AccountId: 011433970860
ContactId: 74b9ba32-99f2-429f-9b5a-c8e060aa98f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369309 ms
Total Talk Time (AGENT): 93535 ms
Total Talk Time (CUSTOMER): 155581 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/74b9ba32-99f2-429f-9b5a-c8e060aa98f2_20250109T15:33_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. Who am I speaking with?
[CUSTOMER][NEUTRAL] Hi, my name is Am. It's [PII].
[AGENT][NEUTRAL] OK, I can barely hear you. Can you speak up?
[CUSTOMER][NEUTRAL] Can you hear me better now?
[AGENT][POSITIVE] Yeah a little bit, yes sir, and how can I help you?
[CUSTOMER][NEUTRAL] Yeah, I'm calling to check claim status.
[AGENT][NEUTRAL] OK, absolutely I can help you with that. But first we're having phone issues. Can I get a callback number in case I lose you?
[CUSTOMER][NEUTRAL] with.
[CUSTOMER][NEUTRAL] Yeah, callback number [PII].
[AGENT][POSITIVE] Perfect and the policy number?
[CUSTOMER][NEUTRAL] 01
[CUSTOMER][NEUTRAL] 822968, M as in Mary, L as in Lima, number 8.
[AGENT][NEUTRAL] OK, and the patient's name?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. Uh, patient name is
[CUSTOMER][NEUTRAL] At least
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And the data service for the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It was for [PII].
[AGENT][NEUTRAL] OK, how much is the claim for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was for $2,461.66.
[AGENT][NEUTRAL] Perfect, we received that claim on [PII].
[CUSTOMER][NEUTRAL] We reaching back to you on.
[AGENT][NEGATIVE] Processed and denied on [PII].
[CUSTOMER][POSITIVE] Pro.
[AGENT][NEUTRAL] Of [PII] as we're needing the primary EOB.
[CUSTOMER][NEUTRAL] That you.
[CUSTOMER][NEUTRAL] OK, so like this will deny the question for the primary you'll be right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And do you have the claim number?
[AGENT][NEUTRAL] Yes, claim number is 3,521,760.
[CUSTOMER][NEUTRAL] Yes, fine.
[CUSTOMER][NEUTRAL] 17
[CUSTOMER][NEUTRAL] OK, so it's 3,521,760.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So like, uh, we have to resubmit a claim with the primary EOP or like we can like sending the primary EOP.
[AGENT][NEUTRAL] You can just send the EOB and just reference the claim number.
[CUSTOMER][NEUTRAL] you just reference.
[CUSTOMER][NEUTRAL] And like, uh, is there any fax number or like the mailing address to send the EV?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Our fax number is 87 I'm sorry 877.
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][POSITIVE] Perfect
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 943.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And who's your attention.
[AGENT][NEUTRAL] Uh, claims.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] And like is there any time frame to submit the primary EOP or like there's no time frame.
[AGENT][NEUTRAL] There is no time frame.
[CUSTOMER][NEUTRAL] 0.
[CUSTOMER][NEUTRAL] And uh I do have one more claim to check. So before we move on to the next 1 may I have a caller reference number on this claim, please?
[AGENT][NEUTRAL] It is just my name.
[CUSTOMER][NEUTRAL] And it's
[CUSTOMER][NEUTRAL] You said your name is [PII]?
[AGENT][POSITIVE] Correct, [PII]
[CUSTOMER][NEUTRAL] Correct, I.
[AGENT][NEUTRAL] Last initial [PII].
[CUSTOMER][NEUTRAL] I need for the next.
[CUSTOMER][NEUTRAL] OK, so I have the next member ID.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 022.
[CUSTOMER][NEUTRAL] 55775 M as in Mary, L as in Lima number 8.
[AGENT][NEUTRAL] OK, patient's name?
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK perfect and [PII]'s data service?
[CUSTOMER][NEUTRAL] Date of service, uh, it was for [PII].
[AGENT][NEUTRAL] OK, and how much is the claim for?
[CUSTOMER][NEUTRAL] It was for $4,563.49.
[AGENT][NEUTRAL] OK, we received that claim on [PII].
[AGENT][NEUTRAL] Processed and denied on [PII] as we're needing the primary EOB as well.
[CUSTOMER][NEUTRAL] And now you have the claim number for this.
[AGENT][NEUTRAL] Claim number is 353.
[AGENT][NEUTRAL] 2790.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] not for the primary he'll be as well, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what is timely filing for the claim submission, the initial claim submission.
[AGENT][NEGATIVE] We do not have timely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right then yeah, um, [PII], that will be all for now. Thank you so much for the information for helping me out.
[AGENT][POSITIVE] Oh, no problem at all. You have a great rest of your day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. You have a great day bye bye.
[AGENT][NEUTRAL] Uh huh bye bye.