AccountId: 011433970860
ContactId: 440e9add-ed55-4f4c-8ca6-a804205f92a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427820 ms
Total Talk Time (AGENT): 209699 ms
Total Talk Time (CUSTOMER): 188315 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/440e9add-ed55-4f4c-8ca6-a804205f92a1_20250122T16:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. With whom am I speaking and how may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII] Webb and Broker Resources. How are you?
[AGENT][NEUTRAL] I'm good. And your name is [PII]?
[CUSTOMER][NEUTRAL] Good, yeah, my name is [PII] I'm broker resources.
[AGENT][NEUTRAL] OK, alright, and what can I help you with today?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, I have a um.
[CUSTOMER][NEUTRAL] I have a person on the phone. She needs to um figure out claims coverage for an insured named [PII]
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] Um, I'm gonna give you 2 because I.
[CUSTOMER][NEUTRAL] Because I found you in line. It's the first one's 205.
[CUSTOMER][NEUTRAL] 954 4.
[AGENT][NEUTRAL] I'm sorry, it's hard for me to hear you. I don't know if you have me on speakerphone. 205.
[CUSTOMER][NEUTRAL] 954 4.
[AGENT][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] And then 251.
[CUSTOMER][NEUTRAL] 5654.
[AGENT][NEUTRAL] OK, and she's calling because she has some questions about her dependent [PII], is that what you're saying?
[CUSTOMER][NEUTRAL] No, she's um.
[CUSTOMER][NEUTRAL] Well, let me go back and.
[CUSTOMER][NEUTRAL] And figure out exactly who she is. I think she's like from the um.
[CUSTOMER][NEUTRAL] Like for she's part of the claims like she's, it's not his, it's not her dependent sorry I'm.
[AGENT][NEUTRAL] OK, well I need to know who she is before you transfer the call. I need her name and I need to know who she is.
[CUSTOMER][NEUTRAL] Yeah, give me just a second.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK, can you hear me?
[AGENT][NEUTRAL] Uh-huh I can hear you.
[CUSTOMER][NEUTRAL] Her name is [PII] with CHI Health.
[AGENT][NEUTRAL] And she's [PII]. OK, alright, go ahead and transfer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I will thank you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK OK I have
[AGENT][NEUTRAL] Hello? Oh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hi [PII]. This is [PII] from American Public Life. I understand you're calling from Chi Health, Chi Health.
[CUSTOMER][NEUTRAL] CHI CHI health.
[AGENT][NEUTRAL] OK, and what's a good call back number for you in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] And your provider, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] And what can I help you with today?
[CUSTOMER][NEUTRAL] Yes, so I was just calling to verify coverage for [PII] or Dubu, excuse me, um, yes, so he has some claims here that goes back to May, and I just want to make sure that we're not that we're not past timely to build the secondary.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, and let's see here so I can assist you with that today. Verification of coverage does not guarantee the payment of a claim. Please verify his date of birth.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that information. So the policy uh 2059544 would cover dates of service [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we don't have a timely filing limit. This is a secondary medical gap insurance, so it's based upon what the primary insurance company uh deems as the insured's uh responsibility in the form of a copay, co-insurance or deductible, and that's the only thing that will be considered up to the benefits on the uh policy. Do you need to verify any benefits?
[CUSTOMER][NEUTRAL] Um, can you verify the, what's the ID number you have? Sorry, did you, I'm sorry, you was.
[AGENT][NEUTRAL] 20
[AGENT][NEUTRAL] These this for for date span [PII] which you said you're trying to file claims for May, the policy number you would file those under is 2059544.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] 2, OK, I'm just, I'm saying this because I'm showing a different subscriber number, so I just wanna see you said 2.
[AGENT][NEUTRAL] You would show a different subscriber number if it's a different data service. If you're trying to file a claim again from [PII], that is the policy number you would use. If it's after [PII] to current, there is a different policy number.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, just a second here after because I have some that's after that date too, so, so it's after.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 251-565-4, that's the one for that date span.
[CUSTOMER][NEUTRAL] 251. OK, that's what.
[AGENT][NEUTRAL] But I gave you
[AGENT][NEUTRAL] I gave you the correct one for the date span that you're filing for. That's not what you would file May claims for [PII]. They wouldn't go up under that policy number that you have. They will go up under the policy number that I gave you the 2059544.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] So that's the policy number that needs to be on your claim.
[CUSTOMER][NEUTRAL] Got it. So I'm sorry, but I'm just gonna clarify what you said as far as the date range. So the one ending in 544, you said [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] so so anything past um [PII], um.
[AGENT][NEUTRAL] Is the policy number you have.
[CUSTOMER][NEUTRAL] So it's not
[CUSTOMER][NEUTRAL] OK, so it's not, it's [PII] starts with the new policy number, so August, so [PII] would be the [PII]. I'm just trying to.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Well, that's not how we rate it in our system, but that's.
[CUSTOMER][NEUTRAL] OK, that's basically.
[AGENT][NEUTRAL] Yeah, that's not how we read it in our system. Our system shows that it goes to others the first and it picks up on others the first.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then [PII] the um first the current is the other one that we have OK because he provided us with the the newest number so OK they can yeah OK and just um yeah, you have a call reference number.
[AGENT][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK, that's fine, that's fine. All right, you have any other questions?
[AGENT][NEUTRAL] It's gonna be my name [PII], last initial [PII] and today's date that'll be your reference for the call.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, and is there also, is there like a direct number we can call because the number I called I think was maybe a switchboard or something is there like a direct number just.
[AGENT][NEUTRAL] You, you call, you call broker resources some kind of way and you should call customer service and that number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate your time.
[AGENT][POSITIVE] OK. You're welcome. You have a great day, [PII]. Thanks for calling APO. Bye-bye. Bye bye.
[CUSTOMER][POSITIVE] Uh huh you too thank you.