AccountId: 011433970860
ContactId: f4fd1e8f-e8f7-4641-aeba-d4b740eda754
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 458190 ms
Total Talk Time (AGENT): 73702 ms
Total Talk Time (CUSTOMER): 212077 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/f4fd1e8f-e8f7-4641-aeba-d4b740eda754_20250402T19:43_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing good how are you?
[CUSTOMER][POSITIVE] Really good, thank you for asking. I'm calling in regards to Bundsecures to check a claim status. I want to know if you received this claim successfully on your end.
[AGENT][NEUTRAL] OK, I can check claim status for you, [PII]. Do you have a good call back number?
[CUSTOMER][NEUTRAL] Sure, let me share my best contact number will be.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. You have the policy number of the patient?
[CUSTOMER][NEUTRAL] Sure, let me share this information real quick with you.
[CUSTOMER][NEUTRAL] Policy I was able to see right here. OK, here is the insurance card.
[CUSTOMER][NEUTRAL] OK, um, it's here. OK. This one is the first one, secondary will be this one. Please bear with me one moment. I was able to see it right away here. OK, this one is for Blue Cross and this one is.
[AGENT][POSITIVE] Oh, no problem.
[CUSTOMER][NEGATIVE] No, this one is not the correct one.
[AGENT][NEUTRAL] I can look it up by patient name too if that's easier.
[CUSTOMER][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] Um, here, this one.
[AGENT][NEUTRAL] Or social.
[CUSTOMER][NEUTRAL] And this one will be for American Public Life. Yes, this one is the correct insurance card.
[CUSTOMER][NEUTRAL] OK, uh, the number will be 02.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 14.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] Sure. A patient named [PII] and date of birth, let me see here, effective.
[CUSTOMER][NEUTRAL] Date of birth will be.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and what's the date of service?
[CUSTOMER][NEUTRAL] Date of service, let me check that real quick.
[CUSTOMER][NEGATIVE] NO service, [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And the bill charges?
[CUSTOMER][NEUTRAL] Let me see here. That will be $390.
[AGENT][NEUTRAL] OK, looks like we received that [PII]. That was denied on [PII].
[AGENT][NEUTRAL] And let me see what the reason was.
[AGENT][NEUTRAL] Um, office visits are not covered under this policy.
[CUSTOMER][NEUTRAL] Not covered under that policy, so that will be patient responsibility.
[AGENT][NEUTRAL] Um, we're a secondary plan, so we don't determine patient responsibility. We can just share with you how the claim was processed.
[CUSTOMER][POSITIVE] Got it. Perfect. Thank you for that information and as we do not have the explanation of benefits for that denial, uh, do you were able to fax that information for me?
[AGENT][NEUTRAL] Sure, what's your fax number?
[CUSTOMER][POSITIVE] Perfect. Let me share that information real quick. fax number will be [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], I'll get that faxed over to you. And is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Sure, uh, if you can help me with other two claims with for the same insurance but different patient, that would be awesome.
[AGENT][NEUTRAL] OK. Uh, give me one moment.
[CUSTOMER][POSITIVE] Sure, take your time, no worries.
[CUSTOMER][NEUTRAL] So the service for is what for end of June, right?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That's all the information I need.
[AGENT][NEUTRAL] OK, do you have the next policy number?
[CUSTOMER][POSITIVE] Sure, give me a minute. I'm getting that information real quick for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, next one will be.
[CUSTOMER][POSITIVE] This one is American life as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry you get lost for this insurance card. Give me 2 seconds please.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, [PII] and the insurance card is here.
[CUSTOMER][NEUTRAL] American public life.
[CUSTOMER][NEUTRAL] OK, perfect. I have the insurance. Let me check here the number.
[CUSTOMER][NEUTRAL] The number is 0204.
[CUSTOMER][NEUTRAL] 4919.
[AGENT][NEUTRAL] OK, and the patient name and date of birth?
[CUSTOMER][NEUTRAL] Name of the patient, [PII], and date of birth, let me check here.
[CUSTOMER][NEUTRAL] Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the date of service?
[CUSTOMER][NEUTRAL] Day of service, [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, I don't show a claim on file.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] No claim on file?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so I'm going to make sure to resubmit this one and receive. Can you please share with me a reference number for this call so I can resubmit this claim, please?
[AGENT][NEUTRAL] Uh, it's my first name, [PII], and then first initial of my last name which is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, perfect, [PII], that will be everything for today. Thank you for your time and assistance. Have a good day. Bye bye.
[AGENT][POSITIVE] OK, well thank you for calling APL you have a good day too.
[CUSTOMER][POSITIVE] Thank you bye.