AccountId: 011433970860
ContactId: d9072d23-a37c-4a23-8b19-f97773448da8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 386359 ms
Total Talk Time (AGENT): 88567 ms
Total Talk Time (CUSTOMER): 167664 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/d9072d23-a37c-4a23-8b19-f97773448da8_20250605T14:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], my name is [PII]. I'm calling from the business office uh.
[CUSTOMER][NEUTRAL] Valley Baptist Medical Center Brownsville to checkpoint, uh, at the status. I would like also to inform you that this call may be recorded and monitored for quality purposes only.
[AGENT][NEUTRAL] OK, I can help you with claim status, and did you say your name was [PII]?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] [PII], sorry.
[AGENT][NEUTRAL] Hey [PII], do you have the policy number for that patient?
[CUSTOMER][NEUTRAL] Um, the policy number for this one is Z for Zulu G for girl, P for Peter 840007075.
[AGENT][NEUTRAL] Um, that's not one of our policy numbers. Do you have the last name?
[CUSTOMER][NEUTRAL] Um, yes, it's [PII].
[CUSTOMER][NEUTRAL] Um, but we have a previous call here. This is the number that.
[CUSTOMER][NEUTRAL] They call and they have the reference number.
[AGENT][NEUTRAL] Um, our reference numbers are just our names in today's date. Are you trying to call American Public Life?
[CUSTOMER][NEUTRAL] Ah yeah.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, and I, we, like I said, our reference numbers are our name and today's date, so I'm not, and that policy number is not ours.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So what was the last thing?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] I'm sorry I didn't
[CUSTOMER][NEUTRAL] I forgot your name. I'm sorry, what is your name again?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Do you have the first name?
[CUSTOMER][NEUTRAL] I'm sorry about the, oh no, I'm sorry about what I gave lately, but the policy number is incorrect and I was, I, I just want to correct that one. The policy number should be 01868783.
[CUSTOMER][POSITIVE] I'm so sorry about that because
[CUSTOMER][NEUTRAL] The primary insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] ID number.
[AGENT][NEUTRAL] OK, and then the patient name and date of birth?
[CUSTOMER][NEUTRAL] The patient's name is [PII] and the date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, the callback number is [PII] and that is the direct line.
[AGENT][NEUTRAL] What is the date of service and bill charges?
[CUSTOMER][NEUTRAL] Um, the date of service for this one is [PII] [PII], and then the bill amount for this one is $99,0071 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] Uh, we received the claim on [PII].
[AGENT][NEUTRAL] It was paid on the same day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Made a payment of 2500.
[CUSTOMER][NEUTRAL] OK, but, um, [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm, I, I'm showing about the payment on our end, but I just want to check about the status that we sent on February. Just give me one moment.
[CUSTOMER][NEUTRAL] Uh, [PII] and I just want to know about the status of the claim.
[AGENT][NEUTRAL] For an appeal.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] So we, we reviewed the appeal, but this our decision stands because the calendar year maximum was met. We can't change that.
[AGENT][NEUTRAL] The policy has a calendar year dollar amount payable, and that's what we paid, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So are you, um, that was the allowed amount for this one?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] This is a secondary plan, so there's not an allowed amount.
[CUSTOMER][POSITIVE] It's the max allowable, yes, yes.
[AGENT][NEUTRAL] You, you mean the max the maximum payable.
[CUSTOMER][NEUTRAL] Mhm. But
[CUSTOMER][NEUTRAL] OK, mhm, but [PII], I just want to, since that bill was upheld and I just want to request about the termination letter for this one.
[CUSTOMER][NEUTRAL] To be faxed to us.
[AGENT][NEUTRAL] The termination letter.
[AGENT][NEUTRAL] Uh, so you need, uh, you mean the, the determination letter, OK, what's your fax?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, give me one moment. The fax number should be.
[CUSTOMER][NEUTRAL] Um, give me one moment. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'll get that faxed over. And is there anything else I can help with?
[CUSTOMER][NEUTRAL] Um, nothing, uh, only the call reference number please.
[AGENT][NEUTRAL] It's my name, [PII], and today's date.
[CUSTOMER][POSITIVE] OK, thank you [PII] for assisting me. Have a great day and always stay safe. Goodbye for now.
[AGENT][POSITIVE] Thanks for calling APL as well. Bye bye.