AccountId: 011433970860
ContactId: e8bd173e-9f18-47aa-ac27-cb4b60357146
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 807250 ms
Total Talk Time (AGENT): 262087 ms
Total Talk Time (CUSTOMER): 227083 ms
Interruptions: 5
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/e8bd173e-9f18-47aa-ac27-cb4b60357146_20250325T20:14_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from service for checking time status. Hi, [PII]. How are you doing today?
[AGENT][NEUTRAL] I'm doing fine, [PII]. So you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, I
[AGENT][NEUTRAL] Can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][NEUTRAL] And how many claims [PII], do you have today?
[CUSTOMER][NEUTRAL] I have 2 claims.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Are your claims for the same patient or different patients?
[CUSTOMER][NEUTRAL] Could you please check with my kid because it's uh in and out. I can't hear clearly.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are your claims for the patient or the patient?
[CUSTOMER][NEUTRAL] Two different patients.
[AGENT][NEUTRAL] Is it multiple to different patients with, OK. So [PII], you will use my name along with today's date as your call reference number for each one.
[CUSTOMER][NEUTRAL] Yeah. Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Also, any information that I provide for you will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Lastly, [PII], if we do have the claims on file and you need of benefits, you can print those with the claim number by going to our port.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So uh maybe help.
[AGENT][NEUTRAL] And our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Very sorry to interrupt you. Uh, your voice is in and out I am not.
[CUSTOMER][NEUTRAL] On the
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Could you please check with your mic once again.
[AGENT][NEUTRAL] Any information that I provide a verification? Yes sir, I haven't moved. I don't know if there's something wrong with the connection and I.
[AGENT][POSITIVE] I do apologize about that.
[CUSTOMER][NEUTRAL] you guys
[AGENT][NEUTRAL] But any information that I provide for you will be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] And as again if we do have the claim on file and you need a copy of the explanation of the, you may print it by going to our portal at secured.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] All right. And what is, you're welcome. What is the first patient's policy number?
[CUSTOMER][NEUTRAL] Patient policy number is 142664.
[CUSTOMER][NEUTRAL] 7 M for Mike, L for Lima.
[CUSTOMER][NEUTRAL] 8
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] The date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I on.
[AGENT][NEUTRAL] Bear with me just a moment. It um.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I'm having to restart one of my screens, [PII], so bear with me just a moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] On.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Are you gonna wait for the account.
[AGENT][NEUTRAL] OK [PII], we'll just see if we can do the best we can um what is the date of.
[AGENT][NEUTRAL] Service and total bill amount, please?
[CUSTOMER][NEUTRAL] So, sort of work.
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] Date of service and total bill amount.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. And the bill amount is $740 even.
[AGENT][NEUTRAL] 740. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Moment.
[AGENT][NEUTRAL] OK, so this claim was received on [PII].
[AGENT][NEUTRAL] And it was processed the same date.
[AGENT][NEUTRAL] The claim number is 350.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] [PII], sorry to interrupt you. Uh, I need an appeal status. I don't, don't want the general claim status. An appeal was submitted through.
[AGENT][NEUTRAL] OK
[AGENT][NEGATIVE] We haven't received.
[AGENT][NEUTRAL] OK. You asked for claim status?
[AGENT][NEUTRAL] We don't show that we have received an appeal.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a we show a second claim that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Was also denied as office visits are not covered.
[CUSTOMER][NEUTRAL] And how to check the.
[AGENT][NEUTRAL] I don't, I do not show that we have received an appeal on this policy.
[AGENT][NEUTRAL] An appeal must be filed
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Writing the 80 days from the date of the day.
[AGENT][NEUTRAL] And sent to our our our a department.
[AGENT][NEGATIVE] But it does not show that we have received an appeal for this patient.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Sorry to interrupt you, your voice was still.
[CUSTOMER][NEGATIVE] Going in and out. I can't.
[CUSTOMER][NEUTRAL] Here anything.
[AGENT][NEUTRAL] OK. I'm, I'm sorry. We have not received an appeal.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For this number.
[CUSTOMER][NEUTRAL] Then can I reserve the top again.
[AGENT][NEGATIVE] This claim was denied.
[AGENT][NEUTRAL] This claim was reviewed, it must be submitted within 180 days from the date of the denial that I gave you.
[CUSTOMER][NEUTRAL] OK. Could you please say the date of the.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Uh, I can't understand what you're saying. Your voice is very mold.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, could you please say the date of the deliver?
[AGENT][NEUTRAL] Could you repeat what you said, [PII]?
[CUSTOMER][NEUTRAL] When the, when it is denied, could you please share the date?
[AGENT][NEGATIVE] This claim was received and denied.
[AGENT][NEUTRAL] It was denied on [PII].
[CUSTOMER][NEUTRAL] On the time of the filing is.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Days from the date of the denial.
[CUSTOMER][POSITIVE] OK. Thank you. Sorry.
[AGENT][NEUTRAL] Do you need the claim number or not on this one? You're welcome. Do do you need the claim number?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, I have a claim number 3509286. Is that right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. Then can we go to next time? Could you please give me the call reference number?
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Hi, so I explained to you initially, [PII], you would use in today's date as the call reference number for each each claim, uh huh. So give me just a moment to finish that OK, give me a moment to finish my note on this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. Sorry.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And what is your next patient's policy number, [PII]?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Once again.
[CUSTOMER][NEUTRAL] The next policy number is 00190.
[AGENT][NEUTRAL] Uh-huh, sure.
[CUSTOMER][NEUTRAL] 138.
[AGENT][NEUTRAL] OK, so we, there's a number that's incorrect there you said 00190138?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, it's the state of [PII].
[AGENT][NEUTRAL] OK, that's not a valid policy number.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Then you, could you please transfer to the American Bank of Tennessee.
[AGENT][NEUTRAL] I didn't understand what you said, [PII].
[CUSTOMER][NEUTRAL] Is this uh American plan administrator?
[AGENT][NEGATIVE] It is not.
[AGENT][NEUTRAL] This is American Public Life Insurance.
[CUSTOMER][NEUTRAL] And could you please transfer to that?
[CUSTOMER][NEUTRAL] Sir, could you please transfer to the department.
[AGENT][NEUTRAL] Uh, so that would be another company, so you would have to call them.
[AGENT][NEUTRAL] At whatever their phone number is.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So is there anything else that I can help you with this afternoon, [PII]?
[CUSTOMER][POSITIVE] Then thank you.
[CUSTOMER][POSITIVE] No, [PII], thank you for assisting me today. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're very welcome and thank you for calling APL. I hope you have a nice afternoon.
[CUSTOMER][NEUTRAL] OK. Bye for now.
[AGENT][NEUTRAL] Bye-bye.