AccountId: 011433970860
ContactId: fc6dd5bc-c83e-4270-997d-b3ca794121b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452570 ms
Total Talk Time (AGENT): 86968 ms
Total Talk Time (CUSTOMER): 163061 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/fc6dd5bc-c83e-4270-997d-b3ca794121b8_20250423T20:30_UTC.wav
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[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, uh, yes, your voice is really low. Can you just, uh, turn up your voice or adjust your mic, please?
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Yes, this is as loud as it goes.
[CUSTOMER][POSITIVE] Yes, yes, it is better now.
[AGENT][NEUTRAL] OK, how can I help you?
[CUSTOMER][NEUTRAL] Uh, so I'm calling from provider's office to check on a claim status.
[AGENT][NEUTRAL] OK, can I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] last name [PII].
[AGENT][NEUTRAL] OK. And a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], and you, do you have the policy number of the patient?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So the policy number is 01.
[CUSTOMER][NEUTRAL] 89
[CUSTOMER][NEUTRAL] 28
[CUSTOMER][NEUTRAL] 40
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima. 8.
[AGENT][NEUTRAL] And the patient name and date of birth?
[CUSTOMER][NEUTRAL] So the patient's name is [PII]. It is [PII] [PII], and the last name is [PII].
[AGENT][NEUTRAL] OK. And the date of birth?
[CUSTOMER][NEUTRAL] And the date of birth is [PII], [PII].
[AGENT][NEUTRAL] OK and the date of service and build them out.
[CUSTOMER][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] And the billing amount is $372.
[AGENT][NEUTRAL] OK, thank you. Um, let me check that. One moment.
[AGENT][NEUTRAL] OK, looks like we received the claim on [PII].
[AGENT][NEUTRAL] The claim was processed [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Uh, we need a copy of the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, yes, we need the explanation of that.
[CUSTOMER][NEUTRAL] And uh what is the status of the claim like it is denied or paid?
[AGENT][NEGATIVE] It's denied, we need the primary explanation of benefits.
[CUSTOMER][NEUTRAL] Uh, which means
[AGENT][NEUTRAL] We need the explanation of benefits from their primary insurance carrier.
[CUSTOMER][NEUTRAL] Oh, primary. You are the primary insurance carrier.
[AGENT][NEUTRAL] No, we're not. We're secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, can I just please uh stay on the line for, for a couple of minutes?
[AGENT][NEUTRAL] Do you need to know who the primary insurance is?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] United Healthcare.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We are not United Healthcare. We are American Public Life.
[CUSTOMER][NEUTRAL] Yes, yes, but here it is showing that just a second, let me just cross check if this was rejected by UnitedHealth or not.
[CUSTOMER][NEUTRAL] Oh, yeah, OK. Just, yeah, just give me a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, hello. Thank you for your patience. Uh, so, yeah, we, uh, we need the denied EOB from your side so that we can, uh, share the
[CUSTOMER][NEUTRAL] Primary UB.
[AGENT][NEUTRAL] OK. What do you need me to fax the EOB or what are you needing?
[CUSTOMER][NEUTRAL] Yes, yes, we need you to fax the EOB.
[AGENT][NEUTRAL] Your fax number?
[CUSTOMER][NEUTRAL] It's 248.
[CUSTOMER][NEUTRAL] 233
[CUSTOMER][NEUTRAL] 2452.
[CUSTOMER][NEUTRAL] And what should I, uh, take up the denial reason in my system?
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] I was denied because you did not provide a primary explanation of benefits.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Is there anything else I can?
[CUSTOMER][NEUTRAL] And may I have your good name, please?
[AGENT][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] First initial to last name, [PII]?
[AGENT][NEUTRAL] Then my name with today's date is the reference number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], and today's date.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so yeah.
[CUSTOMER][POSITIVE] Thank you. Thank you for the assistance, [PII].
[CUSTOMER][POSITIVE] You have a great day.
[AGENT][POSITIVE] OK, thank you for calling APL you as well. Bye bye.