AccountId: 011433970860
ContactId: 68857f51-91e1-439f-ae30-bfad5b1fd172
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 199910 ms
Total Talk Time (AGENT): 69587 ms
Total Talk Time (CUSTOMER): 69999 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/68857f51-91e1-439f-ae30-bfad5b1fd172_20250130T20:17_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] Hi [PII]. This is [PII]. I'm calling from Wake Forest Baptist Hospital, and I need uh some assistance with the claim, please.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] It is 02.
[CUSTOMER][NEUTRAL] 333-064
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] And I did pull that member up. How may I assist you on the claim?
[CUSTOMER][NEUTRAL] Uh, date of service [PII].
[CUSTOMER][NEUTRAL] I needed the claim status.
[AGENT][NEUTRAL] To you.
[CUSTOMER][NEUTRAL] $31,058.92.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And for that claim, it does show that we do have it on file. We received that claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 354.
[AGENT][NEUTRAL] 8311. It shows that the claim process and it denied that the per calendar year max had been met.
[CUSTOMER][NEUTRAL] Her calendar year max has been met.
[AGENT][POSITIVE] Yes, so the benefit ma'am for this member has been met.
[CUSTOMER][NEUTRAL] On January on January.
[CUSTOMER][NEUTRAL] OK. On [PII] he already made it. Oh, OK. Can you fax me a copy of the EOB so I can send this to the patient, please?
[AGENT][NEUTRAL] This claim was for [PII], so it was met with that date of service.
[CUSTOMER][POSITIVE] Oh, that's right, that's right.
[CUSTOMER][NEUTRAL] Oh yeah, you're right. I'm sorry, I'm thinking [PII]. It was just processed in [PII]. OK.
[CUSTOMER][NEUTRAL] You got me, [PII].
[AGENT][NEUTRAL] And you're needing the ERB?
[CUSTOMER][POSITIVE] You got me again. Thank you so much. Yes, please.
[AGENT][NEUTRAL] OK, may I have the fax number to submit that EOB?
[CUSTOMER][NEUTRAL] Sure, 478.
[CUSTOMER][NEUTRAL] 633
[CUSTOMER][NEUTRAL] 5181.
[AGENT][NEUTRAL] Into the attention.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Is it [PII] or KYM?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK. I will get that submitted over to you. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No ma'am that's it thank you so much I appreciate your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.