AccountId: 011433970860
ContactId: cf91a671-7911-4b8d-ad49-24e4e5f39b12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362190 ms
Total Talk Time (AGENT): 129476 ms
Total Talk Time (CUSTOMER): 156136 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/cf91a671-7911-4b8d-ad49-24e4e5f39b12_20250519T17:42_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm needing to check uh claim status for patients.
[AGENT][NEUTRAL] I can verify claim status. May I have your name and the policy number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and the policy number is, let me look it up here again, um, I have.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] I'm showing the ID different than what's on the card. On the card is 2002501, but.
[CUSTOMER][NEUTRAL] I have a different member ID.
[CUSTOMER][NEUTRAL] Starting with a 024.
[AGENT][NEUTRAL] OK, I'll take that one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 024628887.
[AGENT][NEUTRAL] And may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Uh yes, my callback number is [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, yes. Patient's name is [PII], and that's [PII]
[CUSTOMER][NEUTRAL] Um, [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Is this for medical or dental?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] OK. So the first number, the [PII], that is their dental number.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] OK, may I have a date of service?
[CUSTOMER][NEUTRAL] Uh yes, date of service is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And total bill amount?
[CUSTOMER][NEUTRAL] $3,304.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment, I'll get this pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And who would be the provider?
[AGENT][NEUTRAL] On this claim?
[CUSTOMER][NEUTRAL] The provider is um Mercy Hospital, Oklahoma [PII].
[AGENT][NEUTRAL] And can you show the patient's responsibility on that one?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Can I show it?
[AGENT][NEUTRAL] Yes, what is the patient's responsibility on that?
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] 00, after the primary?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, we have $502.24.
[AGENT][NEUTRAL] OK. So it looks like this one was processed to the insured.
[AGENT][NEUTRAL] So I was looking to see if there was a bill. So it looks like the insured submitted and benefits were processed to the insured on that one.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, so it's patient responsibility.
[CUSTOMER][NEUTRAL] Um, have you sent out or do you know when the EOB was sent?
[AGENT][NEUTRAL] OK, because it was sent to the insured, I can't give you that information. I was just looking to see if we had anything from the provider, but I'm not saying that we received anything as of today.
[CUSTOMER][NEUTRAL] So, so there's no claims on file?
[AGENT][NEUTRAL] Not from the, yes, ma'am, not from the provider.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[CUSTOMER][NEUTRAL] OK, we submitted it on for 1 of 25 um.
[CUSTOMER][NEUTRAL] Which has been over a month.
[AGENT][NEUTRAL] Did you
[AGENT][NEUTRAL] Yes, ma'am. Did you mail it, fax it?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, good question. Let me look up in the notes.
[CUSTOMER][NEUTRAL] 41.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] OK, 41 we.
[CUSTOMER][NEUTRAL] Sent it by paper.
[AGENT][NEUTRAL] OK. Well, do you know if it went to [PII] in [PII]?
[CUSTOMER][NEUTRAL] Yeah, that's the only address that we have on file.
[AGENT][NEGATIVE] OK, yes, we should have received that by now, but I don't show.
[AGENT][NEUTRAL] Anything from the provider on 317.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, well maybe I'll uh submit it again because um.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I think that I need the EOB before I can drop that to the patient on my end.
[AGENT][NEUTRAL] OK, would you like to fax it over?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Uh, yeah, we can fax it.
[AGENT][NEUTRAL] It's 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][POSITIVE] Pension claims awesome and uh [PII] do you give out call reference numbers?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII]. Last initial is [PII] along with today's date.
[CUSTOMER][POSITIVE] Awesome you've been so awesome thank you so much.
[AGENT][POSITIVE] [PII], you're so welcome. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, not until I get another patient. I have a question on.
[AGENT][POSITIVE] OK, we'll be here to help you then as well, [PII].
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too, bye-bye.