AccountId: 011433970860
ContactId: f093870d-7026-4020-b132-084541aee364
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 223729 ms
Total Talk Time (AGENT): 80546 ms
Total Talk Time (CUSTOMER): 93699 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/f093870d-7026-4020-b132-084541aee364_20250303T21:50_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to check on the status of a claim.
[AGENT][POSITIVE] OK, I can definitely help you with the claim status. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. Contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Members's policy number is.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] 02388973 M as in Mary, L as in Lima 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um, member's name is [PII] for your child. Date of birth is June, I'm sorry, [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] Data service was [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] Total bill amount was.
[CUSTOMER][NEUTRAL] I'm sorry, $11,156 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Looks like it's this one. Hold on one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Holy Cross Hospital.
[AGENT][NEUTRAL] Alright, so I'm showing the claim was received on [PII].
[CUSTOMER][NEUTRAL] You said it was received on [PII]?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim number is 356.
[CUSTOMER][NEUTRAL] 356.
[AGENT][NEUTRAL] 3842.
[CUSTOMER][NEUTRAL] 3842. OK.
[AGENT][NEUTRAL] And on [PII], the claim was denied as the max um payable for the data service has been met.
[CUSTOMER][NEUTRAL] Macs payable.
[CUSTOMER][NEUTRAL] We're a data service met, um, question, is it possible for me to receive a copy of that denial?
[AGENT][NEUTRAL] Sure, um, I can fax the EOB to you.
[CUSTOMER][NEUTRAL] Sure, OK, let me grab the ULB's fax number. Thank you. OK, OK, you ready?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, it is 312.
[CUSTOMER][NEUTRAL] 957
[CUSTOMER][NEUTRAL] 3431, and you can attention that to my name, [PII].
[AGENT][NEUTRAL] Is it [PII] or [PII]?
[CUSTOMER][NEUTRAL] It's a [PII], it's with a [PII] a [PII], yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's [PII] attention query?
[CUSTOMER][NEUTRAL] Yeah, and um
[CUSTOMER][NEUTRAL] Just, yeah, you could just say yep, and it'll say will it have like American Public Life like on the the cover sheet so I know which insurance is from.
[AGENT][NEUTRAL] I believe it's on the header, but just to make sure I'll put it in the attention.
[CUSTOMER][POSITIVE] OK, I appreciate it. Thank you so much, [PII].
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Did you have a call reference number?
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name and today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much for your help. You have a good rest of your day.
[AGENT][POSITIVE] You also thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.