AccountId: 011433970860
ContactId: 55faf99b-6247-4ce5-9c3f-a8088873f20d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460619 ms
Total Talk Time (AGENT): 124191 ms
Total Talk Time (CUSTOMER): 160902 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/55faf99b-6247-4ce5-9c3f-a8088873f20d_20250123T15:44_UTC.wav
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[AGENT][POSITIVE] Good morning, thanks for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm honestly not sure if I have selected the correct options or not, but hopefully you can help me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] How can I help you?
[CUSTOMER][NEUTRAL] What information can I give you?
[CUSTOMER][NEUTRAL] So I am calling from Prisma Health. I have a question regarding a claim.
[AGENT][NEUTRAL] OK, I can help you with the claim, and may I ask who I'm speaking with?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Thank you and [PII], in case this call is disconnected, may I have your call back number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number [PII], that's spelled D E N A, last initial P.
[CUSTOMER][NEUTRAL] I'm sorry, what's your name?
[CUSTOMER][NEUTRAL] OK, thank you. Uh, patient number is [PII].
[AGENT][NEUTRAL] OK, that wouldn't be the policy number. If you have a copy of their insurance card, it'd be listed as policy cert or certificate number.
[CUSTOMER][NEUTRAL] Oh sir, OK.
[CUSTOMER][NEUTRAL] OK, I'm looking at the card and then I'm, I'm double checking the phone number I dialed.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so I'm looking at the card. It says the employee ID. OK, you said policy sir. I don't see that.
[AGENT][NEUTRAL] Yes, or certificate number. If you don't see that listed, I can, do you have their full social I can enter them in by their first and last name if you don't have the social.
[CUSTOMER][NEUTRAL] Yeah, I just have employee ID group number let's see on the card, um, their social [PII].
[AGENT][NEUTRAL] Thank you, and that was [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm not having that social come up. Do you know if they're the policy holder or they're a dependent under the coverage?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Alright, the insurance card.
[CUSTOMER][NEUTRAL] [PII] is the employee.
[AGENT][NEUTRAL] [PII]. Let me try to by the name then.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you know what state he's out of?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Or do you have a group name or group number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's the Greenville, South Carolina, and the group.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Number on the card.
[CUSTOMER][NEUTRAL] Is 943 7.
[AGENT][NEUTRAL] I'm not having anything come up by that name or social.
[AGENT][NEGATIVE] I have a group coming up with that group, but do you know the name because I don't even show this group is even no longer active and I don't show any, any listings for that name as well.
[CUSTOMER][NEUTRAL] It just says MAU workforce.
[AGENT][NEUTRAL] OK, so that's a different name then you said MAU Workforce?
[CUSTOMER][NEUTRAL] Um, solution.
[CUSTOMER][NEUTRAL] Yes, Workforce Solutions group number 9437 and then it gives an employee ID, which is that first number I gave you. Eloyee name is [PII] family.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It says call 90 degree benefits at [PII].
[AGENT][NEUTRAL] OK, yeah, that's a different number.
[AGENT][NEUTRAL] Let me get you over to them. Yeah, you're in a different area. So let me get you over to them. Give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree Benefits, the administrator for benefits in a card members. Please select from the following options to ensure you are directed to the appropriate party to answer your questions. For questions on IMA Mec Wellness, MVP plans, or COBRA enrollment, please press 1. For questions on the APL hospital indemnity plans or dental coverage, please press 2. For questions on the Vision plan, please press 3.
[CUSTOMER][NEUTRAL] If you are an employee and you have questions on your active enrollment, please press 4.
[CUSTOMER][NEUTRAL] To hear this message again, please press the star key. Thank you.
[CUSTOMER][NEUTRAL] 90 Degree Benefits. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII] with American Public Life, and I have a provider on the line calling trying to check on a claim. I have their member ID number or social.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, what's that ID number?
[AGENT][NEUTRAL] It's D as in David, 43930553.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] She said the policyholder should be a [PII].
[AGENT][NEUTRAL] She gave me a social for the patient number [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let me try that.
[CUSTOMER][NEUTRAL] Mm, I didn't pull up anybody either.
[CUSTOMER][NEUTRAL] Um, what is, do you have a callback number?
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] I have her on the line I can um.
[AGENT][NEUTRAL] Well, she has disconnected now, so I hope she'll probably just call that number directly cause she originally dialed us at first, so she hung up already.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Well, I appreciate you. You have a good day.
[AGENT][POSITIVE] You too thanks bye.
[CUSTOMER][POSITIVE] Thank you. You're welcome. Bye-bye.