AccountId: 011433970860
ContactId: 9d6cba92-886e-4887-afc4-6f1ffe5dba92
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293220 ms
Total Talk Time (AGENT): 148042 ms
Total Talk Time (CUSTOMER): 123738 ms
Interruptions: 2
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/9d6cba92-886e-4887-afc4-6f1ffe5dba92_20250317T13:05_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hi, my name is [PII] and I'm not sure if I pressed the right prompt. I'm just trying to check claim status if I could, please.
[AGENT][POSITIVE] OK, I, I'll be glad to help you, but I am so sorry. I did not catch your name.
[CUSTOMER][NEUTRAL] Oh, certainly, it's [PII].
[AGENT][POSITIVE] All right, [PII], thank you.
[CUSTOMER][NEUTRAL] The IVR. Mhm.
[AGENT][POSITIVE] Yes ma'am. My name is [PII] and go ahead and give me a good policy number.
[CUSTOMER][NEUTRAL] 025032007
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for all of that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number, please.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][POSITIVE] Alright, [PII], thank you so much for all the information. Now, your patient's name and date of birth today, please, ma'am?
[CUSTOMER][NEUTRAL] Mhm. The patient's name is Jeannette Davis Data Service 6868.
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK. All right, date of birth. OK, now, thank you for that, [PII]. Now that data service you're checking out, please, ma'am.
[CUSTOMER][NEUTRAL] OK, yeah, I think I messed that up. I'm so sorry. Date of.
[AGENT][NEUTRAL] That's OK. It's a Monday, so hey, it's OK.
[CUSTOMER][NEUTRAL] I can't believe it's ready. Yeah, date of service is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, and how much is your bill for?
[CUSTOMER][NEUTRAL] Uh-huh. It is $6,148.
[AGENT][NEUTRAL] Alright, it looks like we do have a bill from the facility uh for that amount and we are asking for that primary EOB because we are just that, uh, medical supplemental plan, so in order for us to coordinate benefits, we need that EOB.
[CUSTOMER][NEUTRAL] I'll be darned. OK. Now, I called in. Wait a minute. Well, I actually received a call from the patient, and she said she had the Aetna rep on a three-way call. And the Aetna rep understood that she had no other insurance and they were primary.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] She was going to update the COB and send the claim back that was on 310.
[AGENT][NEUTRAL] Well, let's see if I have anything.
[AGENT][NEUTRAL] No ma'am, as of today we have no other claims submitted mm mm but that is what we need.
[CUSTOMER][NEUTRAL] It's not another claim. The patient called in to tell you that she didn't have any other insurance.
[AGENT][NEUTRAL] OK, well, she has to have primary insurance because we're just a medical supplemental plan.
[AGENT][NEUTRAL] Yeah, she has to have other coverage.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] She's [PII]. Um, could she have a regular plan and not know it? Are you a, are you like a Medicare supplemental?
[AGENT][NEUTRAL] No, ma'am, we're just a regular medical supplemental plan to her primary major medical plan. Let me see, let me pull up another claim and see if I can see who she may have.
[CUSTOMER][NEUTRAL] Yeah, there's no notes in there. It was a three-way call.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah, because she's got to have primary.
[AGENT][NEUTRAL] But I'm gonna look up another claim and see if I can see where she has it, so hang on just a second, see if I can help you out.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let's see. Yes, ma'am.
[CUSTOMER][NEUTRAL] That's really weird.
[CUSTOMER][NEGATIVE] And I couldn't hear the Aetna rep. They were just really, really low.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEGATIVE] My system knows it's a Monday too, so bear with me and it's moving slow.
[AGENT][NEUTRAL] OK, let's see, here we go. Alright, looks like.
[AGENT][NEUTRAL] The EOB that we have is from [PII]. She has that and that's her primary, yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh good [PII]. I called the wrong number. Oh my gosh.
[AGENT][NEUTRAL] Yeah, she does have Aetna, so we need that ELB from Aetnas. Yep.
[CUSTOMER][NEUTRAL] Um, that happened.
[CUSTOMER][NEUTRAL] I did say [PII]. I don't know what in the world. I called American Public Life. This weekend was just way too short. I got a lot of stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] But not ready for it to be Monday. You'll say I apologize. Thank you for checking on that.
[AGENT][POSITIVE] Well, that is OK, absolutely no problem, [PII], and is that all I can help you with?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] OK, [PII], well, you have a great [PII] and thanks for calling APU.
[CUSTOMER][NEUTRAL] You too. Bye.