AccountId: 011433970860
ContactId: f49d05ea-30aa-4e47-897e-897c71761160
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 714500 ms
Total Talk Time (AGENT): 116660 ms
Total Talk Time (CUSTOMER): 204476 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/f49d05ea-30aa-4e47-897e-897c71761160_20250325T18:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. Who am I speaking with?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? This is [PII].
[AGENT][NEUTRAL] Hey so how are you doing?
[CUSTOMER][POSITIVE] Hey, I'm good. How about you?
[AGENT][NEUTRAL] Well, just living the dream one nightmare at a time, my love.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's a good one.
[CUSTOMER][POSITIVE] But yeah, we're on the same page it's OK.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] Um, I have a member on the line that she said that she sent, uh, she believes she sent the information that we needed and that we're just overlooking the information, so, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me give you this policy number. Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, let me go back. OK. That's 242-305-5.
[AGENT][NEUTRAL] OK, and who's it on?
[CUSTOMER][NEUTRAL] It's gonna be for [PII].
[AGENT][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] Mhm. It is the most recent claim.
[CUSTOMER][NEUTRAL] Which we're asking for actual charges mhm.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] And I'm looking at the EOB um the EOB she sent in which it does, uh, indicate some charges for the chemo infusion. I don't know if that's the one that, I mean, I don't know nothing about processing lands for cancer, so.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Me neither girl, so this is gonna be fun.
[CUSTOMER][NEUTRAL] I'm not sure if that's the one.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Me neither.
[CUSTOMER][NEUTRAL] Oh my goodness, I know. Oh, this is so like, uh, OK. We really need those classes because I have no idea. I know I pulled the code. I pulled the code and it did, it did say that that code, the 96413 is for chemo infusion, which I'm thinking that's chemo. So there is a charge there, so I'm not really sure what they're needing.
[AGENT][POSITIVE] Yes, we do.
[AGENT][NEUTRAL] OK, this is [PII] OK um she's in training, so let me.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] But it has to go through audit so.
[CUSTOMER][NEUTRAL] Yeah, because I thought maybe that.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Alright, um, go ahead and put her through. I'm gonna have to get with [PII] and see what it is that she's exactly needing.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK, got you, got you. OK. Well, I fully verify her, so, um, everything's been verified. The callback number, I think, let me double check. I usually write them down, so I don't really pay attention to what is in the system. Um, it's not the same. So let me give you the callback number just in case. It's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me one second, my headset's beeping at me. Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Oh, sure, yeah. Go ahead, go ahead.
[AGENT][NEUTRAL] OK, there we go, are you there?
[CUSTOMER][NEUTRAL] Yeah. Yeah, I'm here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Damn. No, I'm just kidding.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] It didn't go
[CUSTOMER][NEUTRAL] All right, you're ready?
[AGENT][POSITIVE] I am. I'm ready when you are.
[CUSTOMER][POSITIVE] All right. OK. Here she comes. Have a good day.
[AGENT][POSITIVE] You too, love.
[CUSTOMER][POSITIVE] Thank thank you thank you for holding and being patient for me um, Miss [PII], uh Miss [PII], I'm sorry, I got Ms. [PII] on the line and she's gonna assist you from here. She's in the claims department, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome have a good day.
[AGENT][NEUTRAL] Hi Ms. [PII], this is uh [PII]. I'm in the, uh, claims department. Give me one second to just look everything over if that's OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] No problem, give me 1 2nd.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], thank you so much for holding while I looked it over. Um, it looks like you sent in the bill summary we're needing the EOB uh explanation of benefits from your primary insurance showing what you actually owe.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK, I have given you everything that Medishare gives me. OK, I don't have insurance. It's the Medishare, it's medical bill sharing, so they don't use that term when they say explanation of sharing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Be sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And I have given it to you in all the ways that I can get it from them.
[AGENT][NEUTRAL] OK, OK, let me see.
[CUSTOMER][NEUTRAL] And when I first talked to somebody about this back in early, like September.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Looking at that spreadsheet, which is like an overview of all the explanations of sharing, it looked, she thought it looked like about $500 well the $530 that was shared is what is paid. What's shared is what's paid, you know, um, and so she.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, their terminology, OK.
[CUSTOMER][NEUTRAL] So when they say that it's shared, that means it was sent to their members to pay that bill.
[CUSTOMER][NEUTRAL] That, that's what was paid.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Shared amount, yeah.
[AGENT][NEUTRAL] Charges
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] The examiner that processed your claim is in a meeting. Is there any way I can get with her and give you a call back as soon as we I because I wanna go over it with her, um, as soon as she gets out of the meeting I can call you back.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK, that would be great.
[AGENT][NEUTRAL] Is that OK? OK, and uh let.
[CUSTOMER][NEUTRAL] Uh, what's, yeah, sure, what's your name?
[AGENT][NEUTRAL] The number I have is [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I will give you a.
[CUSTOMER][POSITIVE] That's great. And tell me your name again?
[AGENT][NEGATIVE] It's [PII]
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] OK, great.
[AGENT][POSITIVE] OK babe, I'll give you a call as soon as I, OK, no problem, I'll talk to you in a little minute.
[CUSTOMER][POSITIVE] That sounds good.
[CUSTOMER][POSITIVE] Thanks bye.
[AGENT][POSITIVE] No problem have a great day uh huh bye bye.
[CUSTOMER][NEUTRAL] Bye.