AccountId: 011433970860
ContactId: 8e02710f-a204-40ad-a927-fdfe22c98fe8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286790 ms
Total Talk Time (AGENT): 99382 ms
Total Talk Time (CUSTOMER): 82416 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/8e02710f-a204-40ad-a927-fdfe22c98fe8_20250528T16:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling with a couple of claim questions for one of our patients.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yep, my name is [PII] and a callback number is [PII].
[AGENT][NEUTRAL] And could you give me the beginning 3 numbers please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] It's 02150688.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], it's [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in regards to status of claim. May I please have the date of service and total.
[CUSTOMER][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] Yes, OK, so the first.
[CUSTOMER][NEUTRAL] Um, so there was a claim on [PII].
[CUSTOMER][NEUTRAL] And the bill amount let me take a look, sorry.
[AGENT][NEUTRAL] Is that for this year?
[CUSTOMER][NEUTRAL] Yes, I'm sorry uh for this year.
[CUSTOMER][NEUTRAL] And the bill amount was $193.49.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you can also check claim status via our secured portal that is [PII] and I'm pulling that information up for you now.
[AGENT][NEUTRAL] And for that claim we did receive it on [PII].
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 3604.
[AGENT][NEUTRAL] 578. It denied that office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So per their policy office visits are not covered?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And then um the second date of service I wanted to ask about was for [PII].
[AGENT][NEUTRAL] Total bill please.
[CUSTOMER][NEUTRAL] And the total bill on that one.
[CUSTOMER][NEUTRAL] Was $190.16.
[AGENT][NEUTRAL] And for that claim, it does show that we received it on [PII]. It was processed on [PII]. That claim number is 3601436. That claim shows that it processed and that it made a payment in the amount of.
[AGENT][NEUTRAL] $2.52. Let's see what that is for.
[AGENT][NEUTRAL] So it looked like that the other amount actually went towards the member's deductible. They had a $100 deductible that was due.
[CUSTOMER][NEUTRAL] OK, and is that their Medicare deductible or with that or I guess would that be their deductible with your company?
[AGENT][NEUTRAL] That's the deductible that they have with us.
[CUSTOMER][POSITIVE] OK great all right.
[CUSTOMER][NEUTRAL] That is very helpful and then I just have one more question for you. I am walking on a walking pad and it's a little loud on my end. I'm wondering if you can hear it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEGATIVE] No, I'm not able to hear it.
[CUSTOMER][MIXED] You're not OK cool thank you. I just didn't know but all right well I hope you have a wonderful day.
[AGENT][POSITIVE] You're welcome. Oh, no problem.
[AGENT][POSITIVE] Same to you and thank you so much [PII] for calling American Public Life. Enjoy the rest of your day.
[CUSTOMER][NEUTRAL] All right, bye.
[AGENT][NEUTRAL] Bye.