AccountId: 011433970860
ContactId: 16c356a5-e3ae-4d5d-ac78-337fb19471e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417380 ms
Total Talk Time (AGENT): 120049 ms
Total Talk Time (CUSTOMER): 145651 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/16c356a5-e3ae-4d5d-ac78-337fb19471e5_20250421T18:59_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling on behalf of provider's office to check on the status of a claim. Can you help me out?
[AGENT][NEUTRAL] OK, [PII], you have one claim to check status on?
[CUSTOMER][NEUTRAL] Uh, even if it is, uh, I mean, I have, I have two claims but on the same member on a different date of service. Is it possible?
[AGENT][NEUTRAL] Is it correct?
[AGENT][NEUTRAL] OK, yes, you had just said a claim, so you have 1 member for 2 days of service?
[CUSTOMER][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] Two claims, yes, I can help you with that [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] So that is one.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes. Uh, the policy number is 02365911.
[AGENT][NEUTRAL] Thank you one moment while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and I'll send you the information that's provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So on this particular policy there is another company that you will need to speak with [PII].
[AGENT][NEUTRAL] Regarding claim status and that company is called Web TPA.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Their phone number is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And I will be happy to connect you with him if you would like.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, well, is there anything else I could help you with today?
[CUSTOMER][POSITIVE] I know, great. Thank you, [PII].
[AGENT][POSITIVE] OK. OK. Well, you're welcome and thank you for calling APL. I hope you have a nice day today, [PII].
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Uh-huh thank you bye bye. One moment.
[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] 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][POSITIVE] Thank you for calling customer service. My name is [PII]. May I please have the member ID?
[AGENT][NEUTRAL] Hi, did you say this is [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Hi, [PII], this is [PII] with APL. How are you today?
[CUSTOMER][POSITIVE] I'm doing well, ma'am. How about yourself?
[AGENT][NEUTRAL] I'm doing fine, thank you. So I have a gentleman on the line who's needing to check claim status.
[CUSTOMER][NEUTRAL] OK, um, let's see.
[AGENT][NEUTRAL] Uh, the gentleman's name is [PII], and he's calling on policy 02365911 for [PII].
[CUSTOMER][NEUTRAL] OK, hold on one second.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]. Do you have his date of birth?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. I'm so sorry.
[AGENT][POSITIVE] That's right.
[CUSTOMER][POSITIVE] OK, and may I have your name one more time, please? I do apologize.
[AGENT][NEUTRAL] This is [PII] and the gentleman on my line to check status.
[AGENT][NEUTRAL] It's going to be [PII].
[CUSTOMER][NEUTRAL] Just a moment, sorry, my system is being a little slow, Ms. [PII]. I do apologize.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No worries.
[CUSTOMER][POSITIVE] Alright, awesome and
[CUSTOMER][NEUTRAL] Check status for claim or check status as far as like benefits.
[AGENT][NEUTRAL] He said claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, if you want to pass it on over to me, I can take it from here.
[AGENT][POSITIVE] Perfect. Well, thank you so much, [PII]. Have a nice afternoon.
[CUSTOMER][POSITIVE] You do the same, ma'am. Thank you.
[AGENT][POSITIVE] Uh, thank you too. So here comes [PII].
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye.