AccountId: 011433970860
ContactId: 8bcaaa3e-da46-47c4-83e8-1610930128f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 221529 ms
Total Talk Time (AGENT): 81133 ms
Total Talk Time (CUSTOMER): 91003 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/8bcaaa3e-da46-47c4-83e8-1610930128f8_20250605T14:27_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi, very good morning. My name is [PII] and I'm calling you from the provider's office. I'm looking for a claim status. And could you spell your first name for my documentation?
[AGENT][NEUTRAL] It is spelled [PII] with the last initial of [PII] and today's date as the call reference.
[CUSTOMER][POSITIVE] Oh, thank you so much, [PII].
[AGENT][NEUTRAL] You're welcome and [PII], may I please have a callback number?
[CUSTOMER][NEUTRAL] Mhm. It's [PII] direct line. There's no extension.
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] Mhm. And the policy number, which is, one moment. It's 02210438 and Mike Lima number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Spe name, it's [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And you're calling in for status. May I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII], the charge is $238.83.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This issue of not cutting.
[AGENT][NEUTRAL] And that is for data service of [PII] and 24 total bill 23883. I'm pulling that information up for you now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does show that we did receive that claim on [PII]/7.
[AGENT][NEUTRAL] It was processed on [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] The claim number is 35.
[AGENT][NEUTRAL] 99831. It shows that it denied requesting the corrected EOB.
[CUSTOMER][NEUTRAL] So, actually, uh, this patient does not have any other insurance as a primary. Earlier, the primary insurance is Medicare, however, they have already terminated at the time of service.
[CUSTOMER][NEUTRAL] So you guys are the only insurance for this patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We're just their supplemental, so if they don't have primary, we don't cover the insurance.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] We will not cover that claim.
[CUSTOMER][NEUTRAL] So this patient have a supplement.
[AGENT][NEUTRAL] This is a supplemental policy, which is their gap. So it's only based off of their primary insurance.
[CUSTOMER][NEUTRAL] So it will always be supplemented to Medicare or any other insurance.
[AGENT][NEGATIVE] We're the last resort to any insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this patient need to update the COB information.
[AGENT][NEUTRAL] They either need to give you the correct primary insurance and then we will have to have that EOB.
[CUSTOMER][POSITIVE] OK, sounds great. Thank you so much.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, sounds great. Thank you so much for this information. And can I get the reference number of this call?
[AGENT][NEUTRAL] Yes, as I previously stated at the beginning, it is my first name, last initial, and today's date.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sounds great thank you so much for your help and assistance and have a great day bye bye take care.
[AGENT][POSITIVE] You're welcome. Thank you so much for calling American Public Life, [PII]. Have a great day as well. Bye bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm