AccountId: 011433970860
ContactId: 9822c4ce-fa11-4cfa-a415-52878cd1ca92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1008119 ms
Total Talk Time (AGENT): 260572 ms
Total Talk Time (CUSTOMER): 213806 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/9822c4ce-fa11-4cfa-a415-52878cd1ca92_20250519T16:09_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from Pro's office to check the claim status of what are you doing today?
[AGENT][POSITIVE] OK, thank you. How about you? Sure, I can assist you with claim status.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And may I have the
[CUSTOMER][POSITIVE] Yeah, I'm good thank you for asking.
[AGENT][POSITIVE] You're welcome. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. I'll repeat that again, [PII] and there is no extension for that.
[AGENT][NEUTRAL] OK, thank you. What's the name of the facility you're calling from for my notes?
[CUSTOMER][NEUTRAL] HC Florida Oak Hill Hospital.
[AGENT][NEUTRAL] What's the first name? I didn't get that.
[CUSTOMER][NEUTRAL] HC Florida Oak Hills Hospital.
[AGENT][NEUTRAL] OK, thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's 20,240.
[CUSTOMER][NEUTRAL] 892 3
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima, 8.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] How many
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] With the service is [PII].
[CUSTOMER][NEUTRAL] And the bill amount is 22,000.
[CUSTOMER][NEUTRAL] Just a minute.
[CUSTOMER][NEUTRAL] $22,907.52.
[AGENT][NEUTRAL] OK, thank you. That was [PII] [PII].
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I don't have a claim for [PII] for this number.
[CUSTOMER][NEUTRAL] May I know the pay ID?
[AGENT][NEUTRAL] And the payer ID is 60801. Now this claim needs to be either faxed or mailed. We need the primary E will be attached to it.
[CUSTOMER][NEUTRAL] The, their name?
[AGENT][NEUTRAL] I'm sorry, you said pay your name?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's American Group.
[AGENT][NEUTRAL] American Public Life or APL.
[CUSTOMER][NEUTRAL] OK. May I know the patient's effective date?
[AGENT][NEUTRAL] OK, the effective date on this policy is [PII], and it is active at the moment.
[CUSTOMER][NEUTRAL] This plan type
[CUSTOMER][NEUTRAL] It's more people.
[AGENT][NEUTRAL] Um, it's not an HMO or PPO. It is to the employer, but this is the secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, you're always on call.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] This is a secondary supplemental plan for the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the group name?
[AGENT][NEUTRAL] Um, let me get that for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The group name is
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] then
[AGENT][NEUTRAL] Specified.
[AGENT][NEUTRAL] Architectural. OK, I will have to spell it, OK? So the spelling is S [PII].
[CUSTOMER][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] The next word is architectural, which is A [PII], R [PII], C [PII] cat, [PII].
[CUSTOMER][NEUTRAL] OK. OK. OK. May I know the group number?
[AGENT][NEUTRAL] The group number is 23695.
[CUSTOMER][NEUTRAL] You know the timely planning limit.
[AGENT][NEUTRAL] We don't have time finding limits.
[CUSTOMER][NEUTRAL] I know the mailing one.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Mailing address.
[AGENT][NEUTRAL] Mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, ma'am another client, could you please verify with that. Before that, may I know the call reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in the estate if you would like.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK one moment. I will have to make a note on this 11 moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And how do you spell your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm having another claim. Could you please verify with that?
[AGENT][NEUTRAL] Can you, yeah, can you spell your name, Miss [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. One moment. Let me finalize this notes so we can move forward to the next one.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Just a minute.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, the next NPI is 102.
[AGENT][NEUTRAL] I'm waiting for the next policy. Mhm. Mhm.
[CUSTOMER][NEUTRAL] OK. The policy ID is 023.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 638
[CUSTOMER][NEUTRAL] 36.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What is the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. What's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] The date of service is [PII] and the bill amount is $35,956.
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, number [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so it looks like for this one, we need the primary explanation of benefits to continue the processing of this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, just a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] May I know the mailing address?
[CUSTOMER][NEUTRAL] Its same before you provide me?
[AGENT][NEUTRAL] The me
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The phone. The call reference number is the same.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] OK. I'm having another time. Could you please verify that?
[AGENT][NEUTRAL] To another, is another member.
[CUSTOMER][NEUTRAL] Yes, I remember.
[AGENT][NEUTRAL] OK, and you don't need the claim number or anything for this one to submit the primary EOB?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, sorry, one moment.
[CUSTOMER][NEUTRAL] I'm having the primary bill sent through mailing address.
[AGENT][NEUTRAL] OK, bear with me. Let me go ahead and finalize the note.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Alright, what is the next policy number?
[CUSTOMER][NEUTRAL] The next policy number is 01899454 M as in Mike L as in Lima 7.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Um, that's what I pulled, um.
[AGENT][NEUTRAL] Can you verify the date of birth one more time?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's the name?
[CUSTOMER][NEUTRAL] The patient's name is [PII]
[AGENT][NEUTRAL] OK. I don't have [PII] listed under this policy. Do you have another policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm, just a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I don't have other policy number.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, Mr. [PII] is not listed on this one.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] This patient is not in our, in our records.
[AGENT][NEGATIVE] It's not listed correct.
[CUSTOMER][NEUTRAL] Verify this, uh, this is, this one, this number ID X as in X-ray J as in Juliet B as in Bravo, H as in Hotel 25615224.
[AGENT][NEUTRAL] That's not our number. We don't have letters and numbers.
[CUSTOMER][POSITIVE] OK. Thank you for your assistance. Have a great day. Bye-bye.
[AGENT][POSITIVE] Yes sir thank you for calling ATM. Bye bye.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.
[AGENT][NEUTRAL] No.