AccountId: 011433970860
ContactId: 88fc900b-aa04-460b-b106-3ac5d89d719c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331109 ms
Total Talk Time (AGENT): 45921 ms
Total Talk Time (CUSTOMER): 182936 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/88fc900b-aa04-460b-b106-3ac5d89d719c_20250616T19:04_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with Legacy Financial. How are you today?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][NEUTRAL] Good thank you [PII] I'm calling um on behalf of one of our clients that has gap policy um she just wants to confirm if a claim was submitted. She tried to look on her member portal but is not seeing it and I know that the new site's been having some issues so I wanted to call in and see if you're able to see um the, the claim there filed by the by the provider.
[AGENT][NEUTRAL] May I have the policy number?
[CUSTOMER][NEUTRAL] Yes, policy number is 245-03772.
[AGENT][NEUTRAL] And you're calling from the agent or broker's office?
[CUSTOMER][NEUTRAL] Yes, yes, it's Legacy Financial Consulting.
[AGENT][NEUTRAL] And may I have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] May I have the member's first and last name and the date of birth?
[CUSTOMER][NEUTRAL] The member is [PII]. I'm calling in regards to a claim for his daughter though, so would you like his information or the daughter's information?
[AGENT][NEUTRAL] I'm needing the patient's information.
[CUSTOMER][NEUTRAL] OK, it is [PII]. Last name is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] And do you have the date of service and total bill?
[CUSTOMER][NEUTRAL] I do. Yes, the date of service is [PII] of this year.
[CUSTOMER][NEUTRAL] And the billed amount, give me one moment.
[CUSTOMER][NEUTRAL] Uh, one second, it was an urgent care. Give me one second, and I have to scroll down to find it.
[CUSTOMER][NEUTRAL] Um, one moment.
[CUSTOMER][NEUTRAL] We've been at it with this one for a while, so trying to find it in the emails. It was for $125 which was her um urgent care co-pay.
[AGENT][NEUTRAL] OK, so that's just her responsibility. That's not the total bill charge.
[CUSTOMER][NEUTRAL] Oh, the total total? OK, let me see if I could, let me see if I find it.
[CUSTOMER][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Oh wait I think I might have it actually in her file.
[CUSTOMER][POSITIVE] fo li o
[CUSTOMER][NEUTRAL] OK here it is.
[CUSTOMER][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] Uh, total billed, God, this is the receipt.
[CUSTOMER][NEUTRAL] OK, total bill amount was 482 I believe.
[CUSTOMER][NEUTRAL] That says according to her Amed um EOB.
[AGENT][NEUTRAL] OK. Let me pull the image up cause I'm not seeing that total either.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] She submitted it herself, but then it was having issues because I guess there were some codes missing so she had the provider try to resubmit it and supposedly they submitted it on [PII], but she doesn't see it again. I don't know if it's because.
[CUSTOMER][NEUTRAL] The system isn't showing it or.
[CUSTOMER][NEUTRAL] What's going on?
[AGENT][NEUTRAL] OK, so for this data of service of the 482, we've only received claims in from the insured.
[CUSTOMER][NEUTRAL] Not nothing from the provider then.
[AGENT][NEUTRAL] We've only received it from insured.
[CUSTOMER][NEGATIVE] From the insured. OK. So nothing. All right. They said they submitted on [PII], obviously they did not. OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, perfect. I will have her contact them and resubmit it. Maybe they're sending it to the the primary insurance again.
[CUSTOMER][NEUTRAL] T
[CUSTOMER][POSITIVE] OK, excellent. [PII], thank you very much for the information. I appreciate it.
[AGENT][POSITIVE] You're welcome. And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] No, that's it. I think you guys don't do reference numbers, right? It's usually just your name and the date of the date of today's date, correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you [PII] I appreciate it have a good rest of your day.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life, [PII], have a great day as well.
[CUSTOMER][POSITIVE] Thank you bye bye.