AccountId: 011433970860
ContactId: b04deeca-c0a1-48e1-a69e-4885d4caee7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 201550 ms
Total Talk Time (AGENT): 48951 ms
Total Talk Time (CUSTOMER): 57966 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/b04deeca-c0a1-48e1-a69e-4885d4caee7b_20250319T17:45_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] Hello, my name's [PII] and I'm calling from associated anesthesiologist and I was just calling to follow up on a claim for a patient. It looks like we sent it but I haven't heard anything back.
[AGENT][NEUTRAL] May I please have a callback number?
[CUSTOMER][NEUTRAL] Yes, my direct line is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] We have that as.
[CUSTOMER][NEUTRAL] 02579321
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] That is, oh I am so sorry I was looking at the wrong account that is not the right member ID.
[AGENT][NEUTRAL] So may I have the policy number?
[CUSTOMER][NEUTRAL] Yes. So,
[CUSTOMER][NEUTRAL] It looks like we submitted under 01874106 which doesn't match up with what's on the card.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII] for $3000.
[AGENT][NEUTRAL] I'm pulling that information up for you now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so it does look like we received that claim on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] The claim number is 355.
[AGENT][NEUTRAL] 647-6. it processed and denied that the outpatient per calendar year max had been met.
[CUSTOMER][NEUTRAL] OK, so does that put the balance as patient responsibility?
[AGENT][NEUTRAL] That is the provider's discretion.
[CUSTOMER][NEUTRAL] OK perfect all right is there a reference number for this phone call?
[AGENT][NEUTRAL] The reference will be my first name Tarika, last initial of H and today's date.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye.