AccountId: 011433970860
ContactId: 7b95caaf-455c-4587-82c4-2db8d1f20a1b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 442440 ms
Total Talk Time (AGENT): 105751 ms
Total Talk Time (CUSTOMER): 169350 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/7b95caaf-455c-4587-82c4-2db8d1f20a1b_20250619T18:44_UTC.wav
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[CUSTOMER][NEUTRAL] Hello.
[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 for private office. I just want to know about the claim status and denial.
[CUSTOMER][NEUTRAL] Can you
[AGENT][NEUTRAL] Um, OK, so we're needing a clarification regarding a claims and all?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I can get that for you. Can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, of course. Can you spell out first what's your name?
[AGENT][NEUTRAL] Uh, my name is spelled [PII]
[CUSTOMER][NEUTRAL] [PII], right? Do you have your last name, [PII]?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Last initial is [PII]
[CUSTOMER][NEUTRAL] Hey, thank you. My callback number is going to be [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] Yes. The policy number is going to be 02467679.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Yes, the member first name is [PII], middle name is [PII] Last name is [PII].
[CUSTOMER][NEUTRAL] [PII]. And the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Do you have the claim number?
[CUSTOMER][NEUTRAL] Claim number, no. Actually, the claim was processed uh by the primary and uh cross over to the secondary insurance, American Public Life Insurance. So we don't have a claim number for the secondary American public.
[AGENT][NEUTRAL] OK, uh, what was the
[CUSTOMER][NEUTRAL] We are the only claim member of the Prime.
[AGENT][NEUTRAL] Sure, what was the date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The date of service is [PII] and the charge amount of this claim is going to be 3 $637 even.
[AGENT][NEUTRAL] Could you repeat that billed amount, please?
[CUSTOMER][NEUTRAL] $637 even.
[AGENT][NEUTRAL] OK, and you did say that date of service was [PII]?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that we've received a claim for that date of service for this number.
[CUSTOMER][NEUTRAL] Actually, we build this claim by the paper claim on [PII]. So, do you not received yet?
[AGENT][NEUTRAL] Yeah, I, I'm showing that we've received that information.
[CUSTOMER][NEUTRAL] OK. I have one more question. Can you check this?
[AGENT][NEUTRAL] But do you have a mailing address, fax number, and a payer ID I can give you?
[CUSTOMER][NEUTRAL] OK, go ahead. What was the um mailing address, [PII]?
[AGENT][NEUTRAL] That is, yes, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] Zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK. Do you have fax number?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That is 877.
[AGENT][NEUTRAL] 3659423
[CUSTOMER][NEUTRAL] 877
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][NEUTRAL] 365943, right?
[AGENT][NEUTRAL] It's 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So what was the pay ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And what was the time per limit for, what was the time per limit?
[AGENT][NEGATIVE] There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK, thank you. So, can we move to the next one? Next question?
[AGENT][NEUTRAL] Uh, we're looking at a claim for a different member?
[CUSTOMER][NEUTRAL] Yes, with a different member.
[AGENT][NEUTRAL] OK, you can go ahead with that policy number.
[CUSTOMER][NEUTRAL] Mm OK. The policy number is going to be A. 01975791.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for this number, please?
[CUSTOMER][NEUTRAL] OK. The patient's first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and you didn't have this claim number either?
[CUSTOMER][NEUTRAL] Yes. We don't have a claim number.
[AGENT][NEUTRAL] OK. OK. Um, what was that?
[CUSTOMER][NEUTRAL] We have only the data service.
[AGENT][NEUTRAL] That's fine. OK, what was that date of service and then that, uh, build out please?
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And the charge amount of this claim is going to be uh
[CUSTOMER][NEUTRAL] $572 even.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I don't know
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello, hello, hello.
[CUSTOMER][NEUTRAL] Hello, hello, hello, hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello, hello, hello, hello, hello, hello.
[CUSTOMER][NEUTRAL] Anyone hear me?