AccountId: 011433970860
ContactId: 7318fa43-47f1-4f51-9efe-769bb8b19e69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206500 ms
Total Talk Time (AGENT): 86023 ms
Total Talk Time (CUSTOMER): 71446 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/7318fa43-47f1-4f51-9efe-769bb8b19e69_20250529T18:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling concerning a claim.
[CUSTOMER][NEUTRAL] Medical claim.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the claim. Are you the provider? Are you the the insured?
[CUSTOMER][NEUTRAL] Provider.
[AGENT][NEUTRAL] OK, and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII], and it's [PII].
[AGENT][NEUTRAL] Thank you, and [PII], may I have the member's policy number?
[CUSTOMER][NEUTRAL] It is 982-431-075.
[AGENT][NEUTRAL] And is that the member's APL policy number or their major medical?
[CUSTOMER][NEUTRAL] It says, I guess, major, I have two numbers. I you can either pull it up by the 01960211 [PII].
[AGENT][NEUTRAL] Yes, that's our policy number. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] May go risky.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] 416 $25 total bill is 1,118 $1,118.19.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm not showing a claim on file for [PII] for [PII].
[CUSTOMER][NEUTRAL] OK. I have a claim number.
[CUSTOMER][NEUTRAL] Is this getting, I'm confused by this. How you don't have a claim. I have an EOB.
[AGENT][NEUTRAL] It sounds like you
[AGENT][NEUTRAL] OK, hold on one second. I'm here to assist you. It sounds like it it.
[CUSTOMER][NEUTRAL] Are your claims being processed by zealous?
[AGENT][NEUTRAL] If you'll allow me to speak, it sounds like the claim has been submitted to the primary insurance and not us with the secondary insurance, but I can take the claim number if you like and see if there's a claim here.
[CUSTOMER][NEUTRAL] Aren't you imagine? Imagine 360.
[AGENT][NEUTRAL] No, this is American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's try the claim number 2,514,600,880.
[AGENT][NEUTRAL] Right, so that is not an APL claim number. So it sounds like you said the claim was submitted to the primary insurance and has not been submitted to secondary, but there is no timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you have no claim on file for this patient yet?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and what is the address to send claims? I'll send it again.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] You're welcome. Was there anything else