AccountId: 011433970860
ContactId: 0b75443e-7085-4244-a7a8-52ab51a7dc4a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1001169 ms
Total Talk Time (AGENT): 213383 ms
Total Talk Time (CUSTOMER): 393305 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/0b75443e-7085-4244-a7a8-52ab51a7dc4a_20250303T14:14_UTC.wav
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[AGENT][NEUTRAL] I assist you?
[CUSTOMER][NEUTRAL] Hi, um, I'm a provider and I sent in a, um, for a claim form, you know, verifying that the primary, um, insurance, uh, paid off and then you were gonna, um, you know, look at the secondary so I just wanted to check the status of it.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And, what is that policy number of the member that you're checking the claim status for?
[CUSTOMER][NEUTRAL] OK, it starts with a D, right? That's the thing it's D43.
[AGENT][NEUTRAL] Um, no, sir.
[AGENT][NEUTRAL] That's not a policy number here at American Public Life. Do you have the member's social or their full name?
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] OK, well I have the card and that's what it says um uh.
[AGENT][NEUTRAL] No, that's not a policy number here, unfortunately. That's a third party administrator card.
[CUSTOMER][NEUTRAL] Oh, OK, so you want what do you need then what do you need? Yeah.
[AGENT][NEUTRAL] What is the patient's last name?
[CUSTOMER][NEUTRAL] Yeah, uh [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] Address [PII]
[AGENT][NEUTRAL] OK, I'm not finding that name in the system, so give it to me one more time, the last name, [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the first name again, you said it was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What city and state does this member live in?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, let's see, um.
[CUSTOMER][NEUTRAL] He lives in um
[CUSTOMER][NEUTRAL] Yeah, OK, [PII].
[AGENT][NEUTRAL] Thank you. And this is for medical or dental area?
[CUSTOMER][NEUTRAL] Medical, yeah.
[AGENT][NEUTRAL] And what is this member's date of birth?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you're calling about a claim for what date of service?
[CUSTOMER][NEUTRAL] Um, the service was.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Of 25.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So I'm not showing a claim on file. Could you verify where you submitted that claim to?
[CUSTOMER][NEUTRAL] Um, I submitted it to, um, what the, the, the, the address on the card.
[CUSTOMER][NEUTRAL] So the address on the card was um.
[CUSTOMER][NEUTRAL] See, uh.
[AGENT][NEUTRAL] In [PII]?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK, so looks like we haven't received it yet, which you did send it to the correct place. However, once they're done reviewing their claim to see if it's anything that they're gonna pay, they're gonna send it here to us, but we haven't received it yet.
[AGENT][NEUTRAL] However, if you would like to submit the claim here to us, I can give you the fax number, but we haven't received it from IMA yet. You may wanna call IMA to check on the claim status.
[CUSTOMER][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] Oh OK how do you how do you do that?
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] So let me give you the policy number for here when you call here and check on the status of a claim.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let me know when you're ready for it.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It's 2584564. It's 2584564.
[CUSTOMER][NEUTRAL] OK, because that's it's listed on the card as the policy certificate number, but that's really.
[AGENT][NEUTRAL] Right, so when you.
[AGENT][NEUTRAL] No, it's the policy number for IMA, but it's not the policy number here at American Public Life. It has two separate policies, policy numbers because it's very confusing cause it's a third party administrator.
[AGENT][NEUTRAL] So but you call IMA you give them the number that's on the card.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Alright, so 02584564 and that's for you guys.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that's that's for what.
[AGENT][NEUTRAL] 2584564. That is for American Public Life.
[CUSTOMER][NEUTRAL] Right, well that
[CUSTOMER][NEUTRAL] OK, that's APL. What do you call that? Just the num the number, the number you use, right? OK, alright.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is a policy number, the policy number.
[CUSTOMER][NEUTRAL] Alright, but I mean I was told, but then I noticed you have a different payer ID than they do than IMA.
[AGENT][NEUTRAL] Right, because it's two separate companies.
[CUSTOMER][NEUTRAL] So but I'm supposed to submit the claim to IMA right?
[AGENT][NEUTRAL] Yes, you submitted to IMA and then IMA was submitted here to American Public Life once they're done with it.
[CUSTOMER][NEUTRAL] Alright, so it goes first to IMA and then it goes to you guys.
[AGENT][NEUTRAL] Right, that's correct. So when you call here to check the status of the claim, you provide that policy number that I provided you with so that you don't have to give all the patients information to look them up in the system, just give them their policy number.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] 11 calling APL, I use the 02584564, right.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] I know it's confusing, but I just don't want it to be complicated for you. So let me know when you're ready to.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Alright, so what's the number? So IMA is what?
[AGENT][NEUTRAL] It's IMA is the, the primary.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So the number is, let me know when you're ready.
[CUSTOMER][NEUTRAL] So what's their phone?
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. That's [PII]. Would you like for me to transfer you, [PII]?
[CUSTOMER][NEUTRAL] Alright, and that's where, um, and that's nowhere on the card that I have, so I guess it's um that's odd that they put the address.
[AGENT][NEUTRAL] But not the number.
[CUSTOMER][NEUTRAL] But they don't put the
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, they should, they should put the number, right? Yeah, that would be.
[AGENT][NEUTRAL] They should, but
[AGENT][NEGATIVE] They make it complicated, very complicated.
[CUSTOMER][NEUTRAL] Uh, so that's IMA, which is what stands for what.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have no idea.
[CUSTOMER][NEUTRAL] Oh, that's the name of the company. I am a OK, you know, it's not an acronym for something, yeah. Oh, OK. So, so first goes to, so I was right to send it to IMA.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Right, and then it's uh, yeah, yeah, and then it goes to um APL and then you guys are the one who cuts the is that correct?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, yeah, OK, so you're gonna trans so when I call them what number should I use?
[AGENT][NEUTRAL] The one that the D number to start with the D, the number that's listed on the card.
[CUSTOMER][NEUTRAL] Oh, the.
[CUSTOMER][NEUTRAL] Although the the number for the for them but the other number for you, yeah, yeah, OK.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] Uh, alright, thanks a lot you'll transfer me, right?
[AGENT][POSITIVE] You're welcome. Yes, I'm about to transfer you now. Is there anything else, anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Oh that's good thank you yeah.
[AGENT][POSITIVE] You're welcome, thanks for calling APL and hold one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Scenario.
[CUSTOMER][NEUTRAL] Calling IMA, a 90 Degree Benefits Company, the administrator for benefits.
[AGENT][NEUTRAL] I need to do something.
[AGENT][NEUTRAL] Oh, hello.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hold one moment.
[CUSTOMER][NEUTRAL] For questions on the APL hospital indemnity plans or dental coverage, please press [PII]. Yeah. For questions on the vision plan, please press [PII].
[AGENT][NEUTRAL] OK. [PII] are you there?
[CUSTOMER][NEUTRAL] If you are an employee and you have questions on your active enrollment, please.
[CUSTOMER][NEUTRAL] Thank you for calling APL. Your call may be monitored for quality assurance. Para espanol.
[AGENT][NEUTRAL] OK, I'm gonna end the call on my end. Oh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I'm all set then, huh? Yeah.
[AGENT][NEUTRAL] I'm calling me. Hold on, I'm calling myself APL. Hold one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling IMA, a 90 Degree benefits company, the administrator for benefits in a card members.
[CUSTOMER][NEUTRAL] Our office hours are [PII] Monday through Thursday and [PII] on Fridays. If you've reached this message, our offices are currently closed.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits. The all agents are currently assisting other callers.
[CUSTOMER][NEUTRAL] Please remain on the line and your call will be answered by the next agent.
[CUSTOMER][POSITIVE] We appreciate your call.
[CUSTOMER][POSITIVE] We appreciate your patience.
[CUSTOMER][POSITIVE] Please remain on the line, and we will be with you shortly.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][NEUTRAL] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly. Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We appreciate your patience. Please remain on the line, and we will be with you shortly.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][NEUTRAL] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly. Press 1 to leave a voicemail.
[CUSTOMER][POSITIVE] We apologize for the longer than expected wait time.
[CUSTOMER][NEUTRAL] Your call is important to us.
[CUSTOMER][POSITIVE] If you prefer, you can leave a detailed voicemail message, and we will get back to you promptly.
[CUSTOMER][NEUTRAL] Press 1 to leave a voicemail.
[CUSTOMER][NEGATIVE] You are on hold.