AccountId: 011433970860
ContactId: d5e8b71c-d3af-47f0-89e4-8d9039811359
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 424940 ms
Total Talk Time (AGENT): 162191 ms
Total Talk Time (CUSTOMER): 82862 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/d5e8b71c-d3af-47f0-89e4-8d9039811359_20250425T19:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello. Hi. My name is [PII]. I'm calling from the University of Miami and I'm calling to see about a status update for a claim.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] The number is going to be.
[CUSTOMER][NEUTRAL] 024664.
[AGENT][NEUTRAL] 024664
[CUSTOMER][NEUTRAL] I'm sorry, 02464420. Sorry.
[AGENT][NEUTRAL] Um, OK, I, I, I don't think I got it right. Let me have it one more time.
[AGENT][NEUTRAL] 02
[CUSTOMER][NEUTRAL] Yup, 024.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 64
[CUSTOMER][NEUTRAL] 420.
[AGENT][POSITIVE] Yeah. Thank you.
[AGENT][NEUTRAL] May I have the name and the date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] owns [PII].
[AGENT][NEUTRAL] Thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Um, it's gonna be [PII]. The amount is for 9,549.
[AGENT][NEUTRAL] So it's 9,549.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and that's [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. Let me see if I can find this claim and for future you can check claim status online through our website at [PII], and that's just optional.
[AGENT][NEUTRAL] Yeah, let's see, but it's gonna be this one. Let me pull this EOB.
[AGENT][NEUTRAL] Mm, you know, I'm sorry, it's it's taking a few minutes to pull up the document.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're waiting. I'm so sorry.
[CUSTOMER][NEUTRAL] Mm, that's fine.
[AGENT][POSITIVE] Thank you for your patience.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII].
[AGENT][NEUTRAL] And we send a benefit amount of $2,814.16 and with the payment of that check, the policy has maxed out the benefit for the year.
[CUSTOMER][NEUTRAL] Next our benefits.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] When was it deposited again?
[AGENT][NEUTRAL] It was processed
[CUSTOMER][NEUTRAL] Oh, when was it uh received? I'm sorry.
[AGENT][NEUTRAL] It was processed or received, um.
[CUSTOMER][NEUTRAL] Uh, received, sorry.
[AGENT][NEUTRAL] You need the process date or the received date. OK, bear with me. Let me pull that up there. OK, one moment. That's not on the EP. One moment.
[CUSTOMER][NEUTRAL] No, we saved the fine.
[AGENT][NEUTRAL] OK, um let's see.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, that's [PII].
[AGENT][NEUTRAL] OK, it was received on [PII], processed [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um, you said the amount was for 2,846, I believe, right?
[AGENT][NEUTRAL] 0 $2,814.16.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Do you need the claim number or any other information?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please. Can I have the claim number?
[AGENT][NEUTRAL] Sure. The claim number is 354.
[AGENT][NEUTRAL] 1583.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. Um, and if you don't mind, your first name and a call reference number?
[AGENT][NEUTRAL] My name is [PII]'s [PII], and we don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Got it. Um, and I guess just for reference for me, um, in case I wanted to appeal this, um, what would be the address and the information I, or a fax number that I can use?
[AGENT][NEUTRAL] OK, you have 180 days from the decision date to submit any appeals.
[AGENT][NEUTRAL] The address is submitted an appeals is the same one that you used to submit a claim, which is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] Got it. The name of the insurance, if you don't mind?
[AGENT][NEUTRAL] APL or American Public Life.
[CUSTOMER][NEUTRAL] Got it. And then attention to claim department I'm assuming.
[AGENT][NEUTRAL] You can put claims or you can put appeals.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much.
[AGENT][NEUTRAL] You're welcome. Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] That'll be all, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day and good afternoon.
[CUSTOMER][NEUTRAL] Bye.