AccountId: 011433970860
ContactId: 89abe485-72d3-416a-bb2e-b0212c68bd4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371910 ms
Total Talk Time (AGENT): 147470 ms
Total Talk Time (CUSTOMER): 139910 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/89abe485-72d3-416a-bb2e-b0212c68bd4f_20250509T17:16_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hello ma'am. My name is [PII]. I'm calling from provider's office to check on a claim status.
[AGENT][POSITIVE] Oh OK, I can help you with that. Could I get your name again?
[CUSTOMER][NEUTRAL] Um spelled as [PII] initial to my last name, [PII].
[AGENT][NEUTRAL] OK, could I get a callback number, you mayor?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And if I could get the policy number you're calling on.
[CUSTOMER][NEUTRAL] It's 02288514 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you so much and you did say status today what is the date of service you're checking?
[CUSTOMER][NEUTRAL] Uh, date of service is [PII] total charge $425 even actually we have uh we have.
[AGENT][NEUTRAL] OK. Could you repeat that one more time?
[AGENT][NEUTRAL] The data service again?
[CUSTOMER][NEUTRAL] Oh yeah, uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] 24. OK, and the, the uh total bill is 425. And I do show that we've received the claim. It looks like it was received twice, um, once denied for duplicate, uh, the original, uh, denial was, uh, the policy does not cover services rendered in the physician's office.
[CUSTOMER][NEUTRAL] Be the
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Yes ma'am, I do have just one more patient to check if you could assist me.
[AGENT][NEUTRAL] OK, let me note this account and I will get the next policy number.
[CUSTOMER][NEUTRAL] Uh, also, could you provide me the plan name for this patient?
[AGENT][NEUTRAL] This is a supplemental gap policy.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] OK, hold one moment please.
[AGENT][NEUTRAL] OK, and what is the next policy number?
[CUSTOMER][NEUTRAL] 023 00724 M as in Mike L as in Lima number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service you're checking for her?
[CUSTOMER][NEUTRAL] [PII] with the total charge of $897 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show the claim received. It looks like um.
[AGENT][NEUTRAL] Uh, let's see, the claim, so the physician office visit is a non-covered, uh, procedure services. Uh, the policy does not cover the physician visit. The, um, other charge of 379 was denied paid in full by the primary.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] For this one is the same plan, right?
[AGENT][NEUTRAL] It is, yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you, uh, ma'am, I do have just, uh, 3 more claims for this patient. Uh, can you provide me just the status for those 3?
[AGENT][NEUTRAL] OK, when is the next date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Ja
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And this is for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so [PII] is not on file.
[CUSTOMER][NEUTRAL] OK, and this another one is [PII].
[AGENT][NEUTRAL] Total charge.
[CUSTOMER][NEUTRAL] $2,131 even.
[AGENT][NEUTRAL] OK, uh, that claim was received, let me see, claim also denied.
[AGENT][NEUTRAL] Uh, the physician office is not covered. Uh, the other charges were denied, um, paid in full by the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you provide me the claim number for that one?
[AGENT][NEUTRAL] Yes, sir. Claim number is 2, I'm sorry, 359.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 3602.
[CUSTOMER][NEUTRAL] OK and just one last thing, uh, for the [PII] with the total charge of.
[CUSTOMER][NEUTRAL] $1,984.
[AGENT][NEGATIVE] OK, [PII] is, uh, has not been received.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. Just the call reference.
[AGENT][NEUTRAL] To reference our call, you'll use my name [PII] and today's date.
[CUSTOMER][POSITIVE] Oh, thank you so much, ma'am. That's all. You have a great day.
[AGENT][POSITIVE] You're welcome. You have a wonderful day yourself and thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.