AccountId: 011433970860
ContactId: eddc4600-c9f9-49b0-818e-490fe07b2ab9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 207389 ms
Total Talk Time (AGENT): 86975 ms
Total Talk Time (CUSTOMER): 65336 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/eddc4600-c9f9-49b0-818e-490fe07b2ab9_20250107T20:52_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] Good afternoon [PII]. My name is [PII]. I'm calling from a provider's office, and I'm calling to check on the status on a claim for one of my patients.
[AGENT][NEUTRAL] I can verify claim status [PII]. May I have a policy number?
[CUSTOMER][NEUTRAL] Sure, my policy number is going to be.
[CUSTOMER][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] I don't know. 023 04851 M as in Mary, L as in Larry 8 number 8.
[AGENT][NEUTRAL] May I have a good call back number for you, [PII]?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. May I have a date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And total bill amount?
[CUSTOMER][NEUTRAL] Total bill amount was 4100.
[AGENT][NEUTRAL] Thank you for future reference, you may visit our website at [PII] to check claim status as well. One moment.
[AGENT][NEUTRAL] It looks like this processed under claim number 3483829 and it looks like uh
[AGENT][NEUTRAL] Benefits have been made to the insured.
[AGENT][NEUTRAL] So it looks like this
[CUSTOMER][NEUTRAL] So the insurance didn't pay anything?
[AGENT][NEUTRAL] American Public Life did not pay anything on this claim. It looks like the insured submitted this claim prior to the provider submitting it. So it looks like benefits went to the insured.
[CUSTOMER][NEUTRAL] So the insurance paid the insured.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Claim number and how much did the insurance pay the, the patient?
[AGENT][NEUTRAL] Because it went to the patient, we can't disclose that information.
[CUSTOMER][NEUTRAL] OK, and I'm just, I'm curious, why would the payment have gone to the patient if we submitted it, we initially submitted to the primary insurance and then it was submitted to the secondary.
[AGENT][NEUTRAL] OK. So according to this code, it looks like the insured also submitted the claim.
[AGENT][NEUTRAL] And it looks like
[CUSTOMER][NEUTRAL] The insured also submitted.
[AGENT][NEUTRAL] Yes, they submitted it prior to the provider submitting it.
[CUSTOMER][NEUTRAL] And can you tell me when they submitted it?
[AGENT][NEUTRAL] Uh, no, I cannot. I'm sorry.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK, and you said your name is?
[AGENT][NEUTRAL] It's [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] Is that the reference number?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect, thank you, [PII], have a great day.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great day. Bye bye.
[CUSTOMER][NEUTRAL] OK.