AccountId: 011433970860
ContactId: 5f846c82-bcfd-46bc-88c6-920d92342fdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 178600 ms
Total Talk Time (AGENT): 69887 ms
Total Talk Time (CUSTOMER): 53005 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/5f846c82-bcfd-46bc-88c6-920d92342fdd_20250403T20:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, I'm [PII] here from the provider's office of Community Medical Associates for claims center.
[AGENT][NEUTRAL] May I have a callback number?
[CUSTOMER][NEUTRAL] [PII] it's a direct line.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Sure it's gonna be 02449775.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] And you say that you're calling in for status of claim. May I have the date of service and total bill?
[CUSTOMER][POSITIVE] Yeah, perfect.
[CUSTOMER][NEUTRAL] The day or so.
[CUSTOMER][NEUTRAL] [PII] for $242 even.
[AGENT][POSITIVE] Thank you, and you can also check claim status via our secured portal that is [PII] and I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] And for that claim, it shows that we did receive it and it was processed on 37.
[AGENT][NEUTRAL] That claim number is 357.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] 2590 it processed and it denied that office visits are not covered under the patient's plan. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And could you please send the copy of EOB, the flexicipation responsibility through fax?
[AGENT][NEUTRAL] May I have the fax number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you're just needing the the now for that EOB because it doesn't show the patient's responsibility that would be on the primary in EOB.
[CUSTOMER][NEUTRAL] Yeah, I just want to deny that you'll be directly responsible as the member.
[AGENT][POSITIVE] OK, I will get that sent to you. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] And the received date, is it received and processed on the same day?
[AGENT][NEUTRAL] It was received on [PII].
[CUSTOMER][NEUTRAL] Alright, thank you, and just a call reference number and spelling of your name please.
[AGENT][NEUTRAL] The car reference number would be my first name, [PII], spelled [PII] last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you, [PII]. Have a good day. Bye-bye.
[AGENT][POSITIVE] Great as well.