AccountId: 011433970860
ContactId: c6e17e07-b62c-4781-9374-7afe246a03b0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421660 ms
Total Talk Time (AGENT): 108250 ms
Total Talk Time (CUSTOMER): 132701 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/c6e17e07-b62c-4781-9374-7afe246a03b0_20250320T13:47_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from office. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm fine, thank you, sir?
[AGENT][NEUTRAL] Could I get a callback number please?
[CUSTOMER][NEUTRAL] So OK, so my callback number is [PII].
[AGENT][POSITIVE] Thank you and how can I help you today?
[CUSTOMER][NEUTRAL] Uh, [PII], could you provide me the claim for the patient, please?
[AGENT][NEUTRAL] OK and what is the policy number?
[CUSTOMER][NEUTRAL] So, so the policy number would be 02119982 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's first name is [PII] and last name is spelled as [PII].
[AGENT][NEUTRAL] Could I get the policy number again? I'm sorry.
[CUSTOMER][NEUTRAL] And it
[CUSTOMER][NEUTRAL] The policy number is 02119982 M as in Mike L as in Lima 8.
[AGENT][NEUTRAL] Patient's name and date of birth. Patient's date of birth, I'm sorry.
[CUSTOMER][NEUTRAL] Patients first name, uh, OK, the date of birth would be [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the account and you call for status. What is the date of service?
[CUSTOMER][NEUTRAL] date of service would be [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] The total bill?
[CUSTOMER][NEUTRAL] Uh, give me a moment.
[CUSTOMER][NEUTRAL] The total bill amount is $1650 even.
[AGENT][NEUTRAL] $1650.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. I do not show we have a claim on file for $1650.
[CUSTOMER][NEUTRAL] Um, but I can see that it was billed on [PII]. Could you check on that, please?
[AGENT][NEUTRAL] I'm sorry, if you could repeat that.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I can see that this claim was built on [PII], uh, and the pay ID is paper.
[AGENT][NEUTRAL] And it's $1650?
[CUSTOMER][NEUTRAL] Yeah, 1650.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me look here. Hold one moment, let me pull the image on this one.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding. I apologize for the wait. Uh, it looks like this claim was denied in error, so I am going to send it back for reprocessing. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, uh, [PII], could you provide me the status of the claim, like, uh, may I know the denial date and the reason for denial?
[AGENT][NEGATIVE] Well, the denial is not correct, so it needs to be reprocessed. The claim was received on [PII].
[AGENT][NEUTRAL] Of [PII] and processed on February.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So if you didn't deny it our same right.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And may I know the what what was the denial on this claim?
[AGENT][NEGATIVE] The primary did not cover the charges.
[CUSTOMER][NEUTRAL] Primer did not cover the charges. OK, so you're going, you're saying that this is inquired, so you're going to send this claim to deposit, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so let me note it down all of these.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK, and may I know the claim number?
[AGENT][NEUTRAL] Claim number is 3559459.
[CUSTOMER][NEUTRAL] Could you verify it it's 3559459, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And may know the turn around time?
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] 24 hours.
[CUSTOMER][NEUTRAL] 24 hours.
[CUSTOMER][NEUTRAL] Got it. And do you have any case number or a ticket number so I can follow up on this claim?
[AGENT][NEUTRAL] No, I can give you a a call for a reference call, uh, but there is no confirmation number for the client you can call and ask for the claim number data service and they'll give you the updated information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, so, got it, Kea, if you don't mind, could you provide me the call reference number, please?
[AGENT][NEUTRAL] To reference the call, you'll use my name [PII] and today's date.
[CUSTOMER][NEUTRAL] Uh, so it's [PII], right?
[AGENT][NEUTRAL] Mm. Yes.
[CUSTOMER][NEUTRAL] And today's date.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you for thank you for that, Kea, the cause of concern, but by the way, thanks for speaking with me Kea and have a great day.
[AGENT][POSITIVE] You have a wonderful day yourself, [PII]. Thank you for calling APL bye bye.
[CUSTOMER][NEUTRAL] Bye bye.