AccountId: 011433970860
ContactId: 7b1dc681-ca60-48e5-a95a-43b832afc2f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176179 ms
Total Talk Time (AGENT): 69844 ms
Total Talk Time (CUSTOMER): 65612 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/7b1dc681-ca60-48e5-a95a-43b832afc2f3_20250402T21:32_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] I have this insurance for a patient as secondary and I, I, we filed to you but I'm not sure you're even, are you, do you file the medical claims or is this more like a accident thing?
[AGENT][NEUTRAL] OK, we're the members, we have different benefit plans.
[CUSTOMER][NEUTRAL] Perfect. OK, so I need to check to see if you received a claim as a secondary payer from us.
[AGENT][NEUTRAL] OK. May I have your name and a callback number?
[CUSTOMER][POSITIVE] It's [PII] and what was your name? I'm so sorry.
[AGENT][NEUTRAL] It is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the callback number, please?
[CUSTOMER][NEUTRAL] [PII] direct line.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] I have 01457188.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII], [PII].
[AGENT][NEUTRAL] May I have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII] of this year [PII].
[AGENT][POSITIVE] And thank you so much [PII], for verifying the policy. You can also check claim status via our secured portal, that is [PII]. I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So it does show that we did receive that claim on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] That claim number is 358.
[AGENT][NEUTRAL] 1826. It shows that it processed and it denied that office visits and or procedures are not covered under this member's plan.
[CUSTOMER][NEUTRAL] So procedures and office visits not covered. OK, I think I'm just gonna take the insurance out because I don't, that's pretty much what we do procedures and office visits.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So probably doesn't work as a medical plan, does it?
[AGENT][NEUTRAL] It does, it's just based off of what the member has chosen as their benefit package.
[CUSTOMER][NEUTRAL] OK, so, so what does it cover under her benefit package?
[AGENT][MIXED] She does have other benefits, but it's just nothing that uh rendered for the office setting.
[CUSTOMER][POSITIVE] OK, nothing for an office setting. OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.