AccountId: 011433970860
ContactId: d3c34c08-db83-4b54-a15b-4cff959e7254
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 257858 ms
Total Talk Time (AGENT): 83708 ms
Total Talk Time (CUSTOMER): 121405 ms
Interruptions: 4
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/d3c34c08-db83-4b54-a15b-4cff959e7254_20250610T13:52_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, [PII]. My name is [PII]. I need to check on the claim. Can you please help me on this?
[AGENT][NEUTRAL] I can verify claim status. [PII]. May I have your policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 4650.
[AGENT][NEUTRAL] I do apologize. It's 02446520.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] 10, sorry.
[AGENT][NEUTRAL] 02446510
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII], date of birth.
[AGENT][NEUTRAL] Thank you, thank you for verifying that information. One moment.
[AGENT][NEUTRAL] I have a date of service.
[CUSTOMER][NEUTRAL] That service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII], with the total bill amount is $237 even.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] This processed under claim number 3583426. No benefits are payable. They do not have the office visit benefit.
[CUSTOMER][NEUTRAL] And the 3.
[AGENT][NEUTRAL] This claim processed and denied on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 91 41 2025.
[CUSTOMER][NEUTRAL] OK. I have a small clarification. It's uh Blue Cross Blue Shield that process primary. They have paid $70.21. In this case, what happened is,
[CUSTOMER][NEUTRAL] Uh, primary as left over, the co-insurance amount of $17.55 and co-pay amount of $15 and
[CUSTOMER][NEUTRAL] Uh, 0 cents. That has been crossed to a secondary.
[CUSTOMER][NEUTRAL] Uh, have you processed the claim along with the primary UOB?
[AGENT][NEUTRAL] That is correct. This policy does not have that benefit. So therefore, no benefits are due, it becomes patients responsibility.
[CUSTOMER][NEUTRAL] That is correct. This policy does not have that benefit. So therefore those benefits for you, it becomes the patient's responsibility. OK. As you stating that you will not cover patients uh co-pay, co-insurance and deductibles, correct?
[AGENT][NEUTRAL] For this office visit, that is correct.
[CUSTOMER][NEUTRAL] For this office visit, that is correct.
[CUSTOMER][NEUTRAL] Mhm. Not bad, just a moment.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] When was the claim received date?
[AGENT][NEUTRAL] 3:31 2025.
[CUSTOMER][NEUTRAL] 33125.
[CUSTOMER][NEUTRAL] And process on
[AGENT][NEUTRAL] 41 2025.
[CUSTOMER][NEUTRAL] 41 2025.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Then the remaining needs to be billed to the patient, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Ah, that is correct.
[CUSTOMER][NEUTRAL] Can I have the reference number?
[AGENT][NEUTRAL] It will be my name which is [PII] Last initial is [PII] along with today's date. [PII], is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Will be my name which is [PII] last initial along with today's date is there anything else I can assist you with? No, thank you and bye bye.
[AGENT][POSITIVE] Thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you for calling American Public Lifestyle. Have a great day. Bye bye.