AccountId: 011433970860
ContactId: 7560e01d-2103-4a25-ba3c-5d40c06d6f86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321359 ms
Total Talk Time (AGENT): 145284 ms
Total Talk Time (CUSTOMER): 121892 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/7560e01d-2103-4a25-ba3c-5d40c06d6f86_20250204T19:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from the provider's office to check on the claim status, ma'am.
[AGENT][NEUTRAL] OK, I could check on a claim for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Direct line is [PII].
[AGENT][NEUTRAL] OK, thank you. And then do you have the policy number?
[CUSTOMER][POSITIVE] Yes, ma'am. You're welcome. Just a second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The policy number is 02555046.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII]. Uh what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] It's [PII] and the bill amount is $728 even and it's a medical claim.
[AGENT][NEUTRAL] Got it. OK, and that was, I'm sorry, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Sure, ma'am.
[AGENT][NEUTRAL] What was the name of the provider's office, [PII]? I'm sorry.
[CUSTOMER][NEUTRAL] It's Holy Cross Medical Group.
[AGENT][NEUTRAL] OK, so I do believe I found that claim, let's see.
[CUSTOMER][POSITIVE] And I'm so sorry, what was your name, ma'am?
[AGENT][NEUTRAL] It's OK, it's [PII]
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Of course. All [PII], one moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and I'm so sorry you did say that bill amount that was $728?
[CUSTOMER][POSITIVE] That is correct, ma'am.
[AGENT][NEUTRAL] OK, well, I didn't for the state of service I didn't find a claim for that amount. Um, I did find one, it looks like the original bill amount was $214.
[CUSTOMER][NEUTRAL] OK, maybe that is for the different one because I have 728 uh.
[CUSTOMER][NEUTRAL] And this one.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Because previously, mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Previously, I can see I have one claim number that's for the different uh bill amount here. But again, they have submitted this claim on 1222024.
[AGENT][NEUTRAL] 12:20. Let me see.
[AGENT][NEUTRAL] Yeah, I'm not showing that we've received that, um.
[AGENT][NEUTRAL] No this is the only claim that I have for this state of service, um, so the total bill charges were $214 we received the remaining balance of $35.54. So this is a different claim then?
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] Maybe that's a different one. Yeah.
[AGENT][NEUTRAL] OK, so it does not look like you received this one then, [PII].
[CUSTOMER][NEUTRAL] That's correct. 214 I have here and that has been already paid. So, if it, that's not the one, can you please help me with the mailing address and the payer ID ma'am?
[AGENT][NEUTRAL] Of course, um, I've also got a fax number if you'd like. Um, the mailing address is [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] OK. And what is the, one second, copy your ID.
[AGENT][NEUTRAL] Uh, your ID is 60801.
[CUSTOMER][NEUTRAL] Thank you, ma'am. Can I get the member's uh effective date, timely filing limit, and also the fax number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of course, um, so I'll give you that fax number first that is 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] And then there is no timely filing limit.
[AGENT][NEUTRAL] This policy's effective date was [PII], and it is currently active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. [PII].
[CUSTOMER][NEUTRAL] And just to confirm, this member belongs to American Public Life Insurance, correct?
[AGENT][NEUTRAL] Correct. This is their secondary medical policy.
[CUSTOMER][NEUTRAL] OK. So members that is still with American Medical. OK. There is no claim on file. I got everything I guess. OK. Let me go ahead and uh fax out the claim or I will go ahead and resubmit it. Thank you so much for the help, ma'am. Uh, can I get the reference number for this call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, yeah.
[AGENT][NEUTRAL] Reference number would just be my first name, last initial, and today's date. Uh, so my last initial is [PII] Was there anything else I could help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much for the help and you have a wonderful day, [PII]. Thank you.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. You too, bye bye.
[CUSTOMER][NEUTRAL] Bye bye, [PII].