AccountId: 011433970860
ContactId: 4d73c66f-ec77-4c75-ba6c-2adafe5e4da2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241899 ms
Total Talk Time (AGENT): 103917 ms
Total Talk Time (CUSTOMER): 113981 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/4d73c66f-ec77-4c75-ba6c-2adafe5e4da2_20250127T16:54_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, um, I'm calling. I from a dental office. I have a patient, um, I'm trying to figure out if they had coverage. Um, I received an EOB back from data er from a certain data service. It told me to call the.
[AGENT][NEUTRAL] Can I have your name and a callback number? I don't mean to cut you off, but can I get your name and a callback number just in case the call is disconnected and the policy number so that way you don't have to repeat yourself for the reason that you're calling.
[CUSTOMER][NEUTRAL] OK, uh, my name is [PII].
[AGENT][NEUTRAL] Just for your call back number and that policy number?
[CUSTOMER][NEUTRAL] OK, the callback number is [PII].
[CUSTOMER][NEUTRAL] Um, and then it looks like policy number would be.
[CUSTOMER][NEUTRAL] 02567432
[AGENT][NEUTRAL] Could you verify that patient's name and date of birth that you're inquiring eligibility for?
[CUSTOMER][NEUTRAL] It is uh [PII] And hold on just.
[CUSTOMER][NEUTRAL] Hm. Hold on just a second.
[CUSTOMER][NEUTRAL] 7:30 20003.
[AGENT][NEUTRAL] Thank you and just for the claim number that you're inquiring about, do you have that?
[CUSTOMER][NEUTRAL] Uh, I have it for one, yes, um, 354-703-6.
[AGENT][NEUTRAL] This claim is currently pending. It's just currently pending, and we're waiting on eligibility because we're a third party administrator and we're waiting on eligibility to be verified. There's nothing that you have to do or the member. We're just waiting for the third party to send us the eligibility so we can release funding.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So the third party is that the benefits in a card?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, because then like I called them because that's what the EOB says. It says exactly what you said that you're waiting on confirmation and if they have any questions to call the benefits and card. So that's who I originally called and she told me that he didn't have coverage on that date of service and then she transferred me to you.
[AGENT][NEUTRAL] Well, they haven't sent us that information over yet, so we can't.
[AGENT][NEUTRAL] Verify it in the system that's why the claim is currently pending until they send us information over.
[CUSTOMER][NEUTRAL] OK, I don't know if you're can tell me this, but does he he should have another claim.
[CUSTOMER][NEUTRAL] Um, from us, I, I don't have any.
[AGENT][NEUTRAL] He does for data service, what was the date of service?
[CUSTOMER][NEUTRAL] Um, the other date of service would be [PII].
[AGENT][NEUTRAL] It's, it's currently pending as well, waiting on eligibility to be verified by benefit in the card.
[CUSTOMER][NEUTRAL] OK, um, I guess then I'll call them and let them know they need to contact you guys.
[AGENT][NEUTRAL] Right, they have to send us information over. No, there's nothing else that you can do or the member is we're waiting on eligibility to be verified from benefiting the card. Once they send that over to us, like right now in the system when you call here at American Public Life because we're a third party administrator, it shows that the policy is currently active. So if the policy is terminated on their behalf, they haven't sent us any updated information to terminate the policy.
[CUSTOMER][NEUTRAL] Right, cause there's nothing else I can do.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, all right, I will call them then thank you so much for your help.
[AGENT][NEUTRAL] You're welcome, [PII]. Is there anything else that I can assist you with? They probably just gonna tell you to call APL again, but they're, it literally says we're waiting on them to verify eligibility, but they do it all the time.
[CUSTOMER][NEUTRAL] OK, I'll try.
[CUSTOMER][POSITIVE] Right, I'm gonna let them know, yeah, I'm sure it, and it all gets jumbled up, I'm sure. All right, well, now you've been as much help as you can be.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Well thank you for calling APF [PII]. You have a great day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.
[AGENT][POSITIVE] Thanks goodbye.