AccountId: 011433970860
ContactId: ab8ef86c-e894-4d6e-82fb-52d945830e57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 745969 ms
Total Talk Time (AGENT): 236445 ms
Total Talk Time (CUSTOMER): 236656 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/ab8ef86c-e894-4d6e-82fb-52d945830e57_20250509T17:46_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] Good afternoon. My name is [PII] calling from provider's office. Actually, I wanted to know the claim status.
[AGENT][NEUTRAL] I can verify claim status. May I have a policy number?
[CUSTOMER][NEUTRAL] The policy number. Please allow me a minute.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Member ID you mean to say. Am I correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The member ID is 02210575ML. And before we begin, I would like to let you know that this call is being recorded for quality and training purpose.
[AGENT][POSITIVE] OK, thank you. May I have a good callback number?
[CUSTOMER][NEUTRAL] So callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient name is uh [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] Date of service is uh [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] Total bill amount is $1560.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII], check claim status as well. One moment.
[AGENT][NEUTRAL] And that was for data service 113-2025, correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, 1:30, 2025.
[AGENT][NEUTRAL] OK. As of today, I'm not sure we have received that data service for [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So there's no claim on file.
[CUSTOMER][NEUTRAL] So no claim on file?
[CUSTOMER][NEUTRAL] So, may I know, uh,
[CUSTOMER][NEUTRAL] What will be your address?
[AGENT][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the mode of uh submission the claim will be paper or uh electronic?
[AGENT][NEUTRAL] The electronic payer ID is 60801.
[CUSTOMER][NEUTRAL] 60801. And could you just reconfirm the address as well?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much. And uh I just want to know the status of 2 more claims.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] So, can you
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] May I have a policy number?
[CUSTOMER][POSITIVE] Yeah, sure. Please allow me a minute so I can search the policy number for you.
[CUSTOMER][NEUTRAL] So the policy number is 02450102ML7.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Patient name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] May I have a date of service?
[CUSTOMER][NEUTRAL] And date of service is, yeah. And date of service is uh [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] Total bill amount is uh 1600.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] This processed under the claim number 3,569,090.
[AGENT][NEUTRAL] Looks like a benefit amount of $80 processed to the provider.
[AGENT][NEUTRAL] This processed on 227 of 25.
[CUSTOMER][NEUTRAL] 27
[AGENT][NEUTRAL] 2 27 25.
[CUSTOMER][NEUTRAL] 2725. And the, the bill amount is $80. Am I correct?
[AGENT][NEUTRAL] The amount that was paid was $80.
[CUSTOMER][NEUTRAL] OK. So, is this amount paid through check or EFT?
[AGENT][NEUTRAL] It was a single check. Check number was.
[AGENT][NEUTRAL] 2030053
[CUSTOMER][NEUTRAL] OK. And is check cash or not?
[AGENT][NEUTRAL] I cannot verify if it has cash or not. I would have to send it over to the finance department.
[CUSTOMER][NEUTRAL] OK. So, uh the claim number is 3,569,090 with $80.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And like, OK, with the, uh, which process to provider on [PII] with a single check and the check number is 2030053.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So I, I need status of one more claim.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] May I have a policy number?
[CUSTOMER][NEUTRAL] The policy number is 01823339ML8.
[CUSTOMER][NEUTRAL] Patient um is uh [PII].
[CUSTOMER][NEUTRAL] And the date of service is uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], yeah, [PII] and the bill amount is $1200.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So [PII] is the date of birth or [PII] is the date of service.
[CUSTOMER][NEUTRAL] It's the date of service.
[AGENT][NEUTRAL] OK, what is her date of birth?
[CUSTOMER][NEUTRAL] Date of birth is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that. One moment.
[AGENT][NEUTRAL] And what is the bill amount?
[CUSTOMER][NEUTRAL] The amount is $1200 1200.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Thank you. This processed under claim number 3491878. We are asking for the primary insurance explanation of benefits. This claim processed and denied on [PII].
[AGENT][NEUTRAL] And then again it processed and denied as a dupe on [PII].
[CUSTOMER][NEUTRAL] [PII] and [PII]. Again.
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEGATIVE] OK. Again, it's processed on [PII] and [PII] and denied on the same day.
[AGENT][NEUTRAL] It did not as I do, yes, we need the primary insurance ELB.
[AGENT][NEUTRAL] One moment. Let me verify and see if it ever came in. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so it looks like it's actually processed under claim number 3533105. Looks like it paid a benefit amount of $500 to the provider.
[AGENT][NEUTRAL] This claim process.
[CUSTOMER][NEUTRAL] Pay $500.
[AGENT][NEUTRAL] Yes, it paid $500 on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that means, you mean to say the claim is paid on 11-21-2024. Under uh the claim number 3533105.
[AGENT][POSITIVE] That is correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Through check or EFT?
[AGENT][NEUTRAL] It was a single check, check number 2015204.
[CUSTOMER][POSITIVE] 5204. Thank you so much. Can you please help me with your name as well as uh your uh call reference number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, it's [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mo
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And uh the call reference number?
[AGENT][NEUTRAL] will be my name along with today's date.
[CUSTOMER][POSITIVE] Today's date. OK. Thank you so much, [PII]. You were very helpful for today, for these 3 claims. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Are you there [PII]?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] [PII], can you please uh help me with your last name initial because I was forgot to
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII] Thank you so much, [PII]. Have a nice day. Bye-bye.
[AGENT][NEUTRAL] Yes
[AGENT][POSITIVE] You're so welcome. Thank you for calling. Bye-bye.