AccountId: 011433970860
ContactId: cbf9a04c-73ce-44ac-a355-c7eb0c6d3c3f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1039719 ms
Total Talk Time (AGENT): 269955 ms
Total Talk Time (CUSTOMER): 266300 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/cbf9a04c-73ce-44ac-a355-c7eb0c6d3c3f_20250219T14:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider office to check on the claim status. How are you doing today?
[AGENT][POSITIVE] I can verify claim status, [PII]. I'm great. How are you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, I'm good.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] May I have a policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That's 02035270. M as in Marco, L as in Lima, 8.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] Sure. That's [PII]. It's a direct call no extension needed.
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The patient name is
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, that does not match. One moment.
[AGENT][NEUTRAL] [PII]. OK. Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Sure, that's [PII].
[AGENT][NEUTRAL] Total bill amount?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh that's 2,29 dollars.86 cents.
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure. That's $2,29.
[CUSTOMER][NEUTRAL] 0.86 cents.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment.
[AGENT][NEUTRAL] OK, looks like this processed under claim number 3563369. Looks like it paid the benefit to the provider on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, could you please repeat me the claim number? Sorry for that.
[AGENT][NEUTRAL] It is 3563369.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thanks for that. Could you please tell me the claim received date?
[AGENT][NEUTRAL] It was received on [PII].
[CUSTOMER][NEUTRAL] And been processed and paid on [PII]. Am I right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Could you please provide me the allowed amount?
[AGENT][NEUTRAL] Looks like $2,129.86.
[CUSTOMER][NEUTRAL] How much has been paid?
[AGENT][NEUTRAL] $2,129.86.
[CUSTOMER][NEUTRAL] Uh, through which it has been paid?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, through which has the payment has been made through the check or AFT?
[AGENT][NEUTRAL] It was a single trip.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Could you please provide me the check number?
[AGENT][NEUTRAL] 202-767-4.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, could you please provide me the copy of POB?
[AGENT][NEUTRAL] May I have a fax number?
[CUSTOMER][NEUTRAL] Sure. That's 844.
[CUSTOMER][NEUTRAL] 902
[CUSTOMER][NEUTRAL] 3804
[AGENT][NEUTRAL] I'll fax it over to.
[CUSTOMER][NEUTRAL] And the attention
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Attention to the patient's account number, that's 401.
[CUSTOMER][NEUTRAL] 368-814.
[AGENT][NEUTRAL] OK, so I have [PII], 401368-814.
[CUSTOMER][POSITIVE] Yeah, that's correct.
[AGENT][POSITIVE] OK, I'll fax this right over. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] May I know when will I get this copy of EOB?
[AGENT][NEUTRAL] It's just as long as it takes to transmit over. I'm sending it over now.
[CUSTOMER][NEUTRAL] OK, I'm not sure about it. Am I right?
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, yeah, could you please uh provide me call reference number and help with the other two claims if possible.
[AGENT][NEUTRAL] It will be my name which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh, thanks for that. Uh.
[CUSTOMER][NEUTRAL] Could you please help me with the other claim?
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] One moment. Still processing this claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] May I have the next policy number?
[CUSTOMER][NEUTRAL] Uh. Sure. The next policy number is
[CUSTOMER][NEUTRAL] 0248
[CUSTOMER][NEUTRAL] 661 9.
[CUSTOMER][NEUTRAL] M as in Marco, L as in Lima, and 8.
[AGENT][NEUTRAL] OK, that was 02486619?
[CUSTOMER][NEUTRAL] M as in Marco, L as in Lima, and last number is 8.
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure. That's [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. May I have a date of service?
[CUSTOMER][NEUTRAL] Sure, the date of service is uh [PII] and the total charge is $9,846 even.
[AGENT][NEUTRAL] Thank you. For future reference, you may visit our website at [PII] to check claim status as well. One moment.
[AGENT][NEUTRAL] Looks like this processed under claim number 3546718.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And it looks like benefits were previously paid to the insured.
[AGENT][NEUTRAL] This claim was received on
[AGENT][NEUTRAL] [PII] and it processed and denied on [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, could you
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Could you please tell me the general reason, once again, please?
[AGENT][NEUTRAL] Benefits paid to the insured.
[CUSTOMER][NEUTRAL] To the insured
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Uh, thanks for your patience. Uh, could you please provide me the, uh, payment details?
[AGENT][NEUTRAL] I'm sorry because payment was not made to the provider. I cannot give you that information.
[CUSTOMER][NEUTRAL] OK. Uh, may I know what's the reason you have paid to the insured?
[AGENT][NEUTRAL] The claim was submitted by the insured first.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Would you like a copy of this EOB?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Fax it to the same number?
[CUSTOMER][NEUTRAL] The same number, but attention uh to the
[CUSTOMER][NEUTRAL] Patient account number, that's 21482404.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh, could you please provide me call reference number for this call?
[AGENT][NEUTRAL] It would be my name, which is [PII]. Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] OK, I see. Uh, thanks for that. Uh, could you please help me with the other client?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] May I have a policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That's 01978558.
[CUSTOMER][NEUTRAL] M as in Marco, L as in Lima, and the last number is 8.
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] I know it's good for you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Sure. The patient name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. May I have a date of service?
[CUSTOMER][NEUTRAL] Sure, that's [PII].
[CUSTOMER][NEUTRAL] And the total charge is $18,710 even.
[AGENT][NEUTRAL] Thank you. This processed under claim number 3549032. We are asking for the primary insurance explanation of benefits.
[AGENT][NEUTRAL] This claim was received on.
[AGENT][NEUTRAL] [PII] it processed and denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the, uh, mailing address?
[AGENT][NEUTRAL] Yes, the mailing address will be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Am I right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, could you please provide me the effective date and term date?
[AGENT][NEUTRAL] Policy is effective [PII] and it is active.
[CUSTOMER][NEUTRAL] Could you please tell me the plan type?
[AGENT][NEUTRAL] Medlink
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Could you please provide me the timely funing limit?
[AGENT][NEUTRAL] There is no time limit to submit a claim.
[CUSTOMER][NEUTRAL] OK. Uh, could you please provide me the group number?
[AGENT][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] 23061.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Did you.
[AGENT][NEUTRAL] [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, yeah, a minute.
[CUSTOMER][NEUTRAL] OK, uh
[CUSTOMER][NEUTRAL] Could you please provide me the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] OK. Uh, thank you for the, thank you for your assistance. Could you please provide me your call number, call number, please?
[AGENT][NEUTRAL] It will be my name which is [PII]. Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thank you for your assistance. Have a great day.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. Bye.