AccountId: 011433970860
ContactId: ade09272-b79c-474b-b2dc-65cf55626bb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428359 ms
Total Talk Time (AGENT): 193638 ms
Total Talk Time (CUSTOMER): 152353 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/ade09272-b79c-474b-b2dc-65cf55626bb8_20250224T13:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, Ms. [PII]. Uh, my name is [PII], and uh I am calling, ma'am to obtain claim status for one of our patients.
[AGENT][NEUTRAL] OK, [PII], you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Callback number is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] Uh, that is going to be 683-335-170.
[AGENT][NEUTRAL] OK, now that is not going to be a policy number for American Public Life Insurance.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] We spoke to the mom uh for this patient.
[CUSTOMER][NEUTRAL] Um, and she said that, that, that was the insurance. I'm not sure, and she said she spoke to somebody at the insurance and uh they advised her to, uh,
[CUSTOMER][NEUTRAL] To let us know to rebuild. Oh, that is.
[CUSTOMER][NEUTRAL] So you don't have a, that's not a, that's not a member ID.
[AGENT][NEUTRAL] Is that a social security number? Is that a social security number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see, I believe.
[CUSTOMER][NEUTRAL] I think so.
[CUSTOMER][NEUTRAL] Let me see, let me see her notes what she said here, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I believe, I believe that's her.
[CUSTOMER][NEUTRAL] Her social, um,
[AGENT][NEUTRAL] OK, so let's see if I can locate some information for this number uh with that social.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so I do have, I have located someone with that social in our system. So first off, um, I don't any information provided will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, patient's name is uh [PII]. [PII].
[CUSTOMER][NEUTRAL] Yeah, but I, that's the, the number that I provided to you that's, that's, I believe that's the mom's social.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] The subscriber, I'm.
[AGENT][NEUTRAL] OK, so I do show that [PII] is a dependent on this limited benefit plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is active with an effective date of [PII].
[AGENT][NEUTRAL] The correct policy number is 259.
[AGENT][NEUTRAL] 0539.
[CUSTOMER][NEUTRAL] 259-053-9. OK, so does that mean we need to rebull it with that uh member ID?
[AGENT][NEUTRAL] Yes ma'am, uh-huh.
[AGENT][NEUTRAL] With the policy number that I gave you?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][POSITIVE] That would be great. Do you, yes, uh, let me see.
[CUSTOMER][NEUTRAL] Is that is
[AGENT][NEUTRAL] What is the date, so you all did file a claim for part 4 of Charlotte, is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] What let me see if it is on file. What is the date of service and total bill amount for her, please?
[CUSTOMER][NEUTRAL] It is um [PII], and the bill amount is $9,496.01.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me see one moment.
[AGENT][NEUTRAL] And what is the name of the provider, the pro or the provider group?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is um
[CUSTOMER][NEUTRAL] Bluegrass Community Hospital.
[AGENT][NEUTRAL] OK, so yes ma'am, we do not, yes, we do not have a claim on file for her for that data service.
[CUSTOMER][NEUTRAL] OK, and then, um, can I just confirm with you, uh, the claims address I have is [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm, no, ma'am. Where did that number come from? Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I I have no idea.
[AGENT][NEUTRAL] Uh, I've never heard of that address before.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] No, ma'am, um, but the address for APL for submission of claims is going to be [PII].
[AGENT][NEUTRAL] That is in [PII] City, [PII].
[AGENT][NEUTRAL] The zip, I'm so sorry, the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and do you have a payer ID, ma'am?
[AGENT][NEUTRAL] Mhm. Yes, ma'am, we do. 60801.
[CUSTOMER][NEUTRAL] OK, and then what is the timely filing?
[AGENT][NEGATIVE] There is no timely filing with APO.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And then, uh, can I get a reference number for this call, or is it just your name and today's date?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It would be my name in today's date, but then 11 more piece of information also [PII], once we have processed the claim here at APO, we do have a portal that you should also be able to check claim status and have access to our EOBs, and that website that you would go to for that is secured.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK secured.
[AGENT][NEUTRAL] Yes, ma'am. OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII]. Perfect.
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][POSITIVE] All right. Thank you so much, [PII]. I appreciate all your help.
[AGENT][NEUTRAL] So is there anything else that?
[AGENT][POSITIVE] Oh, you're very welcome. Well, thank you again, ma'am for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Oh, that is it.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] You're welcome. Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.