AccountId: 011433970860
ContactId: 6ca0fc73-4b42-4c2c-b3c8-daa701f1b281
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541640 ms
Total Talk Time (AGENT): 170373 ms
Total Talk Time (CUSTOMER): 188716 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/6ca0fc73-4b42-4c2c-b3c8-daa701f1b281_20250116T16:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, hello, um, my name is [PII]. Last name initially [PII], and I'm calling from Laboratory Corporation of America. This call will be recorded for training and quality purposes. Your name is [PII], am I right?
[AGENT][NEUTRAL] [PII] Can you spell your first name, please?
[CUSTOMER][NEUTRAL] OK. My name is spelled [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes ma'am. Last name [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, I am calling regarding a claim that we submitted for one of our mutual patients. Can you please help me?
[AGENT][NEUTRAL] I can assist you. The policy number?
[CUSTOMER][NEUTRAL] It is 17792.
[AGENT][NEUTRAL] Do you have a copy of the card?
[CUSTOMER][NEUTRAL] Oh no ma'am, we don't have.
[AGENT][NEUTRAL] Spell the patient's first and last name?
[CUSTOMER][NEUTRAL] First name spells [PII].
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you for that information, [PII], one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] is the name. Date of birth [PII].
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] You've actually given me that information. One moment.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] You know, if we're doing things repeatedly sometimes we forgot.
[AGENT][NEUTRAL] Right. What state does she reside?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I think this patient is just a subscriber, oh it's just a dependent of the subscriber.
[AGENT][NEUTRAL] And verify her date of birth, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right. I have located the patient. Um, you want the policy number for your records?
[CUSTOMER][NEUTRAL] Yes, please, so you say the good policy number.
[AGENT][NEUTRAL] Yeah, what you provided is not the policy number. Uh, the policy number is 255.
[AGENT][NEUTRAL] 242 7.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said that you're checking claim status for [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um, what's the date of service? Do you have the claim number?
[CUSTOMER][NEUTRAL] I have a
[CUSTOMER][NEUTRAL] It is August 2.
[CUSTOMER][NEUTRAL] Yes, but the date of service is [PII] for $632.10. The claim number I have is 20, I think this is not your claim. This is for the primary insurance, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Mm, it's not
[AGENT][NEUTRAL] Yeah, if it starts with a 2 it's not ours.
[CUSTOMER][NEUTRAL] Yes ma'am, I think this is for the primary insurance.
[AGENT][NEUTRAL] OK, let me see [PII].
[AGENT][NEUTRAL] And you gave me a billed amount of $632. Is this for lab work?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So there's several lab coats on the claim?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this claim was received [PII], [PII], processed [PII]. What's the name of the provider?
[CUSTOMER][NEUTRAL] It is Laboratory Corporation of America Holdings or LabCorp Burlington.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I do show a benefit in the amount of $76.25 was issued.
[AGENT][NEUTRAL] Um, on some of the codes we're requesting a copy.
[AGENT][NEUTRAL] Let me see, one moment.
[AGENT][NEUTRAL] OK. So on some of the codes, it says the maximum uh payable benefits for laboratory and diagnostic test has been met. One moment, let me check the other remark.
[AGENT][NEUTRAL] And then on one of the one of the codes we need a copy of the primary explanation of benefits so.
[CUSTOMER][NEUTRAL] Mhm. Can I, uh, verify what is that particular code?
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] Uh huh, the one that we're requesting the primary explanation is for code 84439.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, did you need the claim number?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] That number is 352-2.
[AGENT][NEUTRAL] 468.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] That's the claim number.
[CUSTOMER][NEUTRAL] OK, thank you, and you said that there is a payment of $76.25?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, what is the mode of payment? Is it a paper check or EFT?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Individual check. The check number is 201.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 0516.
[CUSTOMER][NEUTRAL] And um issue date of the check.
[AGENT][NEUTRAL] The date the claim was processed.
[CUSTOMER][NEUTRAL] OK, which is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you very much. Is it clear?
[AGENT][NEUTRAL] And I show that the check has also cleared the bank on [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Is it a bulk check or a single check?
[AGENT][NEUTRAL] It's a single check.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK, so, uh, in order for the other code to be paid, we need to submit a copy of an of the EOB, right?
[AGENT][NEUTRAL] The primary EOB, that is correct.
[CUSTOMER][NEUTRAL] Thank you. Uh, can I please have a good mailing address for the EOB?
[AGENT][NEUTRAL] Mhm. It's the same address that the claim was mailed to American Public Life.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is a claim mailed from your office or from a different office?
[CUSTOMER][NEUTRAL] From a different office, ma'am.
[AGENT][NEUTRAL] Oh, OK. [PII].
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 8950.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 8950 and a timely filing please?
[AGENT][NEUTRAL] No timely filing limit to submit the ELB.
[CUSTOMER][NEGATIVE] No timely [PII]g limit.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so thank you very much for all the information. [PII], can I have your last name, initial, and the reference number for the call?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] The reference number.
[AGENT][NEUTRAL] My name in today's date.
[CUSTOMER][POSITIVE] OK, so thank you very much, [PII], for all the information and for your help. It is a great help for me. May you have a great day ahead.
[AGENT][POSITIVE] You too, [PII], and if no other questions, thank you for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] Have a great day as well bye.
[AGENT][NEUTRAL] All right. All right.