AccountId: 011433970860
ContactId: ea4677da-69df-4a09-92ac-602e9b9178f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 249190 ms
Total Talk Time (AGENT): 74317 ms
Total Talk Time (CUSTOMER): 116720 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/ea4677da-69df-4a09-92ac-602e9b9178f9_20250530T19:06_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. I'm calling for the provider to check an additional information about the claim that has been denied. Please note this call will be monitored and recorded for quality and training purposes, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, could I get a callback number please, please?
[CUSTOMER][NEUTRAL] It's [PII] and it is a direct line.
[AGENT][NEUTRAL] Can I get the policy number you're calling on?
[CUSTOMER][NEUTRAL] Yes, uh, policy number 1988243 M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yes, uh, patient's name, it is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you so much for verifying the account you said you were calling in reference to a denied claim. What is the date of service?
[CUSTOMER][NEUTRAL] [PII], with the bill amount, it shows.
[CUSTOMER][NEUTRAL] Just one second, it's loading. It's $250 even $250.
[AGENT][NEUTRAL] OK, thank you so much for verifying the account. I mean, um, providing the claim num claim information. Um, I do show the claim uh for this data service. The charges were denied. The policy does not cover physician office visits.
[CUSTOMER][NEUTRAL] OK, uh.
[AGENT][NEGATIVE] And the second claim denied as a duplicate.
[CUSTOMER][NEUTRAL] OK. So the service is not cover physician service is not covered under the patient's plan, I'm right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. May I know the patient's plan name?
[AGENT][NEUTRAL] The plan name or plan type?
[CUSTOMER][NEUTRAL] Planning.
[AGENT][NEUTRAL] Plan name is American Public Life.
[CUSTOMER][NEUTRAL] American Public Life.
[CUSTOMER][NEUTRAL] OK, just one second.
[CUSTOMER][NEUTRAL] And the reason claim it is got in it as a to be them, right?
[AGENT][NEUTRAL] The claim denied, the original claim denied, the policy does not cover physician office visits.
[CUSTOMER][NEUTRAL] OK. And the most recent claim it is got in it as a door, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Uh thank you so much for the confirmation. And so for this one, be able to provide me the
[CUSTOMER][NEUTRAL] Call reference number for this claim.
[AGENT][NEUTRAL] To reference the call to, uh, you'll use my name and today's date.
[CUSTOMER][POSITIVE] OK. I have one more member could be able to assist me.
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, policy number it is 02584454.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name, it is [PII], and date of birth [PII].
[AGENT][NEUTRAL] Thank you and what is the date of service?
[CUSTOMER][NEUTRAL] It's [PII]. And with the bill amount for this one, it shows.
[CUSTOMER][NEUTRAL] $450.33.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I do show the claim received. The claim was denied. Services not covered according to the patient's plan.
[CUSTOMER][NEUTRAL] OK, um, so may I know the patient's planning?
[AGENT][NEUTRAL] The it's American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] American public life. Just one second.
[CUSTOMER][NEUTRAL] OK, just one second.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK. So, for this one,
[CUSTOMER][NEUTRAL] It's the same one call reference number, your name and today's date, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you so much for assisting those two claims. [PII], have a wonderful day. Bye-bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You have a wonderful day thank you for calling APL bye bye.