AccountId: 011433970860
ContactId: 48dbb78b-f30c-40e9-8146-f05ad05c6719
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 796460 ms
Total Talk Time (AGENT): 302998 ms
Total Talk Time (CUSTOMER): 324171 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/48dbb78b-f30c-40e9-8146-f05ad05c6719_20250113T17:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I, so I sent in a claim for a flu shot back in uh [PII] and looks like I'm told that it's gonna take 30 to 45 days and.
[CUSTOMER][NEUTRAL] To have that claim process. I'm just calling to check on the status.
[CUSTOMER][NEUTRAL] Of that claim.
[AGENT][NEUTRAL] Mm. Um, may I have your name one more time?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No
[CUSTOMER][NEUTRAL] And then the last name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected, Mr. [PII].
[CUSTOMER][NEUTRAL] Sure [PII].
[AGENT][NEUTRAL] Thank you. Do you have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, uh, member ID.
[AGENT][NEUTRAL] Let me try that.
[CUSTOMER][NEUTRAL] 681-155-940.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] No, that's not our number. Uh it's gonna be smaller. It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] I'm sorry, I'm with um BWAmericare and I'm a member and they, I called them regarding the claim and they gave me your number. So what number are you asking again? I'm sorry?
[AGENT][NEUTRAL] OK, this is American Public Life.
[AGENT][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] Yes, they said you just for claiming who handle the claim that I made.
[CUSTOMER][NEUTRAL] Through my insurance company.
[CUSTOMER][NEUTRAL] Uh, a medical bill repriser [PII] is where I emailed the claim to.
[AGENT][NEUTRAL] We don't have a reprice sir. um.
[AGENT][NEUTRAL] And you say you're trying to contact American Public Life Insurance APL?
[CUSTOMER][NEUTRAL] Yes, this, this is the number that they gave you guys are the ones who pay out the claims, I'm told.
[CUSTOMER][NEUTRAL] For insurance carriers.
[AGENT][NEUTRAL] We pay out the
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, we only pay the claims for APL.
[CUSTOMER][NEUTRAL] Yeah, I know, um, so, what number are you asking me?
[AGENT][NEUTRAL] Policy certificate is going to start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] No, I don't have um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Maybe with the G, that's the group ID number G1203273.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm no. Mm mm. No, I can do a name search on the system and see if we can find you, but it sounds like you're probably calling the wrong company. So let me just go ahead and check on the system and see if I can find your name.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the last name you said is [PII], which is [PII]
[AGENT][NEUTRAL] And the first name is [PII], which is [PII]
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII] and then [PII].
[AGENT][NEUTRAL] Mm OK.
[AGENT][NEUTRAL] OK, I am one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Um, may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And my email is my name in [PII].
[CUSTOMER][NEUTRAL] And my address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you would be um BWA?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me look at the card. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. Yeah, you're, um, yeah, you're calling the wrong company. Uh, we are, um, we handle your hospital indemnity plan which is um for hospitalizations, intensive care, confinement and admission, and anesthesia. Um, we do not cover any injections, shots, um, preventative, um, those are not covered by us. Um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not really sure who they use for their preventative, but.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] My, my brother
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK, I, I'm sorry I didn't know what you're saying, um.
[CUSTOMER][NEUTRAL] I will call back the BWA and get it, but um my brother also went into um
[CUSTOMER][NEUTRAL] Urgent care or emergency room because he couldn't breathe and um then he was billed and
[CUSTOMER][NEUTRAL] I was wondering if that claim has been settled. That's, that was back in when? March of last year.
[AGENT][NEUTRAL] And who's your brother?
[CUSTOMER][NEUTRAL] I'm still receiving.
[CUSTOMER][NEUTRAL] Uh, he's next to me if you need to speak to him. Uh, is this [PII].
[CUSTOMER][NEUTRAL] [PII] all one word.
[CUSTOMER][NEUTRAL] And then the last name is [PII].
[AGENT][NEUTRAL] OK, let me look for his policy. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so the last name you said is [PII].
[AGENT][NEUTRAL] And the first name, can you repeat the spelling of the first name one more time?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, what does [PII] stand for?
[AGENT][NEUTRAL] Girl, go.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, yeah. And then, and then it's all, and then, and then the other part of his name is [PII] again.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] OK, um, let me verify some information with him and get his permission.
[CUSTOMER][NEUTRAL] Sure, go ahead.
[AGENT][NEUTRAL] OK, um, good afternoon, Mr. [PII]. This is So with APL. I need to verify your date of birth.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, it's the [PII].
[AGENT][NEUTRAL] And your email address and your permission to release information to your brother.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] [PII]. [PII], [PII], my last name [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. What about the address?
[CUSTOMER][NEUTRAL] My home address?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Firestown, Colorado.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and are you giving me permission to release information to your brother?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, Mr. [PII], it's gonna be a minute. I'm waiting on his information to pull up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] We received a bill saying that we are uh past due and we were kind of like alarmed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah. Yeah, we have not received that claim as of today. Um, he does have benefits for emergency room, but we have not received that claim as of today. I don't know if you want to just contact them and let them know that we have not received that claim to go ahead and submit the claim. Um, just, um, make sure that they're sending the claim to us directly. Um, let me give you the address.
[CUSTOMER][NEUTRAL] OK, [PII]e me one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, the address is [PII], and it's gonna be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me know when you're ready for the zip code. OK. It's [PII], OK, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, right.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So I need to contact the hospital and give them this address?
[AGENT][NEUTRAL] Give them the policy number um which is um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But, yeah.
[AGENT][NEUTRAL] Let me give you the policy number. It's 02.
[CUSTOMER][NEUTRAL] What, what policy number, is it the same one I have that I get, I try to give to you, or is it different for you guys?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's different.
[CUSTOMER][NEUTRAL] OK, how do I, how do I, uh, I
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can give you your policy number as well. Let me just go ahead and give you your brother's and then I can go back to yours.
[CUSTOMER][NEUTRAL] OK, that's, yeah.
[AGENT][NEUTRAL] OK, so the, the one for, for your brother for the ER visit is 02396164.
[CUSTOMER][NEUTRAL] Just to my brother's house.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And that's for him to.
[CUSTOMER][NEUTRAL] They don't, they didn't see.
[CUSTOMER][NEUTRAL] I'm sorry, so, so, so they, so you, you don't have anything regarding the emergency visit, but the, so we called the hospital and they had a reference number um from you guys, is what they were what we were told.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They had a reference number.
[AGENT][NEUTRAL] Um, we don't give out a reference number, we give out our name and today they. Did they say when they called in?
[CUSTOMER][NEGATIVE] No, I'll call them and I'll start. This is why I'm trying to take care of it because my brother somehow when he does things, it just never gets done.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm, OK. Yeah, I, we don't have no calls and records indicating there was a call about the ER visit and we have no claims on file indicating we have received a claim. So there's no records at all and we notate every call we get.
[CUSTOMER][NEUTRAL] OK. Um, do I, I, I never visit the ER so I don't really need the number. Um, I have since canceled this policy.
[CUSTOMER][NEGATIVE] Uh, because I am getting horrible service, not with you, but with BWA about other claims that I've done and
[CUSTOMER][NEGATIVE] They keep giving me other people, they gave me your number for my flu shots.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] Now you're telling me that it's not you guys, so I don't, now I have to call them back, but this is how they do their business, and this is why I'm not a member anymore.
[AGENT][POSITIVE] I'm so sorry. Yeah.
[CUSTOMER][NEGATIVE] But um, but this emergency visit needs to be covered because it was done in March, way before I covered, um, way before I canceled.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes. Yes. If you can have them just to go, just call directly the provider of service and have them to submit the claim directly to us, provide the policy number and the address so they can send us the claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] All right. Thank you so much for your help.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's everything. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.