AccountId: 011433970860
ContactId: bb2bc50a-b259-48cf-af18-62b9a6da4d0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 600270 ms
Total Talk Time (AGENT): 165418 ms
Total Talk Time (CUSTOMER): 364067 ms
Interruptions: 10
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/bb2bc50a-b259-48cf-af18-62b9a6da4d0f_20250130T14:33_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office, and I'm looking for the claim status. Could you please assist me with that?
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] Yeah, I can help you. What's the policy number?
[CUSTOMER][NEUTRAL] Uh, just a moment, just give me a moment. The policy number is 1896483.
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, what's a good phone number for?
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] The callback number is.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Callback number is [PII], which is the direct line?
[AGENT][NEUTRAL] OK, and I'm sorry, uh, [PII], did you say you're checking claim status or eligibility and benefits?
[CUSTOMER][NEUTRAL] OK, and I'm sorry, uh, [PII], did you say you're checking claim status or eligibility that claim status.
[AGENT][NEUTRAL] OK. Thank you. I can help you with that information. Can you verify the patient's name and date of birth for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That information, can you verify the patient's name and date of birth for me? Yes, uh, the patient's first name is [PII]. It's [PII] and the last name is [PII]
[CUSTOMER][NEUTRAL] And uh the uh the date of service, uh, I'm sorry, the date of birth is?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thanks for that information, [PII]. What's the date of service in charge?
[CUSTOMER][NEUTRAL] Thanks for that information and what's the data service in charge? Uh, date of service is [PII]. It's [PII], and it was for the total bill amount which is $7,069 7069.00.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And is this for a facility or professional fee?
[CUSTOMER][NEUTRAL] It's a facility.
[AGENT][NEUTRAL] What's the name of the facility?
[CUSTOMER][NEUTRAL] The name of the facility? Memorial Hospital for Cancer and Allied Diseases.
[AGENT][NEUTRAL] OK, so I'm not I'm not showing a claim for the date of service, I mean for the amount, um.
[CUSTOMER][NEUTRAL] Do you need the tax ID?
[CUSTOMER][NEUTRAL] Not sure.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] I mean, for the amount, um.
[AGENT][NEUTRAL] That you provided for [PII].
[CUSTOMER][NEUTRAL] Provided [PII].
[CUSTOMER][NEUTRAL] Mhm, just a moment, just give me a moment.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, what's your name by the way?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] First initial last name is [PII].
[CUSTOMER][NEUTRAL] OK, I just finish your first name is [PII]. OK. As for you, there is no claim on file.
[AGENT][NEUTRAL] Not for the total charge you you provided and uh and not for the name of the facility.
[CUSTOMER][NEUTRAL] Not for the total charge you provided and uh not for the evening so late.
[AGENT][NEUTRAL] That you provided.
[CUSTOMER][NEUTRAL] Uh, name of the, is it the name of, uh, or shall I give you the NPI or tax ID or the another name of facility is Memorial Sloan Catering Cancer Center?
[AGENT][NEUTRAL] Mhm, you gave me that earlier. um, what's the tax ID number?
[CUSTOMER][NEUTRAL] me that earlier um what's the tax ID number? [PII]
[AGENT][NEUTRAL] OK, so I show a claim for this date of service with that tax ID number, but the charge is $1,201.
[CUSTOMER][NEUTRAL] OK, so if she'll apply for this data service with that SID number but the charge is $1,201.
[AGENT][NEUTRAL] What type of service is it for?
[CUSTOMER][NEUTRAL] OK, I'm sorry, I'm sorry. What this is it for?
[CUSTOMER][NEUTRAL] Uh, what type of service you mean?
[AGENT][NEUTRAL] Was it for surgery, therapy?
[CUSTOMER][NEUTRAL] Was it for surgery, therapy?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I don't have ID on that. Yes, I, I was wrong. Actually, the total bill amount is $1,201.
[AGENT][NEUTRAL] Do you have a copy of the itemized bill?
[CUSTOMER][NEUTRAL] Have a copy of the itemized bill.
[CUSTOMER][NEUTRAL] So do you have a claim?
[AGENT][NEUTRAL] Uh that's, I'm trying to verify that if you have a copy of the itemized bill, can you tell me the name of the facility that's on this claim?
[CUSTOMER][NEUTRAL] I'm trying to verify that if you have a copy of the itemized bill, can you tell me the name of the facility that's on this plane?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I have a claim form actually. The, the facility name on the claim form is David H. Coach Center for Cancer Care. Is that?
[AGENT][NEUTRAL] OK. OK, that's what I'm showing. That is what I'm showing.
[CUSTOMER][NEUTRAL] The one you have?
[CUSTOMER][NEUTRAL] OK that's what I'm showing that is what I'm showing. OK. OK. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I show that we received the claim twice. Do you want the information for both or the latest one received?
[CUSTOMER][NEUTRAL] So that we received the point twice, you want the information for both or the latest one received?
[CUSTOMER][NEUTRAL] Uh, the original claim which you received and when it is processed, is there any denial or how?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, it was denied. The date of service is after the policy terminated. Give me a moment, I'll give you the claim number and then I'll give you the date the policy term.
[CUSTOMER][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] It want to know the date of services after the policy terminated it. Give me a moment. I'll give you the claim number and then I'll.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The of
[CUSTOMER][NEUTRAL] Could you please give me the claim number, the claim.
[AGENT][NEUTRAL] So the claim was
[AGENT][NEUTRAL] The claim was received [PII].
[CUSTOMER][NEUTRAL] [PII] 248.
[AGENT][NEUTRAL] Process [PII].
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] And the claim number?
[CUSTOMER][NEUTRAL] Uh, just a moment, just a moment. Just a moment. Uh, please give me the claim number first, then we'll then receive date and process date. What is the claim number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 338.
[CUSTOMER][NEUTRAL] 38. Mhm.
[AGENT][NEUTRAL] 5061.
[CUSTOMER][NEUTRAL] 5 061. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Receive date is [PII].
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] The date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Process date is [PII].
[CUSTOMER][NEUTRAL] The date is [PII].
[AGENT][NEUTRAL] And I show the policy termination date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the policy termination date is [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] And what is the policy?
[CUSTOMER][NEUTRAL] Start date?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's [PII] or [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK, thank you so much.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEGATIVE] So it is denied because just a moment so he was denied because uh.
[CUSTOMER][NEUTRAL] Our policy has terminated.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, do you see any other uh insurance uh member have on the date of service which is, which he is active on the date of service? Not with American public.
[AGENT][NEUTRAL] You not with American public life, not with American public life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No other uh claim, no other insurance as well.
[AGENT][NEUTRAL] There is no other active policy with American public life.
[CUSTOMER][NEUTRAL] No other at their policy with American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, ma'am. Thank you so much for that. Uh, so, so could you please send us this, uh, denied UOB to us on the fax number? I'll give you the fax number.
[AGENT][NEUTRAL] Anything else?
[AGENT][NEUTRAL] OK, so the explanation was.
[AGENT][NEUTRAL] The explanation of benefits was mailed along with the when the check the claim was processed and it's now available to download on our online service center. I can provide you with that address and then help you set the account up to download the ALD.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Gonna benefits with the check the claim was processed and it's now available to download on our online service centers. We provide you with an address and then help set the account up to download the AOB.
[CUSTOMER][NEUTRAL] You cannot send us to the fax number?
[AGENT][NEUTRAL] I can fax it.
[CUSTOMER][NEUTRAL] Yeah, yeah. So could you please fax the POV to the fax number I'll give you.
[AGENT][NEUTRAL] Yeah that
[AGENT][NEUTRAL] The fax number, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Fax number please? It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. Anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] Anything else I can help with today, [PII]?
[CUSTOMER][POSITIVE] Uh, no, I don't have any other question for you. Thank you so much for assisting me today. Could you please provide me the reference number?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][NEUTRAL] in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when will I receive this fax?
[AGENT][NEUTRAL] Allow 1 to 2 business days.
[CUSTOMER][NEUTRAL] But did you business day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else?
[CUSTOMER][NEUTRAL] Anything else? No.
[AGENT][POSITIVE] Alrighty. Well, thank you for calling APL [PII]. Have a good day.
[CUSTOMER][POSITIVE] Thank you so much. Bye.