AccountId: 011433970860
ContactId: c079958a-99cc-4758-bf47-78880b89559e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 558229 ms
Total Talk Time (AGENT): 128629 ms
Total Talk Time (CUSTOMER): 218068 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/c079958a-99cc-4758-bf47-78880b89559e_20250128T21:15_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] Hi, ma'am. This is [PII]. Um, I had a policy, uh, last year, um, and I'm receiving a bill from a radiology facility, and they're stating they have not received payment when they filed for the co-insurance deductible amount.
[AGENT][NEUTRAL] OK. May I have the policy number?
[CUSTOMER][NEUTRAL] Yes, the policy number is 01868815.
[AGENT][NEUTRAL] And [PII], could you please verify your date of birth and mailing address, please?
[CUSTOMER][NEUTRAL] Uh yes. The date of birth is [PII] and the mailing address should be [PII].
[AGENT][NEUTRAL] OK, that's not the one that we have in the system.
[CUSTOMER][NEUTRAL] OK, uh, try [PII].
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, OK, then it's, uh, give me one sec [PII], either [PII] or [PII].
[AGENT][NEUTRAL] No, I'm not seeing anything for [PII] for this policy.
[CUSTOMER][NEUTRAL] OK. And then maybe they provided my new address which is [PII].
[AGENT][NEUTRAL] That is correct. And may I have the email address that is listed on file as well, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the email address should be [PII].
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, then it's [PII].
[AGENT][NEUTRAL] That is correct, and may I please have a callback number just in case this call is disconnected?
[CUSTOMER][NEUTRAL] Yes, it's area code [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have the date of service that you're calling in regards to?
[CUSTOMER][NEUTRAL] Um, let me just see what date of service it was.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Um, I'm looking.
[CUSTOMER][NEUTRAL] Ah.
[CUSTOMER][NEUTRAL] It doesn't have it on the statement.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Give me one moment, I'm trying to get that for you.
[CUSTOMER][NEUTRAL] OK date of service is [PII].
[AGENT][NEUTRAL] And it is [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] I'm not seeing a claim receipt for that date of service.
[CUSTOMER][NEUTRAL] OK and no claim on file.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] If I you you still do the, the, if I, if I submit a claim like pay this.
[CUSTOMER][NEUTRAL] And then I submit a claim. Do you still do that?
[AGENT][NEUTRAL] If, if we receive that claim and you'd still have benefits available with all the needed documentation, if we hadn't received it from the provider, then we will process it and it will submit payment to you.
[AGENT][NEUTRAL] If the claim comes in from the provider before we receive it from you, then it would go to the provider.
[CUSTOMER][NEUTRAL] Yeah, because they said that they billed a paper claim on [PII].
[AGENT][NEUTRAL] We don't have a claim.
[CUSTOMER][NEUTRAL] So they have, they, and you have no claim. OK, so is there any way that you can email me the claim form for me to submit back to you so I can pay this and then submit the claim to you?
[AGENT][NEGATIVE] I don't have a way of submitting an email because it's not secured.
[CUSTOMER][NEUTRAL] OK, how can I, because I no longer work for the company, so I don't have access.
[CUSTOMER][NEUTRAL] To.
[AGENT][NEUTRAL] If you're, if you're just needing the claim form, you will be able to go up on the [PII] and go to the claims form tab and download the midlink claim form.
[CUSTOMER][NEUTRAL] [PII]. [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I can get the claim form from there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, then I'll go ahead and, and do that. Thank you so much. Can I have your name and a reference number for the call, please?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, the name is [PII], that is spelled [PII] last initial of [PII] in today's date. Now, when you submit that information in, you have the option to submit it via fax or mail.
[AGENT][NEUTRAL] And the needed documentation would either be that statement that you're stating that you have.
[AGENT][NEUTRAL] The EOB that matches the date of service and the diagnosis code, which is the reason for that visit, for that date of service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The EOB from my from the primary.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and diagnosis code for data of service. OK, can I, and is the address still [PII] 39205-0925?
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so that's [PII], [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. OK, got it. All right. OK, then I will go ahead and give them a call. Thank you so much for your time.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Rights Center. Have a great day.
[CUSTOMER][POSITIVE] Thank you you too.