AccountId: 011433970860
ContactId: 243b7508-a72d-47d4-9b25-55ae1bd4f08b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243860 ms
Total Talk Time (AGENT): 130491 ms
Total Talk Time (CUSTOMER): 80644 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/243b7508-a72d-47d4-9b25-55ae1bd4f08b_20250416T19:36_UTC.wav
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[AGENT][NEUTRAL] Contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm with Western Arkansas anesthesia Staffing, and I was looking to have a claim looked at.
[AGENT][POSITIVE] OK, I can certainly help. What is that policy number, please?
[CUSTOMER][NEUTRAL] It is 02497254.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and then date of birth [PII].
[AGENT][POSITIVE] I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and it is my direct line.
[AGENT][NEUTRAL] Thank you. What data service are we looking for for [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] $450.
[AGENT][NEUTRAL] OK, just checking here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this is a hospital indemnity policy and what it does is it pays very specific um.
[AGENT][NEUTRAL] Benefits. So in this case, it will only pay anesthesia if we have the um surgery bill in first, and then what it does is it pays a percentage of the surgery um so.
[AGENT][NEUTRAL] The, the, um, anesthesia alone won't be paid. We, we need to have both of the charges for the surgery and for the anesthesia.
[CUSTOMER][NEUTRAL] Well, I, I had called a little bit ago and was was told that so I then hung up the phone and called the hospital and they confirmed that they billed you guys and the surgeon billed you guys and that both claims were adjusted and then she gave me an ICN. I don't know if I can give you this if you can look that up.
[AGENT][NEUTRAL] OK, and what is that, please?
[CUSTOMER][NEUTRAL] 202408-230045
[AGENT][NEUTRAL] OK. The, the main administrator for this policy is a company called um Benefits and a Card.
[AGENT][NEUTRAL] And that that might be there um.
[AGENT][NEUTRAL] That might be their policy number. Uh, it's not, um, it's not the same as ours. So with these policies, uh, because they're, they're a little bit different, um, you would file through, um, benefits and a card or IMA, uh, one of those two, and then it would be filed through us. Uh-huh.
[CUSTOMER][NEUTRAL] I filed it to IMA.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, then it it's probably their number.
[CUSTOMER][NEUTRAL] And then that's when I got my.
[AGENT][POSITIVE] I'm, I'm sorry
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] What do you suggest, then what do you suggest I do since the hospital's telling me that you guys did adjust the surgeon's claim.
[AGENT][NEUTRAL] That that's when
[CUSTOMER][NEUTRAL] I mean, do you suggest I call them back and try to find something else to give you guys in order to find that?
[AGENT][NEUTRAL] Well, you may see if they, if they, if they can actually submit the, the uh surgery bill to us because it, it's, if you, if you submit it to IMA it's not really the same as it because we're two separate entities. It's not, I don't show it at all. I mean.
[CUSTOMER][NEUTRAL] No, they told me.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] They told me that they submitted it to American Public Life Insurance. We submitted it to IMA.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's, let's see because I'm not seeing it at all. Um, just check here. Yes, I don't have this at all. Um, the only thing I have is the, the, no, they did send the, we did get the surgery bill again. Um, someone submitted the surgery bill twice, um, but that's the only thing that I have for this, excuse me, the anesthesia bill, excuse me. That's the only thing that I have for this.
[CUSTOMER][NEUTRAL] The anesthesia bill.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, um, if I could just get a reference number then.
[AGENT][NEUTRAL] OK, my name is [PII]. The first letter of my last name is [PII], and we'll use that in today's date as a reference.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, thanks for contacting me