AccountId: 011433970860
ContactId: f9abed62-3738-482a-b4b2-454de594196c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 572229 ms
Total Talk Time (AGENT): 242402 ms
Total Talk Time (CUSTOMER): 171375 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/f9abed62-3738-482a-b4b2-454de594196c_20250116T21:15_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling from South Florida Pediatric surgeons. Calling to follow up on the status of some claims I faxed over for one of my physicians and his family members.
[AGENT][NEUTRAL] OK, I can take a look at it. Um, [PII], what is a good callback number for you?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure, [PII]. Welcome.
[AGENT][NEUTRAL] Thank you and what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Sure it's gonna be 01842154.
[AGENT][NEUTRAL] The patient's name and date of birth.
[CUSTOMER][NEUTRAL] Uh, so there was 3, it's the same physician's, uh, policy number, but it was his a claim for him, some claims for his wife and some claims for his daughter. Um, his name is Doctor [PII].
[AGENT][NEUTRAL] OK, let's start with.
[AGENT][NEUTRAL] OK, and his date of birth?
[CUSTOMER][NEUTRAL] His date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, I won't be able to give much information, uh, without third party authorization, but.
[CUSTOMER][NEUTRAL] He's here in the office. Can he give you authorization to speak to me?
[AGENT][POSITIVE] OK. He can, yes.
[CUSTOMER][NEUTRAL] Alright, let me have him pick up one second, give you authorization. One moment.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Your call is important to us we'll be right with you.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hi, Mr. [PII].
[CUSTOMER][NEUTRAL] It's [PII], yeah.
[AGENT][POSITIVE] Hi, this is [PII] with American Public Life. I just wanted to make sure it is, I'm good. How are you today?
[CUSTOMER][NEUTRAL] How are you?
[CUSTOMER][POSITIVE] Uh huh, fine, thank you.
[AGENT][NEUTRAL] I want to make sure it's OK uh to speak with [PII] regarding your uh claims for your family. OK, I will note that in the uh file, so anytime she calls, there won't be an issue.
[CUSTOMER][POSITIVE] Always OK, yes.
[CUSTOMER][POSITIVE] Yes, it's OK.
[CUSTOMER][POSITIVE] Appreciate it thank you very much.
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] So, yeah. Alright, I'm back.
[AGENT][POSITIVE] OK, thank you. Let me note the account really quick that way any time you call.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, if anyone says anything, just let them know it, uh, it shows in the notes. Let's see 3.
[CUSTOMER][POSITIVE] Beautiful.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Party
[AGENT][NEUTRAL] And [PII], could I get a last name for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's go back and we're gonna start with him. What is the data service in question for him?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh, the claim I sent for him, I think I only sent one for him, um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm, I don't show [PII]. I do show a [PII].
[CUSTOMER][NEUTRAL] Yeah, no, [PII]
[CUSTOMER][NEUTRAL] You're looking for under Doc because I sent 3 different people under him. This is the one for him directly, right?
[AGENT][NEUTRAL] Yes, this is just for him, let me.
[CUSTOMER][NEUTRAL] For Doctor [PII], yeah, it says it says date of visit at the top of the EOB that I faxed [PII].
[AGENT][NEUTRAL] OK, let me pull up the image.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I think I.
[AGENT][NEUTRAL] [PII] I do see that.
[AGENT][NEUTRAL] OK, I do see um the [PII]. It looks like in.
[AGENT][NEUTRAL] A mistake was made on this particular charge, um, because I do show for [PII], um, there is, let's see, some patient responsibility under copay.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And on the other procedure.
[AGENT][NEUTRAL] Looks like
[AGENT][NEUTRAL] $10.44. So I will have this one sent back. Uh, I do show patient responsibility here on this.
[AGENT][NEUTRAL] That needs to be taken care of. OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] I appreciate you checking on that.
[AGENT][NEUTRAL] No problem. Let me look here.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] So we get back to it. If not, don't worry about it. OK, thank you so much.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And uh we can move to the next um.
[CUSTOMER][NEUTRAL] Yeah, got you. Um, her date of birth is [PII].
[AGENT][NEUTRAL] Uh, member in the family.
[AGENT][NEUTRAL] OK, and this
[CUSTOMER][NEGATIVE] And there's actually several claims I sent for her, but he didn't get anything back on any of hers yet.
[AGENT][NEUTRAL] OK, let's take a look.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, I do see some charges for her.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, it looks like payment was made, um.
[AGENT][NEUTRAL] On, let's see, we have [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh, let's see what else, and yeah, those are the 3 days. It looks like a payment of $650 was made to the insured.
[CUSTOMER][NEUTRAL] When did that go out because he has not received that yet.
[AGENT][NEUTRAL] OK, that one went out on, no, [PII], so a month ago. Let me check something here.
[CUSTOMER][NEUTRAL] Maybe it just went.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] 201
[AGENT][NEUTRAL] OK, so it does look like the check has not cleared um if we can.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] verify, uh, he would have to verify his mailing address if he doesn't mind getting on and verifying the mailing address.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure, sure, give me one second, let me walk back in his office. Hold on.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] Your call is important to us we'll be right with you.
[CUSTOMER][POSITIVE] We realize your time is valuable. We'll be with you momentarily.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, Doctor [PII]. I would like, uh, I'm good. Do you mind uh verifying your mailing address to make sure we have it correct?
[CUSTOMER][NEUTRAL] Hey how are you?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 4 well I got the other check so I'm sure you do, but [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. OK. Just making sure and then what I'll, yeah, I'll get that one reissued, voided and reissued for you. OK, thank you.
[CUSTOMER][NEUTRAL] So I don't know what happened to the other check.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alright, thank you very much have a great day. Do you need [PII] back or that's it? OK, thank you.
[AGENT][NEUTRAL] You too.
[AGENT][NEUTRAL] Uh, I believe she may have more to go over.
[CUSTOMER][NEUTRAL] No, I think she said she's done. She, she's standing with me. She said she's done.
[AGENT][NEUTRAL] OK. So, um, that, uh, the check that needs to be reprocessed, if you would allow 24 to 48 hours, uh, it will be sent out.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] Yeah yeah no problem I just wanted to make sure because I was when I was checking online, yeah, thanks a lot.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Oh, OK. You're welcome. You have a wonderful day. Thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] You too bye bye.