AccountId: 011433970860
ContactId: a062c063-0e56-4d0a-9985-111898b147d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 465179 ms
Total Talk Time (AGENT): 153778 ms
Total Talk Time (CUSTOMER): 134072 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/a062c063-0e56-4d0a-9985-111898b147d5_20250228T19:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling about a claim that was submitted. I received a letter, but I'm not sure I understand it, so I was hoping you could assist me.
[AGENT][NEUTRAL] May I have your name and a call back?
[CUSTOMER][NEUTRAL] I'm sorry, my name is [PII]?
[AGENT][NEUTRAL] And a callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and my phone number is [PII].
[AGENT][NEUTRAL] And may I please have the policy number?
[CUSTOMER][NEUTRAL] The policy is 0246.
[CUSTOMER][NEUTRAL] 9967
[AGENT][NEUTRAL] And could you please verify your date of birth and the mailing address listed on file?
[CUSTOMER][NEUTRAL] Um, mine or the patients?
[AGENT][NEUTRAL] Are you the member?
[CUSTOMER][NEUTRAL] I'm the main member. My husband is a patient, so you need my date of birth or his?
[AGENT][NEUTRAL] OK, so this is for the the member listed on the policy, yes. May I have the member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], and it's [PII].
[AGENT][NEUTRAL] And also I do need the mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I also need to verify the email address to make sure that is correct in our system.
[CUSTOMER][NEUTRAL] Um, it could be [PII] or [PII].
[AGENT][NEUTRAL] OK, so the email is supposed to be [PII]?
[CUSTOMER][NEUTRAL] Uh, do you have payroll email on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, I'm asking for your email address.
[CUSTOMER][NEUTRAL] Yes, it's my [PII].
[AGENT][NEUTRAL] OK, cause that's what we had and uh that's why I was making sure because.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And how may I assist you on the claim?
[CUSTOMER][NEUTRAL] OK, so I received um the claim number is 356.
[CUSTOMER][NEUTRAL] 5913 we've submitted a few claims so which claim is this for and what information do I need to provide you guys with? because I thought I said what you needed but I'm not understanding what.
[CUSTOMER][NEUTRAL] Let's request this.
[AGENT][NEUTRAL] OK, I'm pulling that claim up for you.
[AGENT][NEUTRAL] So it looks like this claim is saying that they're needing diagnosis codes.
[AGENT][NEUTRAL] For the data service of 666765.
[CUSTOMER][NEUTRAL] 666 7 and 65 or 8?
[AGENT][NEUTRAL] 65 it's showing 656667 of 2024 and then also for data service of 2625.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 56566.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] 7 and 2625.
[CUSTOMER][NEUTRAL] OK, and this is the claim that in the 18,000.
[CUSTOMER][NEUTRAL] 872.
[AGENT][NEUTRAL] Let me pull that up for you.
[AGENT][NEUTRAL] OK, so for this claim.
[AGENT][NEUTRAL] It's showing total bill of 2604.
[CUSTOMER][NEUTRAL] Is it multiple claims?
[AGENT][NEUTRAL] Let me pull the image up.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Itemized bill with diagnostic code.
[AGENT][NEUTRAL] OK, so I'm just seeing the total bill for the 144573.
[AGENT][NEUTRAL] For a hospital service, so it's not showing us the complete total bill charge.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If it's supposed to be that much, but this is, it's in hospital services.
[AGENT][NEUTRAL] And this is just a statement.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the charges could be more, go ahead.
[CUSTOMER][NEUTRAL] OK, so what I need to request.
[CUSTOMER][NEUTRAL] OK, so what I need to request from the hospital is an itemized bill with diagnose codes for 656667 and 26.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, can you tell me where the 26 digit was because that's separate.
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][NEUTRAL] OK, so what it is, the 26 came in is showing the statement date, so we're not actually sure what date of service this is. We can only go by what is listed on here for a date, and that's [PII].
[AGENT][NEUTRAL] So this is just a statement.
[CUSTOMER][NEUTRAL] So, is there an amount for that for that payment?
[AGENT][NEUTRAL] That's the one that's the 14,000.
[AGENT][NEUTRAL] Bill, let me pull it up again.
[AGENT][NEUTRAL] It is showing Huntington Health as the provider for the facility.
[CUSTOMER][NEUTRAL] OK, oh, the 1404 1445.
[AGENT][NEUTRAL] Yes, the 144573. So with us not knowing the exact date of service, so you would have to submit if it is the EOB it needs to, you would have to submit that EOB in I mean the itemized bill in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For that date of service for this provider.
[CUSTOMER][NEUTRAL] OK, so I I know I know for those. OK, and 68. OK, so, OK, I'll get the information and then send it over.
[AGENT][NEUTRAL] OK, and is there anything else that I can assist you with today, Ru?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Um, no, that's all. Thank you for your help.
[AGENT][POSITIVE] Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye bye