AccountId: 011433970860
ContactId: 223589bb-31c5-4f79-8c13-18835587369a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 499140 ms
Total Talk Time (AGENT): 199010 ms
Total Talk Time (CUSTOMER): 185212 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/223589bb-31c5-4f79-8c13-18835587369a_20250423T20:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is.
[AGENT][NEUTRAL] This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Wait, what was your name again? I, I missed it.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII]. Hello, [PII]. Uh, my name is [PII]. Um,
[AGENT][NEUTRAL] Yes, sir. Hi.
[CUSTOMER][NEUTRAL] Yeah, I, I called.
[CUSTOMER][NEGATIVE] Oh, I just got an email about a bill and I'm really, really confused about this bill.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright [PII] I can help you with your bill um and answer questions for you can I please get your call back number sir just in case the call is disconnected?
[CUSTOMER][NEUTRAL] It's not
[CUSTOMER][NEUTRAL] Yeah, this is my callback number.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your policy number?
[CUSTOMER][NEUTRAL] Uh, my policy number, I don't really know. Let me have to double check. Give me, give me a second to grab the information.
[AGENT][NEUTRAL] OK, if you don't know it, I can look it up with your social if you'd like to give that to me.
[CUSTOMER][NEUTRAL] Yeah, my social my social is um [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look up that policy for us real quick.
[AGENT][NEUTRAL] OK, [PII], uh,
[AGENT][NEUTRAL] Is it a dental bill you got or is it a medical bill that you received?
[CUSTOMER][NEUTRAL] Uh, so I was under the MEC plan.
[CUSTOMER][NEUTRAL] Um, so I was under the MEC plan until the end of February, and I, I, uh, as you can see, I went to a, I got a service.
[CUSTOMER][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I just got a bill for, I, I, I had to double check this information for influenza vaccines, and it is covered under the MEC plan. So,
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEGATIVE] I, I just wasn't sure why I got charged.
[AGENT][NEUTRAL] OK, alright, um, I'll be able to look at your claim. [PII], first, I'll need you to verify your policy for me. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Mhm. My date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then also your
[CUSTOMER][NEUTRAL] And I, uh, do you need any other information?
[AGENT][NEUTRAL] Yeah, your address, phone number, and
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII] and then my OK I was just trying to find this email. I need to put this a star. OK so uh and then my uh my number, my number is [PII].
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, and then your email address that we have on file for you, sir?
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. I appreciate you verifying that information. OK, and what date did you say that the date of services?
[AGENT][NEUTRAL] That you went?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So [PII], um, yeah.
[AGENT][NEUTRAL] OK, let me look real quick and see what claim came in after [PII].
[CUSTOMER][NEUTRAL] I get, oh, I give you the well, I think under the wrong policy number, that's why, um.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Claim, I can give you the claim number.
[AGENT][POSITIVE] Yes, if you can give that to me that'll pull it right up for me.
[CUSTOMER][NEUTRAL] Yeah, the claim number is um 3587452.
[AGENT][NEUTRAL] OK, I'm looking at it right here.
[AGENT][NEUTRAL] OK, so it is denying it because this policy does not provide benefits for vaccines and immunizations or the administration of the injections.
[CUSTOMER][NEUTRAL] Right. I mean, that's, but that's through the group hospital amenity policy. I mean, the uh policy, right? Um, I, I, I had the MEC. The MEC is a different policy number, right? I had the, the
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I mean, I, I don't have MEC right here.
[AGENT][NEUTRAL] What is that policy number?
[CUSTOMER][NEUTRAL] Let me see doesn't really have a policy number. It has, let me see, multiplan, um, do do do.
[CUSTOMER][NEUTRAL] It has the employee ID that's it, and the group number, the group policy 9490.
[AGENT][NEUTRAL] OK, so what I'm gonna need to do is it looks like I'm going to need to transfer you on over to multiply.
[AGENT][NEUTRAL] I am so that you can talk to them about your benefits.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Does it say anything about IMA or 90 degree benefits?
[CUSTOMER][NEUTRAL] No, it's it's a multi-plan.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Multipla
[CUSTOMER][NEUTRAL] Uh, but it goes through APL, right? And it goes through American public life.
[CUSTOMER][NEUTRAL] Everything, everything that like goes back to American public life.
[AGENT][NEUTRAL] Yeah, all the claims come through.
[AGENT][NEUTRAL] Through us, but if you have a different policy number, then that means that you would have a different policy and
[CUSTOMER][NEGATIVE] they didn't even give us a policy number. They just give us a group ID and employee ID for the for the MEC plan, um.
[AGENT][NEUTRAL] This
[AGENT][NEUTRAL] OK, what is the employee ID number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The employee ID number is D4.
[CUSTOMER][NEUTRAL] 90,000.
[CUSTOMER][NEUTRAL] 90.
[AGENT][NEUTRAL] OK, so that will be IMA and let me give you that number real quick so that I can transfer you on over but if we get disconnected you'll be able to call them.
[CUSTOMER][NEUTRAL] Right, and so what is the IMA before you, before you transfer me?
[AGENT][NEUTRAL] Uh, it's 90 degree benefits IMA.
[AGENT][NEUTRAL] And then um.
[CUSTOMER][NEUTRAL] OK, 90 degree benefit, uh.
[CUSTOMER][NEUTRAL] Do you not do the claims for those or does someone else do the claim for those?
[AGENT][NEUTRAL] Yes, with that day with that.
[AGENT][NEUTRAL] Well, they do, they do claims also, so that's why I need to transfer you to them too because that number that you gave me that started with a D that told me that it was IMA.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Um, let me give you that number real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's 1-800.
[AGENT][NEUTRAL] 83
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 33
[AGENT][NEUTRAL] 4296.
[CUSTOMER][NEUTRAL] 833
[AGENT][NEUTRAL] Yes, 833-4296 and once you get through, you'll click option one and that'll get you to the benefits department.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But I'm gonna go ahead and transfer you on over now and then if you get disconnected you have the number now just in case you need to call back.
[CUSTOMER][POSITIVE] Perfect. Thank you so much, [PII], it's been a pleasure. Thank you so much for explaining the whole process.
[AGENT][POSITIVE] You're very welcome, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. And we thank you for calling APO.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] It's just, it's just, it's just not a small bill. So, of course, of course. Thank you.
[AGENT][NEUTRAL] Oh, OK, yeah.
[AGENT][POSITIVE] Alright, well you take care. It's gonna be a brief hold and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you for calling 90 Degree Benefits. If you would like.