AccountId: 011433970860
ContactId: f52c9940-8ee3-4e73-96ab-45bd100afe74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 210100 ms
Total Talk Time (AGENT): 60588 ms
Total Talk Time (CUSTOMER): 66074 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/f52c9940-8ee3-4e73-96ab-45bd100afe74_20250319T16:42_UTC.wav
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[CUSTOMER][NEUTRAL] C R.
[AGENT][NEUTRAL] Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I am calling to check status of a claim. Are you able to assist me with that?
[AGENT][NEUTRAL] Yes, may I please have a callback number?
[CUSTOMER][NEUTRAL] Yes, my direct line is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] I have 02415249.
[CUSTOMER][NEUTRAL] And I believe it's supposed to be outpatient, so it's ML 8. Let me just make sure this is an outpatient.
[CUSTOMER][NEUTRAL] Services.
[CUSTOMER][NEUTRAL] Yeah, was outpatients.
[AGENT][NEUTRAL] And are you calling from the provider's office?
[CUSTOMER][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] And I need the data service and total bill.
[CUSTOMER][NEUTRAL] [PII] $459 and that is for Holy Cross Medical Group.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so it looks like we received this claim in twice.
[AGENT][NEUTRAL] And I'm pulling both information for you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So the first time of receiving the claim was [PII].
[AGENT][NEUTRAL] It was processed on [PII]. That claim number is 353.
[AGENT][NEUTRAL] 976 8. It shows that it processed and it denied 99214 as office visits is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So a patient will be responsible for that. OK.
[AGENT][NEUTRAL] That is the provider's discretion.
[CUSTOMER][NEUTRAL] Mhm. Um, is there
[AGENT][NEUTRAL] And then the second claim would have just denied duplicate of the previous claim.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Is a duplicate, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so but if Blue Cross. OK, no problem. Is there a reference number for my call?
[AGENT][NEUTRAL] Yes, the reference will be my first name, [PII], last initial of [PII] and today's date.
[CUSTOMER][POSITIVE] Thank you so much for your time and your patience and you have a great day.
[AGENT][POSITIVE] You're welcome thank you for calling American Public Life, have a great day as well, [PII].
[CUSTOMER][NEUTRAL] Bye bye.