AccountId: 011433970860
ContactId: 273bb914-e4d5-4812-97b3-6c5a4aca70bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306399 ms
Total Talk Time (AGENT): 98886 ms
Total Talk Time (CUSTOMER): 122068 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/273bb914-e4d5-4812-97b3-6c5a4aca70bf_20250508T12:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. I am calling from Harbin Clinic, and I need clarification on a claim that we submitted for a patient, please.
[AGENT][NEUTRAL] OK. Happy to check on the claim, [PII]. What's the patient's uh policy number?
[CUSTOMER][NEUTRAL] Um, let me get down to his card uh policy policy.
[CUSTOMER][NEUTRAL] Uh, is that the employee ID?
[AGENT][NEUTRAL] It should start with like a 0102, something like that.
[CUSTOMER][NEUTRAL] Uh this one starts with the.
[AGENT][NEUTRAL] D
[CUSTOMER][NEUTRAL] Uh, no, that's the payer, uh, yeah, a D.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Did you ever get a claim number? I can look it up by claim if you have that by chance.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Um, let me go to the next page here.
[CUSTOMER][NEUTRAL] Uh, explanation of benefits, policy check date, uh, patient.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's weird because on here it says American Public Life Insurance is that you guys?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We're American Public Life, yeah.
[CUSTOMER][NEUTRAL] OK, I have a, oh wait, claim number 3593056.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can get.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] All right, and then [PII], if you could just verify with me um the insured's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Perfect
[AGENT][NEUTRAL] All right, so it looks like on this Sandra, we're just awaiting some information from their employer uh to verify eligibility. Uh, they're with a staffing agency and so sometimes we'll have to verify that and looks like we just haven't heard anything back yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, will you guys automatically reprocess this claim when you hear back or?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And how long do you give them?
[AGENT][NEUTRAL] Um, usually it'll take anywhere from like 7 to 10 days, um, but once we receive the information we just continue processing the claim.
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] And do you know when you guys reached out to the employer?
[AGENT][NEUTRAL] Uh, let's see what the date was on this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like it was on the [PII], so that was a Friday.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] OK um.
[CUSTOMER][NEUTRAL] I'm just trying to wonder if I should.
[CUSTOMER][NEUTRAL] Send the patient a letter.
[CUSTOMER][NEUTRAL] Or wait
[AGENT][NEUTRAL] Yeah, I hear you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's kind of like that fine line right there.
[AGENT][NEUTRAL] Yeah, I know.
[CUSTOMER][NEUTRAL] Um, OK, I'll just make a note and then maybe um I'll check back next week to see if you guys have heard anything and if not then at that point I will reach out and see if we can get the, um, patient to get a hold of the employer. OK, [PII], is there a reference number please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, absolutely. The reference is gonna be my name with my last initial and then today's date. My name again is [PII], so that's [PII] initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right, [PII], thank you so much. You have a great rest of your day.
[AGENT][POSITIVE] You too, [PII]. Take care.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye.