AccountId: 011433970860
ContactId: 8ff637f6-a2b5-4df1-a4e4-2e16fa2eaa9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 770900 ms
Total Talk Time (AGENT): 197102 ms
Total Talk Time (CUSTOMER): 321217 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/8ff637f6-a2b5-4df1-a4e4-2e16fa2eaa9a_20250228T13:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. My last name is [PII]. I would like to uh request you to check the status of the payment. Would you be able to help me with that?
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. It is 135932.
[CUSTOMER][NEUTRAL] 2.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, sure. It is [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure. The patient's name is uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. May I have the date of service?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, sure. The date of service is [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] It is $1,456 even.
[AGENT][NEUTRAL] Thank you. For future reference, you may visit our website at [PII] to check claim status as well.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Mhm. Thank you so much for that information.
[AGENT][NEUTRAL] You're welcome. Looks like this process under claim number 3375918. No benefits were payable. The policy was not active at time of service, it looks like policy term 7-12023.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And there is no active policy on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] A the file.
[CUSTOMER][NEUTRAL] Thank you so much for that information. And uh can I have uh uh the claim fax, I mean, EOB fax to me because I don't have the EOB.
[AGENT][NEUTRAL] Sure. May I have a fax number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, sure. It is 585.
[CUSTOMER][NEUTRAL] 440
[CUSTOMER][NEUTRAL] 9493.
[CUSTOMER][NEUTRAL] And the attention is my name with my last initial.
[AGENT][NEUTRAL] Can you spell your name for me?
[CUSTOMER][NEUTRAL] Yes, sure. My name is spelled as [PII]. Last name [PII], it is [PII].
[AGENT][NEUTRAL] Thank you. I'll fax right, I'll fax it over to [PII].
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][POSITIVE] Yes, you got it correct. Thank you so much for that.
[AGENT][POSITIVE] You're welcome. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yes, I do have like a few more clients with me, around 9 more clients. Would you be able to assist me with that?
[AGENT][NEUTRAL] OK, I can only do 5 at a time. One moment. Let me finish this one out.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] it
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Another call has gone.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] OK. May I have the next policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, sure. The next policy number, it is 023-212915.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. May I have a date of service?
[CUSTOMER][NEUTRAL] Yes, sure. Give me a moment. Yeah. Date of service is [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] $176 even.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] As of today, I'm not showing we received data service 106-2023 for [PII].
[CUSTOMER][NEUTRAL] OK, give me a minute, let me check something here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. You said that uh you're not able to find the
[CUSTOMER][POSITIVE] Flying for [PII], thank you so much for that for the date of service [PII]. Great. And uh can I know the time you're falling to submit the claim?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] There is no time limit to submit a claim.
[AGENT][NEUTRAL] Would you like to fax it?
[CUSTOMER][NEUTRAL] OK. So we can just uh
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Fax number is 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And for the same patient, I have 2 more uh data service with me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I will pull up here a moment.
[CUSTOMER][POSITIVE] I'm sorry for that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. I'm ready with the next date of services here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was on [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] To double the amount. Yes, it is.
[CUSTOMER][NEUTRAL] $176 even.
[AGENT][NEUTRAL] OK, this claim processed under claim number 3424939. No benefits are payable. They do not have the office visit benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So office visits are not payable under the patient's plan, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, great. Thank you so much. And can I have the receipt date and process date for this claim?
[AGENT][NEUTRAL] It was received on [PII]. It processed and denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, great. Thank you so much. And I would like to uh receive this claims UB as well.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is there another data service?
[CUSTOMER][NEUTRAL] Yes, there is.
[CUSTOMER][NEUTRAL] So the next date of service, it's [PII].
[AGENT][NEUTRAL] And total bill?
[CUSTOMER][NEUTRAL] Total amount, yes. It is $173 even.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEGATIVE] Data Service 6-13-2023 has not been received.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] 6:30. It is 30.
[AGENT][NEUTRAL] 63023.
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Data service 630-2023 has not been received.
[CUSTOMER][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Same here. Let me check if I have any update on my end.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Same here. So thank you so much. So uh I can fax this claim along with the previous one to the fax number which you have provided is 877365-9425.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] OK, 23, great. Thank you so much. My bad.
[CUSTOMER][POSITIVE] Thank you so much for that. And uh here's the last claim. I'm pulling it up here.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Bear with me. The system is loading here.
[CUSTOMER][POSITIVE] I'm sorry for that. Yes. Got it.
[CUSTOMER][NEUTRAL] So the next uh member ID whenever you are ready.
[AGENT][POSITIVE] I am ready.
[CUSTOMER][NEUTRAL] Mhm. It is 01891850.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] OK. Take your time, no issues.
[AGENT][NEUTRAL] The service.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Total bill.
[CUSTOMER][NEUTRAL] $122 even.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] This process under claim number 3225468. No benefits are payable. They do not have the office visit benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Noted it. Thank you so much. And may I also have the received date and process date?
[AGENT][NEGATIVE] Yes, it was received on [PII]. It denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you so much for that. And uh thank you so much for the information. I have got enough information from you. Thank you so much for that. And can you uh spell me your name for the documentation purpose with the NATO codes?
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you so much for that. It's been a really great to talking with you. Thank you so much for that and have a great day.
[AGENT][POSITIVE] So, you're so welcome. Thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.