AccountId: 011433970860
ContactId: c8111077-12bf-4938-820d-164b0904b9e4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 741440 ms
Total Talk Time (AGENT): 215149 ms
Total Talk Time (CUSTOMER): 312003 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/c8111077-12bf-4938-820d-164b0904b9e4_20241231T16:19_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I am needing to check on claim status for a patient, please.
[AGENT][NEUTRAL] OK, I can help you with the provider's office.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's the your name and the policy number?
[CUSTOMER][NEUTRAL] My name is [PII]. Policy number is 02510454.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I'll get phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and that is direct.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] What's the date of birth again?
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Oh sorry, I clicked off that [PII].
[AGENT][NEUTRAL] Uh-huh. OK, thank you. And what's the date of service of the claim?
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] I have to, uh, no, I've actually paid on [PII].
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] That was for $1,444.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, so we're checking claim status for [PII] for date of service 8-15-24 dollars for $1444444.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] What were the services uh provided?
[CUSTOMER][NEUTRAL] Um, she had, yes, I had 2 surgical extractions with anesthesia.
[AGENT][NEUTRAL] Some extraction.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so I showed the claim processed on [PII]. Um, under this policy, it covers uh preventive and basic major is not covered, so there was no benefit payable, payable on this claim.
[CUSTOMER][NEUTRAL] you're not covered, OK. And did you all send an EOB out or can I get an EOB?
[AGENT][NEUTRAL] Mhm, uh, it's automatically generated when the claim is processed, so it would have released the next business day and it's now available to download on our online service center can help you, um, download that if you would like, if you've not received a copy. Now what's your billing address?
[CUSTOMER][NEUTRAL] For that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, that'd be great.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's the full address?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thanks.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And so, uh, the website is [PII].
[CUSTOMER][NEUTRAL] Secured A [PII].
[AGENT][NEUTRAL] Uh-huh. The [PII].
[CUSTOMER][POSITIVE] OK, I'll see if I can get on that while I'm on here with you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it all together? It's not separated, is it?
[AGENT][POSITIVE] It is, it is secure. [PII]. Amublic is all together.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Security check, OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I don't know if this is it or not. That's what I know. It's it's funny to me to install something. I can't do that.
[AGENT][NEUTRAL] I shouldn't ask you. Did you come to, what, what do you show on the homepage?
[CUSTOMER][NEUTRAL] Uh, I guess.
[CUSTOMER][NEUTRAL] Let me um.
[CUSTOMER][NEUTRAL] Well, nothing it was just wanting me to install something that was.
[AGENT][NEGATIVE] Mm mm that's not the right page then secured.
[CUSTOMER][POSITIVE] Yeah, OK, so yeah I got yeah I got it now so.
[AGENT][NEUTRAL] Uh-huh. You got it. OK.
[CUSTOMER][NEUTRAL] Well, do I need to go on, what do I need to go on though because it's giving me it's APL secured but then it says American Public Life APL.
[CUSTOMER][NEUTRAL] QPG.
[AGENT][NEUTRAL] What did you type in in your search engine? Tell me what you typed in.
[CUSTOMER][NEUTRAL] Secured secured space [PII].
[AGENT][POSITIVE] It's secure.t.
[CUSTOMER][POSITIVE] Uh secured.
[AGENT][NEUTRAL] Instead of space, it's do [PII]. That's OK.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Try out.
[CUSTOMER][NEUTRAL] Yeah, I pulled up the same thing so I just need to go I guess to claim status.
[AGENT][NEUTRAL] You said it pulled up the same thing?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] is what's pulling up.
[AGENT][NEUTRAL] Mm, no.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you're typing in secured. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yep, that's what I typed in and it pulled up the very same thing. It just that stop it starts, it's wanting me to pick one of these APL secured. Is that where I need to go?
[CUSTOMER][NEUTRAL] Let me just click on it and see. OK, so my page looks like has APL at the top left and big.
[AGENT][NEUTRAL] Online service center. Welcome.
[CUSTOMER][NEUTRAL] OK. Yes, yes, mhm, yes.
[AGENT][NEUTRAL] OK, that's it, and to the right you're gonna click on the new user tab.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Mhm and then select which role role that best describes you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Tax ID.
[AGENT][NEUTRAL] And what tax ID number will you enter on there? We need to make sure that what you enter matches what we have in our system.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the patient account.
[CUSTOMER][NEUTRAL] And then it says a patient yeah.
[AGENT][NEUTRAL] Mhm. It's gonna be in box 23 of the ADA form.
[CUSTOMER][NEUTRAL] Do I just
[CUSTOMER][NEUTRAL] Oh OK uh.
[CUSTOMER][NEUTRAL] So it's just their ID number.
[AGENT][NEUTRAL] No, it's the patient account number that's assigned, yeah, for the patient. What number is that?
[CUSTOMER][POSITIVE] Correct. Oh, I see it I see it.
[CUSTOMER][NEUTRAL] 169947 and then I guess I have to space it and then it's 16 420. Do I need to put the space in there?
[AGENT][NEUTRAL] Give me one second because I
[AGENT][NEUTRAL] Give me 1 2nd because I show a different patient account number on there. Let me pull up the, the document.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm showing the 560599-585.
[CUSTOMER][NEUTRAL] Oh, I don't have that at all. OK, tell me what it is again.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Let me pull up the claim real quick.
[AGENT][NEUTRAL] In box number 23.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have on the claim, it says 5605.
[AGENT][NEUTRAL] 99585.
[CUSTOMER][NEUTRAL] OK, that is not what it's showing on my claim when I pull it up.
[CUSTOMER][NEGATIVE] It's odd.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, mine shows 16,994,716,420 in box 23 on that claim when I pulled that up.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] I'm not sure. I don't.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We're looking at the claim that we received from this office.
[AGENT][NEUTRAL] And that's what's listed in that box.
[CUSTOMER][NEUTRAL] Mm, OK, well that's weird it's coming electronically though, so I don't know what happens when it leaves me so OK so I put the 560.
[AGENT][NEUTRAL] OK. OK. Gotcha.
[CUSTOMER][NEUTRAL] 599585 in the patient account box, correct?
[AGENT][NEUTRAL] Yes, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and let's just hit next. OK, so now I guess it's wanting me to create a user name.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, it's just a minimum of 8 letters, um, and just include one character and I think it gives you the characters that are accepted and then just one number.
[AGENT][NEUTRAL] In the anywhere in the the the uh password.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And let's see.
[CUSTOMER][NEGATIVE] I have to pay a capital.
[CUSTOMER][NEUTRAL] Oh I bet I had to put a number on that one too.
[CUSTOMER][NEUTRAL] Oh yeah it does need upper case sorry.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and then confirm.
[CUSTOMER][NEUTRAL] And I don't need, I can't put a text message phone number in here, so that's OK to leave that alone.
[AGENT][NEUTRAL] Is it asking you that for that to send you a code?
[CUSTOMER][NEUTRAL] I, I don't know. Let me just hit next and see, you know, it's not accepting something, shoot.
[CUSTOMER][NEUTRAL] Please enter a valid user name. User name must be one of 20 characters and they contain a combination.
[CUSTOMER][NEGATIVE] Don't really know what it wants me to do here.
[CUSTOMER][NEGATIVE] So user name is 1 to 20 characters. I have that and may contain any combination of A Z A through Z9 underscore and a dash maybe it doesn't like this.
[CUSTOMER][NEUTRAL] Check this out, OK.
[CUSTOMER][POSITIVE] It's been successful so let's go log in.
[CUSTOMER][NEUTRAL] OK, so I'm into, I'm in here now climbing the it says claim status.
[AGENT][NEUTRAL] Mhm. So it's a quick search whereby you can enter the patient's first name, their date of birth, and the claim number. And if I didn't give you the claim number, I can provide that, uh, for you.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Uh, that number is 353.
[AGENT][NEUTRAL] 9961.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So if that's one L or two L's H A L L. I think it's L L I.
[CUSTOMER][NEUTRAL] Birthday.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I believe I found it. Let's see.
[CUSTOMER][NEUTRAL] 35 OK let me see if let me pull it up here.
[CUSTOMER][POSITIVE] OK, I've got it thank you very much for walking me through that. I really appreciate it. I've got it thank you.
[AGENT][NEUTRAL] You got it?
[AGENT][POSITIVE] You're, you're welcome, [PII]. If no other questions, thanks for calling APL and have a good new year, OK?
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh bye bye.