AccountId: 011433970860
ContactId: 093d111d-71cc-4f43-875e-5e811e317d37
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 484970 ms
Total Talk Time (AGENT): 84873 ms
Total Talk Time (CUSTOMER): 212920 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/093d111d-71cc-4f43-875e-5e811e317d37_20250317T16:36_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, so I have a question for you.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I'm, I'm uh I received a um collections bill from my
[CUSTOMER][NEUTRAL] Doctor
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'm trying to figure out where this bill is stemming from because I have quote unquote hopefully insurance.
[CUSTOMER][NEUTRAL] With you guys, and I'm trying to figure out.
[CUSTOMER][NEGATIVE] Why am I being charged this, I mean, why am I, a bill that's been collection I have no clue about.
[CUSTOMER][NEUTRAL] Um, what information would you need?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I can check and see if we received that claim. Um, let me have um your name and a callback number.
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Do you have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, my policy number is.
[CUSTOMER][NEUTRAL] Uh looks like 02.
[CUSTOMER][NEUTRAL] 365906
[AGENT][NEUTRAL] OK, for security, may I have your date of birth and mailing address?
[CUSTOMER][NEUTRAL] Date of birth is [PII]. Mailing address is [PII].
[AGENT][NEUTRAL] OK. And the claim was medical claim?
[CUSTOMER][NEUTRAL] Yes, uh, my doctor sent me, they sent a bill.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To collection and I don't even know what it's built. I mean, where it's coming, it's showing something. I, I, I don't know. So I'm just trying to figure out if.
[AGENT][NEUTRAL] OK. What
[AGENT][NEUTRAL] No, that's fine, thank you. Um, what is the date of service for that bill?
[CUSTOMER][NEUTRAL] Uh, looks like the data service was on.
[CUSTOMER][NEUTRAL] Uh, let's pop, let's say.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And there's another one they're showing for [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII] and [PII]. OK, let me get um web TPA on the line. They're the ones that handles the claim. I'm just gonna go ahead and give them this information to see if they can find these claims for you, OK? One moment.
[CUSTOMER][NEUTRAL] Mm, OK.
[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 1. For information and phone numbers for the Beach Street PPO network, please press 2.
[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 3 now or simply stay on the line and someone will assist you. Thank you.
[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.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] So
[CUSTOMER][POSITIVE] Thank you for calling customer service this is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi [PII], this is so with APL. I'm trying to transfer a member that he's looking for a claim status.
[CUSTOMER][NEUTRAL] Sure, what's in writing.
[AGENT][NEUTRAL] Uh, I have the policy number. I'm not sure if it's the same as the policy ID, but it's uh 02365906.
[CUSTOMER][NEUTRAL] Patient's name, date of birth?
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][POSITIVE] Thank you, you go ahead and pass him through.
[AGENT][NEUTRAL] OK, let me give you the dates because he already gave them to me. The date of service he's looking for is [PII] and [PII].
[CUSTOMER][NEUTRAL] Don't have a [PII], but you can pass them through.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Thank you for holding and being patient for you, Mr. [PII]. I got a representative on the line that can assist you with the claims, OK?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, hello, sir, my name is [PII] with customer service. Can I just get you to verify your name and date of birth?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Date of birth is [PII].
[CUSTOMER][POSITIVE] A good call back number sir.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And she said you're calling on two claims. What's the first claim?
[CUSTOMER][NEUTRAL] Uh, uh, uh, let me see here.
[CUSTOMER][NEUTRAL] What I mean what as possible as you need like a number or anything or?
[CUSTOMER][NEUTRAL] Data service, sir.
[CUSTOMER][NEUTRAL] Uh, date of service was on [PII].
[CUSTOMER][NEUTRAL] Doctor? But
[CUSTOMER][NEUTRAL] Uh, doctor, uh, [PII].
[CUSTOMER][NEUTRAL] Of esi help
[CUSTOMER][NEUTRAL] But there's also another one that was rendered on [PII] also. [PII], OK, so for the first one.
[CUSTOMER][NEUTRAL] Oh.