AccountId: 011433970860
ContactId: 8e26590e-86c6-4623-8e9b-b3561c080a74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 651119 ms
Total Talk Time (AGENT): 137968 ms
Total Talk Time (CUSTOMER): 214780 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/8e26590e-86c6-4623-8e9b-b3561c080a74_20250124T19:37_UTC.wav
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[AGENT][POSITIVE] Thank you for calling.
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[AGENT][NEUTRAL] This is [PII] with American Public Life Insurance Company. Can I help you?
[CUSTOMER][NEUTRAL] Yeah, this is [PII]. My last initial is [PII], checking for the claim status, [PII].
[AGENT][NEUTRAL] It's [PII] First initial of my last name is [PII] And what's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Yes, sir, one moment. Let me find.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] And that should be 022.
[CUSTOMER][NEUTRAL] 751.
[CUSTOMER][NEUTRAL] 46
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Callback number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], it's a direct line.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, the patient name is [PII], [PII].
[AGENT][NEUTRAL] OK, thank you for that. And you said that you're checking a claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] $150 even.
[AGENT][NEUTRAL] OK, so the claim was received [PII], processed [PII]. Uh, there was no payment made on this claim.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, the
[AGENT][NEUTRAL] Maximum, uh, the benefit maximum for this state of service.
[AGENT][NEUTRAL] Has been met.
[CUSTOMER][NEUTRAL] OK, it is um, it is the number of visits or number of dollars.
[AGENT][NEUTRAL] It's the dollar amount per visit.
[CUSTOMER][NEUTRAL] OK, one second, uh.
[CUSTOMER][NEUTRAL] It exceeded number of dollars.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It exceeded number of dollars.
[CUSTOMER][NEUTRAL] OK. How much the amount is exceeded?
[AGENT][NEUTRAL] It's, it's $75 per day.
[CUSTOMER][NEUTRAL] OK, download is $75 per day, right?
[AGENT][NEUTRAL] $75 per day.
[CUSTOMER][NEUTRAL] It allowed
[CUSTOMER][NEUTRAL] 75.
[CUSTOMER][NEUTRAL] Dollars.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] And the
[CUSTOMER][NEUTRAL] OK. May I know the date of when the patient has been made for the dollars?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] So it reached uh on [PII], right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK. May I know the previous state of service, uh, it has been exceeded?
[AGENT][NEUTRAL] It's from a different provider, sir, we can't disclose that information. So your claim was received after the 5 visits were paid and so there were no benefits available at that time. Let me know when you're ready for the claim number.
[CUSTOMER][NEUTRAL] 0202.
[CUSTOMER][NEUTRAL] Yes 50.
[CUSTOMER][NEUTRAL] OK, one second. So the last claim billed on [PII] with a different provider and same patient, right?
[AGENT][NEUTRAL] Uh, we can't disclose any other information outside of your own.
[CUSTOMER][NEUTRAL] No, I'm asking you, just yes or no. The last name billed on [PII] with this different provider and the same patient, right?
[AGENT][NEUTRAL] Your claim was received on [PII], processed on [PII]. It denied us the maximum benefit met. That's the extent of information that I can provide on this date of service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, it's OK. The last claim billed on [PII], right?
[AGENT][NEUTRAL] Are you referring to the claim that was submitted by your office?
[CUSTOMER][NEUTRAL] OK. One second. 11 moment.
[CUSTOMER][NEUTRAL] OK. What is the call reference? OK, what is the claim number?
[AGENT][NEUTRAL] The claim number for your date of service is 346.
[CUSTOMER][NEUTRAL] is going to be 97202-9160 is direct line.
[AGENT][NEUTRAL] 4816.
[CUSTOMER][NEUTRAL] 346-481-6, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can you fax me the copy of the UB?
[AGENT][NEUTRAL] Uh, the explanation was actually mailed the next business day and it's now available to download online. I can help you create that account if you would like to download a copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No need, uh, so you can fax over my fax number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the fax number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are you ready?
[AGENT][NEUTRAL] The fax number please?
[CUSTOMER][NEUTRAL] [PII]. OK, move on to the next set of service.
[AGENT][NEUTRAL] OK. And anything else I can help out with today, [PII]?
[AGENT][NEUTRAL] Is it for the same patient?
[CUSTOMER][NEUTRAL] Yeah, same patient.
[AGENT][NEUTRAL] Day of service.
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Yeah, the date of service is [PII].
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] $265.07.
[AGENT][NEUTRAL] Did you have any more dates of service for this patient?
[CUSTOMER][NEUTRAL] No, that's all. This one, just so you can fax the copy of the UB, that's all.
[AGENT][NEUTRAL] OK OK.
[CUSTOMER][NEUTRAL] For the state of service.
[AGENT][NEUTRAL] OK, anything else I can help out with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] All righty. Thank you for calling APL [PII]. Have a good day.
[CUSTOMER][NEUTRAL] OK. How many days it will take to receive the copy of the UB?
[AGENT][NEUTRAL] Allow 7 to 10 days for it to be released from our office and once it's mailed, I don't know how what's the time frame between the two locations, but allow at least 7 to 10 days for it to be mailed from our office.
[CUSTOMER][POSITIVE] OK. OK, thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] [PII], did you have any other questions? I show that we're still connected.
[CUSTOMER][NEUTRAL] OK. Can you give me the call reference number?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] OK, [PII]. Uh, and one more thing, uh, one moment.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][POSITIVE] OK thank you bye bye.
[AGENT][POSITIVE] You're, you're welcome. Thanks for calling APL. Have a good day.