AccountId: 011433970860
ContactId: a41715fc-03f9-4b20-83e7-3d098700be60
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 549880 ms
Total Talk Time (AGENT): 159092 ms
Total Talk Time (CUSTOMER): 138293 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/a41715fc-03f9-4b20-83e7-3d098700be60_20250116T14:07_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling you from provider's office checking on general claim status.
[AGENT][NEUTRAL] You said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And do you have a callback number?
[CUSTOMER][NEUTRAL] [PII] is the direct line.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] 10605184 M as in Mike L as in Lima number 7.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] That policy number didn't pull up. What's the policy number again?
[CUSTOMER][NEUTRAL] 106.
[CUSTOMER][NEUTRAL] 05184 M as in Mike, L as in Lima, number 7.
[AGENT][NEUTRAL] That was 10605184.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That number is not pulling up. Do you have their social security number?
[CUSTOMER][NEUTRAL] Uh, no, actually, I don't have the Social Security number. After 84, there are two alpha prefixs that is [PII]. After that, number 7.
[AGENT][NEUTRAL] Yes, we don't need that ML 7, but that is not the right policy number. Do you have their name? Whose name is the policy in?
[CUSTOMER][NEUTRAL] Yeah. The patient's first name is [PII], and the last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, what was the last name? [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And I'm sorry, what was that date of birth again?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you were just needing claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can look that up for you. What date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII]. Total charge $665 even.
[AGENT][NEUTRAL] That was 1127, 24.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] We do not have that claim, but this policy canceled [PII].
[CUSTOMER][NEUTRAL] Uh, could you please repeat once again?
[AGENT][NEUTRAL] No claim on file for that date of service. This policy canceled [PII].
[CUSTOMER][NEUTRAL] OK. The policy was terminated on [PII]. I'm right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Can I get the effective date of this policy?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Hold on just a moment. They may have another policy that I didn't see. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] OK, she does have another policy, but it's under [PII].
[AGENT][NEUTRAL] That's why I couldn't pull it up. Um, the policy number?
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] 60.
[AGENT][NEUTRAL] 51
[AGENT][NEUTRAL] 84
[CUSTOMER][NEUTRAL] The policy number is 01605134. Am I right?
[AGENT][NEUTRAL] 18
[AGENT][NEUTRAL] 016051
[AGENT][NEUTRAL] 84.
[CUSTOMER][NEUTRAL] OK. And what was the insurance name?
[AGENT][NEUTRAL] American Public Life Insurance.
[AGENT][NEUTRAL] You can put APL.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] What was the total charge for that bill? 1127?
[CUSTOMER][NEUTRAL] $65 even.
[AGENT][NEUTRAL] 665. What is one of the procedure codes that was on that bill?
[CUSTOMER][NEUTRAL] 99205.
[AGENT][NEGATIVE] OK, we did get that claim. It was denied.
[AGENT][NEUTRAL] Hold on just a moment now.
[CUSTOMER][NEUTRAL] When it was received on.
[AGENT][NEUTRAL] Office visits.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hold on just a moment, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 3548.
[AGENT][NEUTRAL] Benefits payable under this certificate are limited to those outlined in the schedule of benefits. This is not a covered loss under the plan. Therefore, no amount is payable for this expense. It is not covered.
[CUSTOMER][NEUTRAL] OK, can I get the claim number?
[AGENT][NEUTRAL] 354-8062.
[CUSTOMER][NEUTRAL] 62. OK, sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, it was great speaking with you. Have a good day. Bye-bye.
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, not for today. Have a good day. Bye-bye.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You as well. Bye-bye.