][NEUTRAL] Uh yes. The date of service is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 322.
[AGENT][NEUTRAL] OK, I show that claim was received on [PII], processed and paid on [PII].
[AGENT][NEUTRAL] And the policy paid $5700.
[AGENT][NEUTRAL] Which maxed out their inpatient benefits.
[CUSTOMER][NEUTRAL] OK. May I get that claim number?
[AGENT][NEUTRAL] Yes, uh, claim number is 351.
[AGENT][NEUTRAL] 6322.
[CUSTOMER][NEUTRAL] And I'm sorry, you said it was because of maxed out benefits?
[AGENT][NEUTRAL] It is the 5700 maxed out the rest of their benefits.
[AGENT][NEUTRAL] So anything remaining will be patient responsibility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and can you see if you received this um professional claim? It's for [PII].
[CUSTOMER][NEUTRAL] Through the [PII] for $1,035.
[AGENT][NEUTRAL] No, I let me hold, let me see if this it.
[AGENT][NEUTRAL] And how much was it for?
[CUSTOMER][NEUTRAL] $1,035?
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Yes, we did receive that one on [PII] and it processed and denied on [PII] needing a more detailed EOB. It was not breaking down deductible co-insurance or co-pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And may I have that claim number?
[AGENT][NEUTRAL] That claim number is 350.
[AGENT][NEUTRAL] 2003.
[CUSTOMER][NEUTRAL] And where could we send that out to?
[AGENT][NEUTRAL] I can give you an address or a fax number, which one would you like?
[CUSTOMER][NEUTRAL] Uh, let me get the facts.
[AGENT][NEUTRAL] OK, fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 9423.
[CUSTOMER][NEUTRAL] And I would go attention to whom?
[AGENT][NEUTRAL] Claims
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there a timely filing to have that sent in?
[AGENT][NEGATIVE] No ma'am we do not have timely.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK. And is there a reference number for our conversation today?
[AGENT][NEUTRAL] No reference, just my name [PII].
[AGENT][NEUTRAL] Anything else I can help you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you, [PII]. Have a great day.
[AGENT][POSITIVE] You too [PII] thank you for calling APEL have a great rest of your day.
[CUSTOMER][NEUTRAL] You