AccountId: 011433970860
ContactId: 80ab75e0-f823-4ab4-9db0-3602dcfb1833
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 490119 ms
Total Talk Time (AGENT): 85067 ms
Total Talk Time (CUSTOMER): 121486 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/80ab75e0-f823-4ab4-9db0-3602dcfb1833_20250529T14:31_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm calling you from the provider's office. How are you doing today?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][POSITIVE] I'm good thank you so much for asking. Uh, actually I have a specific question regarding the claim, so can you assist me with that?
[AGENT][NEUTRAL] OK, and could you spell your name for me please?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]
[AGENT][NEUTRAL] And may I please have a callback number?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Um, it's 01.
[CUSTOMER][NEUTRAL] 989-389.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] and the date of birth will be [PII].
[AGENT][NEUTRAL] OK, that does not match the date of birth for the member.
[CUSTOMER][NEUTRAL] Sorry, uh,
[CUSTOMER][NEUTRAL] Just a minute, just a minute.
[CUSTOMER][NEUTRAL] OK, actually the um name is different. The patient name is different. It, it is [PII].
[AGENT][NEUTRAL] OK, and you're calling in regards to a claim for this member?
[CUSTOMER][NEUTRAL] Um, no, actually I have a question for this.
[AGENT][NEUTRAL] OK how assist you?
[CUSTOMER][NEUTRAL] OK, um, just a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so here actually, um.
[CUSTOMER][NEUTRAL] We submitted a claim to American Public Life with the primary EOB.
[CUSTOMER][NEGATIVE] And then I don't have any status right now.
[CUSTOMER][NEUTRAL] But I'm seeing that.
[CUSTOMER][NEUTRAL] The patient is no longer eligible under this policy, so you can just explain me about uh like what is happening.
[AGENT][NEUTRAL] OK, so you're calling in for status of a claim. May I please have that data service and the.
[CUSTOMER][NEUTRAL] Yeah, sure, the date of service will be [PII].
[CUSTOMER][NEUTRAL] And the bill amount will be $2,365.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I did pull that claim up and it shows that this patient is no longer eligible dependent under this policy, so at the.
[AGENT][NEGATIVE] This member was not active under us.
[CUSTOMER][NEUTRAL] Can you provide me the effective dates?
[AGENT][POSITIVE] Yes, let me pull that up for you.
[AGENT][NEUTRAL] So this member was affected [PII].
[AGENT][NEUTRAL] 1
[AGENT][NEUTRAL] No, [PII] and it shows that this member is no longer active. Let me get you that time this member.
[AGENT][POSITIVE] And I'm pulling it up for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the term date is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, and can you just provide me that like who is secondary so we can just file him to them.
[AGENT][NEUTRAL] You will have to check with the policy holder.
[CUSTOMER][NEUTRAL] So we have to contact the um patient, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, just a minute. I'm just saving all the information. Can you give me a minute?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello, are you there?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] All right. um, thanks for the information. Can you just provide me the call reference number and your name?
[AGENT][NEUTRAL] Yes, the car reference would be my first name [PII], that is spelled [PII] with the last initial of 8 in today's date. Is there anything else I can assist you with today, Aha?
[CUSTOMER][NEUTRAL] No, um, it was only one claim for today um have a good day bye bye.
[AGENT][POSITIVE] Thank you and thank you so much for calling American Public Life. Have a great day.