AccountId: 011433970860
ContactId: a7055441-e926-4bb4-8e8e-2f0b57466e51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204000 ms
Total Talk Time (AGENT): 72839 ms
Total Talk Time (CUSTOMER): 91119 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/a7055441-e926-4bb4-8e8e-2f0b57466e51_20250317T22:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Yeah, I'm calling with the, uh, Texas Health Service at Rockwall. Um, I am calling, um, to see if we are in network with the plan. Um, the patient provided as a secondary insurance.
[AGENT][NEUTRAL] May I have your name and a policy number?
[CUSTOMER][NEUTRAL] Spelled [PII] um and then the policy number for the patient, I have 02341573.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, patient's name is [PII] and date of birth, [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. There is no network that can utilize any provider. We follow the primary, so we will pick up the copays, the co-insurers, and our deductibles up to the benefit amount.
[CUSTOMER][NEUTRAL] OK. And um let me see.
[CUSTOMER][NEUTRAL] No network. And so it doesn't have like a Medicare reimbursement rate?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] No, OK, no, thank you.
[CUSTOMER][NEUTRAL] And does the patient have to um send you guys the EOB after the claim or it just?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The Blue Cros, well, she has Blue Cross as primary. Would they just send over the EOB to you guys and then pay it out that way when they submit the claim?
[AGENT][NEUTRAL] No, ma'am, it will come from, it will come from the the provider. Once they file with primary, they can send it over. If not, then she can go ahead and submit it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you confirm the claim address?
[AGENT][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK and then what is that um payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK perfect and did you have an effective day for the patient's policy?
[AGENT][POSITIVE] Yes, this plan is effective.
[AGENT][NEUTRAL] [PII] and it is active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you and I think that's really all I needed um could I get a, a reference number for the call?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] Wednesday. OK, perfect. Well thank you so much for your help.
[AGENT][POSITIVE] You're so welcome, and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye.