AccountId: 011433970860
ContactId: 4368f253-3485-4b99-8b09-8c174c8dbafd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 560320 ms
Total Talk Time (AGENT): 122158 ms
Total Talk Time (CUSTOMER): 213679 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/4368f253-3485-4b99-8b09-8c174c8dbafd_20250625T19:46_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is lady. I'm calling as provider and I need information about something, please.
[AGENT][NEUTRAL] OK, I'm happy to check on the claim. Can I get the policy number?
[CUSTOMER][NEUTRAL] Yeah, I'm calling to American Financial Services, right?
[AGENT][NEUTRAL] I'm sorry, what was your question again?
[CUSTOMER][NEUTRAL] Um, I'm I calling to American Financial Services, right?
[AGENT][NEUTRAL] This is American Public Life Insurance APL.
[CUSTOMER][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] Uh, it's OK. OK. The subscriber ID is 02107543.
[AGENT][NEUTRAL] And then can I get your name and a callback number for documentation?
[CUSTOMER][NEUTRAL] Yeah, sure. My name is [PII] and um my callback number is [PII].
[AGENT][NEUTRAL] Patient name and date of birth?
[CUSTOMER][NEUTRAL] My name, uh, for the patient or?
[AGENT][NEUTRAL] Mhm. Patient.
[CUSTOMER][NEUTRAL] OK, it's [PII] and the DOV is 11031961.
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] 801302025.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] Not showing any claims on file for that date of service.
[CUSTOMER][NEUTRAL] Um, OK, so I need to resubmit it. Mm, can you give me a reference number for this patient, please?
[AGENT][NEUTRAL] Call reference is my name with today's date. My name is [PII], that's [PII] H. initial to my last name is [PII], and then today's date.
[CUSTOMER][POSITIVE] Oh, OK. Thank you so much.
[AGENT][NEUTRAL] You're welcome. Have a
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I have um a different patient. Could you help me, please?
[AGENT][NEUTRAL] Let me note this one and we can move on to the next one moment.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Let
[CUSTOMER][NEUTRAL] 2
[AGENT][NEUTRAL] What is the next member's ID?
[CUSTOMER][NEUTRAL] It's 02273691.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Fill them out.
[CUSTOMER][NEUTRAL] It's um $158.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] This claim was received on [PII]. It looks like of [PII].
[AGENT][NEUTRAL] Processed on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] You mean the patient is not covered, right?
[AGENT][NEUTRAL] Office visits are not covered under the member's policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, how would I to proceed with this claim?
[AGENT][NEUTRAL] It's up to the facility or the provider to decide on the patient responsibility. We're not able to advise on that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Mm, we have a different patient. Could you call me please?
[AGENT][NEUTRAL] You have another patient, is that what you had said?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I have
[AGENT][NEUTRAL] Let me just note this one and we can move on to the next.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] What is the next member ID?
[CUSTOMER][NEUTRAL] It's 02356342.
[AGENT][NEUTRAL] Name and date of birth.
[CUSTOMER][NEUTRAL] [PII], NOB, it's [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] For claim questions on this, these would go through web TPA at a different number. Would you like that number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So for this patient, I have to call to this number, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, thank you so much. And I have the last station. Would it be possible that you can check it, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the member ID?
[CUSTOMER][NEUTRAL] Um, the member ID, give me a moment, please.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 8021526777.
[AGENT][NEUTRAL] Will you repeat that back to me one more time, please?
[CUSTOMER][NEUTRAL] Yeah, sure. It's 02152677.
[AGENT][NEUTRAL] Name and date of birth?
[CUSTOMER][NEUTRAL] It works and DDOV [PII].
[AGENT][NEUTRAL] Data service.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, $320.
[AGENT][NEUTRAL] No claims on file for [PII].
[CUSTOMER][NEUTRAL] OK, um, your reference number will be the same one?
[AGENT][NEUTRAL] Mhm. It is my name with today's date.
[CUSTOMER][NEUTRAL] OK, so you mean no claim on file, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, [PII], thank you so much. That will be everything for today. Have a nice day.
[AGENT][POSITIVE] Have a good day. Bye bye.
[CUSTOMER][NEUTRAL] OK.