AccountId: 011433970860
ContactId: 9ab86792-bb5f-40e5-abfa-19c38c7034ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 443029 ms
Total Talk Time (AGENT): 105007 ms
Total Talk Time (CUSTOMER): 103295 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/9ab86792-bb5f-40e5-abfa-19c38c7034ff_20250530T20:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office.
[AGENT][NEUTRAL] Hi, [PII].
[CUSTOMER][NEUTRAL] Checking on a claim status?
[AGENT][NEUTRAL] OK, I can help you with claim status, Ms. [PII]. Can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, sure. I'll callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]. And it is a direct line?
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, patient's first name is.
[CUSTOMER][NEUTRAL] It is [PII]. Last name is [PII]. Patient's policy ID is 02201842 and date of birth is [PII].
[AGENT][NEUTRAL] OK. All right, let me look that up real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright and then may I have the date of service and the charge amount?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, date of service for this member is [PII]. The total charge amount $204 even.
[AGENT][NEUTRAL] OK, and then what are the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Uh, actually, uh, this claim is denied as duplicate. This is the first, uh, like we have submitted this claim.
[AGENT][NEUTRAL] OK. Um, and then what's the.
[AGENT][NEUTRAL] Charges after the primary paid their part?
[CUSTOMER][NEUTRAL] Oh, no, actually, no, uh, primary insurance is not paid. We have directly submitted this claim to
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] American Public Life.
[AGENT][NEUTRAL] OK, thank you. And then what is the name of the facility you're calling for?
[CUSTOMER][NEUTRAL] Yeah, I'm calling from Energy Parkland LLC.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold.
[AGENT][NEUTRAL] And I'm gonna look up this claim for us, Miss [PII] and I'll be right back.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Thank you, Ms. [PII], for holding for me. So I have the claim information for you. The claim number is 3545581.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the claim was denied because um the policy does not cover conditions other than sickness or injury.
[CUSTOMER][NEUTRAL] 15.
[CUSTOMER][NEUTRAL] OK. Denied that policy?
[AGENT][NEGATIVE] Does not cover conditions.
[AGENT][NEUTRAL] Other than sickness or injury, so it's non-covered service.
[CUSTOMER][NEUTRAL] OK. Conditions uh uh does not cover conditions apart from?
[AGENT][NEUTRAL] Sickness or injury.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this is non-covered service?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, you said it is, uh, injury and illness, right?
[AGENT][NEUTRAL] Only sickness or injury is covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and uh so this is non-covered service, this is the original claim, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK. Thank you so much for this information. Also, help me with the claim received and processed it.
[AGENT][NEUTRAL] OK, let me look that up for you real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We received the claim on [PII] and processed it on [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much for this information. Uh, just help me with that call reference number for today.
[AGENT][NEUTRAL] Yes, you can use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK. Thank you so much for helping. Have a nice day. Stay safe. Bye-bye. Happy weekend.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] You have a happy weekend too. Thank you for calling APL Ms. [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Sure. Bye-bye.