AccountId: 011433970860
ContactId: 1f69059d-2ca0-4cc8-8438-9796de365d4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423059 ms
Total Talk Time (AGENT): 198403 ms
Total Talk Time (CUSTOMER): 124834 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/1f69059d-2ca0-4cc8-8438-9796de365d4e_20250401T12:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII]. I'm calling from Atrium Navison Medical Center.
[CUSTOMER][NEUTRAL] And I'm trying to see if a claim had been received that we had sent in.
[AGENT][NEUTRAL] OK [PII], so you're wanting to verify if a claim was received for a member, is that correct? that you all submitted? Yes ma'am, I can certainly help you with that. And [PII], what is a good call back number for you please?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII] and that's my direct line.
[AGENT][NEUTRAL] OK, and [PII], you're, we have, we don't have a great connection. So what was your area code again? I'm sorry, I didn't catch all of that. I heard [PII].
[CUSTOMER][NEUTRAL] Oh, your son [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Let's see, that is D as in David, 47630917.
[AGENT][NEUTRAL] OK, thank you. Now, [PII], that is not an APL policy number. That is a 90 degree benefit or IMA number. Some of these members also have policies with APL. Do you know, were you trying to reach 90 degree benefits or did, do you know if they have a policy with APL?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I am not sure, um.
[CUSTOMER][NEUTRAL] Cause I went on 90 degrees.
[CUSTOMER][NEGATIVE] Portal and it said that was not found.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Then
[CUSTOMER][NEUTRAL] I was trying to find a copy of her card.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And we did not have one.
[AGENT][NEUTRAL] OK. So, do you happen to have the subscribers full social?
[CUSTOMER][NEUTRAL] We don't, I can't see all of it.
[AGENT][NEUTRAL] Um, OK. I can try by the name. I cannot search my date of birth, [PII], so if it's a real common name.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You know, I don't know if I can locate, but we will certainly try. What is the last name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the first name?
[CUSTOMER][NEUTRAL] [PII] and it's [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so just a moment please.
[AGENT][NEUTRAL] OK, I may have located a policy for her, so just one moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and then the information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is her date of birth, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And the date of service and total bill amount?
[CUSTOMER][NEUTRAL] Let me see here, hold on one second. Let me get back to that screen.
[AGENT][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] All right. Let's see here. That was for [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] $753.
[AGENT][POSITIVE] Alright thank you
[AGENT][NEUTRAL] OK, so here at APL we do not have a claim on file for 2-18-2025. Now her policy number for APL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is 02.
[AGENT][NEUTRAL] 23
[AGENT][NEUTRAL] 9995.
[AGENT][NEUTRAL] And this policy is active and the effective date on it is [PII].
[CUSTOMER][NEUTRAL] All right. Well, let me do some work and see if I can.
[CUSTOMER][NEUTRAL] Go back through and see if maybe they have scanned the card in on one of her other visits and see where exactly she is through.
[AGENT][NEUTRAL] OK. And then,
[AGENT][NEUTRAL] Yes, ma'am. Now, if some of these members have dual policies with APL and 90-degree benefits. Now, the phone number for IMA or 90 Degrees is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And option one.
[CUSTOMER][NEUTRAL] All right. I will try that after I do a little bit more research and see if I can.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] trying to make sure this is where she actually has it.
[AGENT][NEUTRAL] OK, well, now, um, and one last thing, should you end up filing a claim with us for her, [PII], once the claim has been processed, we do have a portal in which you should be able to check our claim status also and you can go to [PII] for that and if for any reason you're not able to pull it up then you can also call us obviously.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Well, thank you, [PII], and you have a great day.
[AGENT][POSITIVE] Well you, well, I hope you do too. Is there anything else there, [PII], I could help you with this morning?
[CUSTOMER][NEUTRAL] No, I think that's it.
[AGENT][POSITIVE] OK, well then, thank you again.
[CUSTOMER][POSITIVE] You've helped a lot, so that way, hopefully.
[AGENT][POSITIVE] Well, I'm glad that I could help this morning. So if that's all I can help you with right now anyway, thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Yes ma'am, thank you.