AccountId: 011433970860
ContactId: 5d12d355-3590-41d6-b14d-4c7fc95346a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305559 ms
Total Talk Time (AGENT): 116517 ms
Total Talk Time (CUSTOMER): 118358 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/5d12d355-3590-41d6-b14d-4c7fc95346a7_20250123T19:01_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This [PII] calling from Mercy facility, checking on the, uh, some inquiry about the claim. Hi, how are you, ma'am?
[AGENT][POSITIVE] I'm doing well, thank you for asking [PII]. How are you today?
[CUSTOMER][POSITIVE] Yeah, me too. Good. Thank you so much for that. How was your day?
[AGENT][POSITIVE] It's going good.
[AGENT][POSITIVE] Just waiting for tomorrow. Nice to talk to you as well.
[CUSTOMER][POSITIVE] Nice to talk to you.
[AGENT][NEUTRAL] And see what is a good callback number?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the, uh, I'm sorry, what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Policy number is 01835841.
[AGENT][NEUTRAL] And the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Uh yeah, sure. The patient name is [PII] is the last name. [PII] is the date of birth.
[AGENT][NEUTRAL] Alright, thank you. And are you needing eligibility and benefits or claim status?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, I just want to know whether you received the claim or not.
[AGENT][NEUTRAL] Alright, and I can help you with that and see what is the data service.
[CUSTOMER][NEUTRAL] 922 of 2024, bill charges is.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] $3,801.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] 922 2024.
[AGENT][NEUTRAL] I'm checking on that. $3,801.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] $3,801 yes. May I have your name, please? Can you just spell it out for the documentation purpose?
[AGENT][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][POSITIVE] OK nice.
[AGENT][NEUTRAL] And what is the name of the facility, Sia?
[CUSTOMER][NEUTRAL] Uh, it's a Mercy Hospital.
[AGENT][NEUTRAL] All right, thank you. Is that [PII]?
[CUSTOMER][POSITIVE] Yes, correct, ma'am.
[AGENT][NEUTRAL] Alright, thank you, and I can help you with that claim status. Now we actually we did receive the claim on 10-14-24.
[CUSTOMER][NEUTRAL] Did you receive?
[CUSTOMER][NEUTRAL] [PII] miss.
[AGENT][NEUTRAL] Now this claim
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1014 of 2024, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] And process on?
[AGENT][NEUTRAL] 1017 2024.
[CUSTOMER][NEUTRAL] And what is the claim number?
[AGENT][NEUTRAL] The claim number is 351.
[AGENT][NEUTRAL] 8149.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] And is it paid or denied?
[AGENT][NEUTRAL] It's actually pending for the primary EOB. We are secondary to the patient's major medical coverage.
[CUSTOMER][NEUTRAL] Denied for a primary UB, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So I request you to send me the UOB through fax, ma'am. I provide you the fax number.
[AGENT][NEUTRAL] If EOBs are obtainable on a provider portal at secured and that's [PII].
[CUSTOMER][NEUTRAL] 99.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] What is the call reference?
[AGENT][POSITIVE] The call reference number is my name and today's date, and I spell my name [PII] I've already spelled that for you. I apologize.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, and
[CUSTOMER][POSITIVE] OK, no issues. One second.
[CUSTOMER][NEUTRAL] It's the American public.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] American Public Life. Let me just check if I have one more or not.
[CUSTOMER][NEUTRAL] So you only have with uh this member ID or do you have any different member ID also which you can access?
[AGENT][NEUTRAL] For this patient, only this policy.
[CUSTOMER][NEUTRAL] Mhm, one second.
[CUSTOMER][POSITIVE] OK. So I have accent also, so that is what I was asking you. OK, no issues. Thank you, madam.
[AGENT][NEUTRAL] It's