AccountId: 011433970860
ContactId: 931aa233-ec8e-4ef3-80c5-ad17f242ea4d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422920 ms
Total Talk Time (AGENT): 132472 ms
Total Talk Time (CUSTOMER): 111255 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/931aa233-ec8e-4ef3-80c5-ad17f242ea4d_20250203T13:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from provider office to checking on the claim status.
[AGENT][POSITIVE] OK, well I'll be more than happy to help you with the claim status. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. Hi, I'm [PII], last name [PII]. callback number [PII]. It's a direct line. There is no extension.
[AGENT][NEUTRAL] OK, hold on one second. Can you repeat the last four digits slowly, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and you said there's no extension?
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] Thank you and may I have the member's policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0247326
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you for that. And [PII], how many claims do you have in total today?
[CUSTOMER][NEUTRAL] Only one claim?
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 0247326. Am I missing a number?
[CUSTOMER][NEUTRAL] Here it's showing alphabets, M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] Right, but what are the, what are all the numbers before then it's missing a number?
[AGENT][NEUTRAL] Can you say the policy number again?
[CUSTOMER][NEGATIVE] I didn't get you.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 73
[CUSTOMER][NEUTRAL] 26 M as in Mike, L as in Lima, 8.
[CUSTOMER][NEUTRAL] At last.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh, it's missing a number. Hold on, I, I get what you're saying, but there's a number missing. What's the member's first and last name?
[CUSTOMER][POSITIVE] You got it
[CUSTOMER][NEUTRAL] Oh, just a second.
[CUSTOMER][NEUTRAL] Just a second please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] After 3 to 64.
[AGENT][NEUTRAL] So there's a 4 at the end?
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 0247
[CUSTOMER][NEUTRAL] 3264
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8, you got it?
[AGENT][NEUTRAL] OK, so it was missing the 4. Can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you want me to check on?
[CUSTOMER][NEUTRAL] It's, it's a date range from [PII] with the bill amount.
[CUSTOMER][NEUTRAL] $1,414 even?
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm not showing anything with your total bill, but there are 2 claims that came in for this data service. Hold on 1 2nd.
[AGENT][NEUTRAL] Let me see if any of these have your total bill and who's the provider on the claim?
[CUSTOMER][NEUTRAL] Just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Holy Cross Hospital.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so it's this one. Hold on one moment.
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 353.
[AGENT][NEUTRAL] 3656.
[AGENT][NEUTRAL] And on [PII], the claim was denied.
[AGENT][NEUTRAL] Requesting the explanation of benefits from primary insurance.
[CUSTOMER][NEUTRAL] Which is primary for this?
[AGENT][NEUTRAL] Um, hold on one moment.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, could you please provide me the.
[CUSTOMER][NEUTRAL] Eligibility for the Florida Blue.
[AGENT][NEUTRAL] No, that's a different insurance policy, so we don't have that information. We just have the insurance name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] American Public Life is the secondary.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, it is active for data service, right?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] American Public Life is active for data service, right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, could you please provide me the call reference number for the call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. So that's [PII], first initial to my last name is [PII], and then today's date.
[CUSTOMER][NEUTRAL] OK, could you please send that it will be through fax.
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That was [PII]?
[CUSTOMER][NEUTRAL] [PII]. How much time it will be taken to receive the AOB?
[AGENT][POSITIVE] For faxes, typically you um give it at least an hour. Um, if you don't receive it by the end of the day, you can definitely give us a call back and we'll be more than happy to resend it.
[CUSTOMER][POSITIVE] Thank you so much for that. Thank you so much for your assistance. Have a nice day. Bye for now.
[AGENT][POSITIVE] You also and thanks for calling APL bye bye.
[CUSTOMER][POSITIVE] Thank you.