AccountId: 011433970860
ContactId: 083361da-e456-4591-9034-19657dea0724
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394739 ms
Total Talk Time (AGENT): 75011 ms
Total Talk Time (CUSTOMER): 133550 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/083361da-e456-4591-9034-19657dea0724_20250213T21:43_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] How do you spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Awesome thank you my name is [PII] and I'm calling from SDMI. I'm trying to get the status of a claim for one of your members.
[AGENT][NEUTRAL] Sure, I can assist you with claim status, Ms. [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02501329
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] for $440.
[AGENT][NEUTRAL] OK, thank you. Let me see if I can find this claim.
[AGENT][NEUTRAL] And Miss [PII], I just need to let you know that for future you can check status online through our website, um.
[AGENT][NEGATIVE] Bear with me just a second, Ms. [PII]. It looks like this one is not with us.
[AGENT][NEUTRAL] This is for medical, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEGATIVE] Yeah, this one is not with us. This is with TPA.
[AGENT][NEUTRAL] Um, let me get with TPA on the line, OK? um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The number to web TPA just in case for future is 1-8669759458. Again, that's 1-8669759458. Let me go ahead and get them on the line for us. Is there anything else I may help you with today before I transfer you?
[CUSTOMER][POSITIVE] That's it thank you.
[AGENT][NEUTRAL] You're welcome, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Web TPA, the administrator for the limited benefit health insurance program underwritten by American Public Life Insurance Company. If this is an emergency, please hang up and dial [PII].
[CUSTOMER][NEUTRAL] If you are a member calling about your premium billing or need to make changes to your account such as an address change, add or drop a dependent, or wish to modify your coverage in any way, please call American Public Life at [PII]. If you are a physician or hospital calling to verify medical eligibility, please press [PII]. For information and phone numbers for the Beach Street PPO network, please press [PII].
[CUSTOMER][NEUTRAL] For questions concerning pharmacy services, you may contact Caremark at [PII]. To speak to a customer service representative regarding any other issues, please press [PII] now or simply stay on the line and someone will assist you. Thank you.
[CUSTOMER][NEUTRAL] Due to severe winter weather, you may experience longer wait times. If this is not an urgent matter, please call back at a later date. Thank you for your patience.
[CUSTOMER][NEUTRAL] Please note, your call may be monitored or recorded for quality assurance. The information provided during this call is only a description of benefits and is not a guarantee of payment. Benefits are based upon eligibility at the time services are rendered and all plan provisions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] no
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you for calling customer service. This is [PII].