AccountId: 011433970860
ContactId: c8cf7d76-63e3-4a10-9bb2-80d64e042113
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385450 ms
Total Talk Time (AGENT): 148698 ms
Total Talk Time (CUSTOMER): 75377 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/c8cf7d76-63e3-4a10-9bb2-80d64e042113_20250604T12:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the facility office to check up on a claim that is holding [PII].
[AGENT][POSITIVE] I'm doing fine, thank you. And I'm so sorry, what was your name again?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] [PII], OK, [PII], thank you. And you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, sir, I can help you with that and then what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] direct line.
[AGENT][NEUTRAL] Thank you. And what is the, um, you only have one claim then to check status on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is that member's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02312664 M as in Mike, L as in Lima, 7.
[AGENT][NEUTRAL] OK, thank you. Give me a couple of moments then to get the member's information pulled up please.
[AGENT][NEUTRAL] And then any information provided will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, I can see the patient name has been [PII], date of birth has been [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her?
[CUSTOMER][NEUTRAL] [PII]. Charge amount has been $41,853 even.
[AGENT][NEUTRAL] 41853. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Sound
[AGENT][NEUTRAL] OK, so [PII], there is not a claim on file for this member for data service [PII] and the amount of $41,853.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah. Could you verify the mailing address for me?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] And because this is a supplemental policy ban to the primary insurance, we will also have to have a copy of the primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK, 1 2nd.
[CUSTOMER][NEUTRAL] OK, once again.
[AGENT][NEUTRAL] And then, uh-huh.
[CUSTOMER][NEUTRAL] What is the zip code again? [PII], right?
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK. Do you have a pay ID to submit a claim?
[AGENT][NEUTRAL] 60801.
[AGENT][NEUTRAL] And again, we must also have a copy of the prime.
[CUSTOMER][NEUTRAL] 60
[AGENT][NEUTRAL] 60801.
[AGENT][NEUTRAL] And again, we must have a copy of the primary insurance company's explanation of benefits also.
[CUSTOMER][NEUTRAL] OK. What is the plan type?
[CUSTOMER][NEUTRAL] Yeah, fine.
[CUSTOMER][NEUTRAL] So what is the plan type?
[AGENT][NEUTRAL] This is a supplemental.
[AGENT][NEUTRAL] Policy called Medlik.
[CUSTOMER][NEUTRAL] OK. And the member ID which I gave you is the correct member ID, right?
[AGENT][POSITIVE] You did. The policy number you gave me is correct.
[CUSTOMER][NEUTRAL] And the insurance name has been
[CUSTOMER][NEUTRAL] American Public Life Insurance, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And the group number?
[AGENT][NEUTRAL] 17816.
[CUSTOMER][NEUTRAL] And the effective date?
[AGENT][NEUTRAL] The supplemental policy is effective [PII], no term date.
[CUSTOMER][NEUTRAL] OK. And the time limit?
[AGENT][NEGATIVE] No timely filing limit.
[AGENT][NEUTRAL] And then ma'am
[CUSTOMER][NEUTRAL] Could you provide me the call reference number?
[AGENT][NEUTRAL] My name in today's date.
[AGENT][NEUTRAL] And once the claim has been processed here at at APLBN we do have a portal that you should be able to check the claim status in. If you go to [PII].
[CUSTOMER][NEUTRAL] Yeah, I see.
[CUSTOMER][POSITIVE] Yeah, OK, [PII], have a wonderful day. Bye for now.
[AGENT][POSITIVE] Well, I hope you have a wonderful day too. And if that is all I can help you with then, then thank you again for calling APL.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh-huh. OK, bye-bye.