AccountId: 011433970860
ContactId: 1ee7aed8-2798-4697-90cf-0530bb2ca769
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425510 ms
Total Talk Time (AGENT): 156193 ms
Total Talk Time (CUSTOMER): 151382 ms
Interruptions: 4
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/1ee7aed8-2798-4697-90cf-0530bb2ca769_20250219T19:15_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Hi, this is [PII] from Pa's office. Mm, I'm looking for the clinic.
[AGENT][NEUTRAL] I'm sorry. I'm having trouble hearing you.
[CUSTOMER][NEGATIVE] too much.
[CUSTOMER][NEUTRAL] So I'm audible. I'm audible now.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, sir, but uh there's something in the background that I'm hearing that's louder than your voice, so it's making it difficult for me to understand you.
[CUSTOMER][NEUTRAL] Well we're not gonna take
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Is it OK now?
[AGENT][POSITIVE] That is slightly better. And [PII], how can I help you today?
[CUSTOMER][NEUTRAL] I'm looking for the claim status.
[AGENT][NEUTRAL] OK, you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that and what is your callback number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, I'm sorry, I'm not able to understand you. You'll have to start over.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, what are the last four numbers?
[CUSTOMER][NEUTRAL] You're asking for the callback number, right?
[AGENT][NEUTRAL] I'm asking for the last 4 numbers of your phone number.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and how many claims [PII], do you have to check status on?
[CUSTOMER][NEUTRAL] I have, I have one.
[AGENT][POSITIVE] OK, yes, I can help.
[CUSTOMER][NEUTRAL] Actually, that is uh
[CUSTOMER][NEUTRAL] I had to file a claim to Cigna. Cigna denied for the primary EOB. We had another name there.
[CUSTOMER][NEUTRAL] American Life Insurance Company, so we need to verify that it's your family account.
[AGENT][NEUTRAL] OK, [PII], [PII], OK.
[AGENT][NEUTRAL] [PII], your voice has an echo in it. I, I cannot hardly understand what you are saying.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, please check the payment status.
[AGENT][NEUTRAL] OK, you have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is your, yes, I can help you with that. What is the patient's policy number?
[CUSTOMER][NEUTRAL] 02521473 M as in Mary, L as in Lima, 8.
[AGENT][POSITIVE] Thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, in the name.
[AGENT][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Sorry, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Last name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh thank you, and again, any information that is provided will be a verification of benefits and not a guarantee of payment. What is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] Total charge $680.
[AGENT][NEUTRAL] 680, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And again you said it was for [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we do not have a claim on file for this member for that data service and build out.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And this policy was not active for that data service.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][POSITIVE] This policy had an effective date.
[CUSTOMER][NEGATIVE] And the plan was not activated the problems.
[AGENT][POSITIVE] Uh, that is correct.
[AGENT][NEUTRAL] This policy was active as of [PII] and it turned on [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh, with the term date of [PII]. I'm sorry, the term date is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], it's uh [PII], right?
[AGENT][NEUTRAL] Yes, sir. The member did not have a policy active with our company for your date of service.
[CUSTOMER][NEUTRAL] You are the American Life Insurance Company?
[AGENT][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] You are American Public Life Insurance Company?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] This was a supplemental policy to his primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does every member have a Medicare active.
[CUSTOMER][NEUTRAL] [PII]. Uh, may I have your name?
[AGENT][NEUTRAL] Again, my name is [PII] and you would use my name along with today's date as your call reference number [PII] if you need a reference number.
[AGENT][NEUTRAL] And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] OK, well then thank you again for calling APL uh-huh.
[CUSTOMER][NEUTRAL] W.
[CUSTOMER][NEUTRAL] COVID 19 of 25.
[AGENT][POSITIVE] And I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] Thank you. Have a nice afternoon too.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.