AccountId: 011433970860
ContactId: 56f54134-a090-483c-87c1-cb9b395f09ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 809830 ms
Total Talk Time (AGENT): 411524 ms
Total Talk Time (CUSTOMER): 436463 ms
Interruptions: 34
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/56f54134-a090-483c-87c1-cb9b395f09ac_20250108T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi, uh, this is [PII]. Initial to last name is [PII]. How are you doing today?
[AGENT][NEUTRAL] I'm fine, sir. How are you doing?
[CUSTOMER][POSITIVE] I'm fine, thank you for asking.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] How can I help you today, Mr. [PII]?
[CUSTOMER][NEUTRAL] I have a one-up member and we are looking for the claim status.
[AGENT][NEUTRAL] Looking for claim status?
[CUSTOMER][NEUTRAL] for
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, I can help you with that. Can you provide me with the policy number, please?
[CUSTOMER][NEUTRAL] Mhm. Yeah, the policy number is going to be 02496872.
[AGENT][NEUTRAL] Thank you. Give me just a moment while I pull that information up, [PII], and we'll do a quick verification.
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, [PII], what is the name of the, the patient?
[CUSTOMER][NEUTRAL] OK, what is the name of the, the patient?
[CUSTOMER][NEUTRAL] Yeah, the patient's first name is [PII] and the last name is [PII] And the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Yes. Yeah, the date of birth is [PII].
[AGENT][POSITIVE] Wonderful. And let's just, oh, hold on one second, I'm sorry.
[AGENT][NEGATIVE] It kicked me out.
[AGENT][NEUTRAL] OK, any second now. There we go. All right, [PII], do you by chance have the address of the, uh, the patient?
[CUSTOMER][NEUTRAL] Alright I see about.
[CUSTOMER][NEUTRAL] Yes, I have.
[CUSTOMER][NEUTRAL] OK. So the patient address is going to be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Excellent. Thank you so much. Um, all right, so you're checking out claim status. What was the date of service, [PII]?
[CUSTOMER][NEUTRAL] So much.
[CUSTOMER][NEUTRAL] Date of service is number [PII].
[AGENT][NEUTRAL] OK, I'm sorry, can you give that to me one more time?
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Yeah. Number 1818, 18, [PII].
[AGENT][NEUTRAL] So it was [PII].
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] No. [PII].
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] November. Yes. [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII] and last year, [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Excellent, thank you. OK, let me check something here. What I'm going to do, [PII], but I want to check on something. [PII], I'm going to give you a different policy number, OK?
[CUSTOMER][POSITIVE] Excellent
[CUSTOMER][NEUTRAL] OK, let me check something here. What I'm going to do, [PII], because I want to check on something. [PII], I'm going to give you a different policy number, OK?
[AGENT][NEUTRAL] Because they've had an update so they do have a new policy number.
[CUSTOMER][NEUTRAL] an update so they do have a new policy number.
[AGENT][NEUTRAL] So, can I give that to you, please, sir?
[CUSTOMER][NEUTRAL] OK, go ahead with the new policy ID.
[AGENT][NEUTRAL] Are you ready?
[CUSTOMER][POSITIVE] Yes, I'm ready.
[AGENT][NEUTRAL] OK, 02.
[CUSTOMER][NEUTRAL] OK, 0
[AGENT][NEUTRAL] 56.
[AGENT][NEUTRAL] 9076.
[CUSTOMER][NEUTRAL] This is the new policy ID of the member?
[AGENT][NEUTRAL] Correct. The other policy is no longer active, but this is the, uh, the new policy number. OK?
[CUSTOMER][NEUTRAL] The other policy is no longer active.
[CUSTOMER][NEUTRAL] This is the um.
[CUSTOMER][NEUTRAL] Can you give, can you give me the effective date when to when, uh, with this active member with this policy ID?
[AGENT][NEUTRAL] Alright, this policy is active, uh.
[AGENT][NEUTRAL] Let's see, [PII]. [PII] [PII] [PII]
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII], right?
[AGENT][NEUTRAL] Right. [PII]. And um
[CUSTOMER][POSITIVE] And the still lucky.
[AGENT][NEUTRAL] Uh, it hasn't termed, it's still active, but it's only paid to [PII].
[AGENT][NEUTRAL] [PII], but the policy is still active. The group probably just pays late.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] So let me take a quick look at that.
[CUSTOMER][NEUTRAL] OK. So the
[CUSTOMER][NEUTRAL] OK. So the policy ID which we have billed, that is, that was the uh uh terminated, right?
[AGENT][NEUTRAL] The other policy, it turned, it termed at the, uh, it turned 531-2024.
[CUSTOMER][NEUTRAL] The other phone.
[AGENT][NEUTRAL] The 02.
[CUSTOMER][NEUTRAL] 531 2021.
[AGENT][NEUTRAL] Right, 02496872, it turned.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Um, now I can place you through to our benefits department. Chances are it's just the claim is being pended for payment.
[CUSTOMER][NEUTRAL] I can place you through to our.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK. So we need to build you the claim once again, right? With the correct, with the updated policy ID right?
[AGENT][NEUTRAL] Right, I would go ahead and bill it again.
[AGENT][NEUTRAL] And hopefully by the time they received the bill, the payment will have been received.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Then what is your, what is your mailing address and the fax number so that we can resend the claim?
[AGENT][NEUTRAL] All right, let me find that information for you. Give me one moment.
[CUSTOMER][NEUTRAL] Sure. You can go ahead with the fax number for the claim submission.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, we're gonna find that fax number for you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And really.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] political though.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Address payments, where is that fax number?
[AGENT][NEUTRAL] OK, I have the fax number when you're ready.
[CUSTOMER][POSITIVE] Yeah, I'm ready.
[AGENT][NEUTRAL] OK, that's one.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Now I'm very hoarse, so tell me if you don't understand me. OK, let me start over. 18.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[AGENT][NEUTRAL] 77.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what is the uh mailing address for the claim submission?
[AGENT][NEUTRAL] OK, so that's gonna be addressed to APL [PII].
[CUSTOMER][NEUTRAL] OK so.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] [PII] So [PII]'s our [PII] for American Public Life APL.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I would find A [PII]
[AGENT][NEUTRAL] Space, you know, put a space, uh, claims. So that way it'll go to our claims department. So APL [PII].
[CUSTOMER][NEUTRAL] This.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] And the next
[CUSTOMER][NEUTRAL] Can you spell [PII]?
[AGENT][NEUTRAL] Certainly. [PII] [PII]
[CUSTOMER][NEUTRAL] Sorry
[AGENT][NEUTRAL] M [PII]
[CUSTOMER][NEUTRAL] You know.
[AGENT][NEUTRAL] City, C.
[CUSTOMER][NEUTRAL] Okla, [PII]
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] [PII], I'm sorry, [PII]
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] No [PII], one word.
[CUSTOMER][NEUTRAL] OK. [PII], right?
[AGENT][NEUTRAL] Correct. The next word would be [PII] So it's [PII] City, uh, the state abbreviation is [PII].
[CUSTOMER][NEUTRAL] And the next?
[CUSTOMER][NEUTRAL] Alright, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What does it mean? OK.
[AGENT][NEUTRAL] It means [PII], the state of [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, I see. [PII]. Nice state. OK.
[AGENT][NEUTRAL] Right, it's just the abbreviation for [PII]. And the zip code, now it has the extra four digits. I'll give you the 1st 5 and then the extra 4. So it's [PII].
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Then put a dash.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 95.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What should be the attention?
[AGENT][NEUTRAL] Uh, it, well, the attention will be APL claims. They'll see that it says claims and they'll know to send it there.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] And there.
[CUSTOMER][NEUTRAL] May I know your good name?
[AGENT][NEUTRAL] Excuse me?
[CUSTOMER][NEUTRAL] May I know your good name?
[AGENT][NEUTRAL] No my name.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, my name is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Initial to last name.
[AGENT][NEUTRAL] Last initial is [PII]
[CUSTOMER][NEUTRAL] You can go ahead with the reference number.
[AGENT][NEUTRAL] Excuse me? I'm sorry.
[CUSTOMER][NEUTRAL] May I know the reference number?
[AGENT][NEUTRAL] Say it one more time, dear.
[CUSTOMER][NEUTRAL] Yeah. Can you, can you give me the reference number, reference number?
[AGENT][NEUTRAL] Reference number. OK. So that would be uh it would be my like just what you put down, [PII] I S A E.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it would be like.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 08.
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] 2025.
[AGENT][NEUTRAL] 20 yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, what I have understood, the member policy ID which we have billed that is no longer active, it has already been termed on [PII]. So we need to bill the claim once again with the new policy ID which is 02569076.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And it was effective from [PII] to still active, right?
[AGENT][NEUTRAL] Correct. And the policy is still active. You're welcome. Is there anything else we can help you, [PII], help you with?
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] OK, thank you so
[CUSTOMER][POSITIVE] Uh, no, thank you. Thank you so much, [PII]. It was fantastic talking to you and wonderful day. Bye. And one more thing which I need to ask you, one more thing which I need to ask you. I'm so sorry to keep asking you the question. So, uh, you guys, you guys will be off on uh [PII] due to the, uh, [PII] birthday?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You as well.
[AGENT][NEUTRAL] Certainly.
[AGENT][NEUTRAL] No, you're fine.
[AGENT][POSITIVE] That, you know what, that's a very good question. I do believe we are. Let me check our calendar. Yes, [PII], we will be closed.
[CUSTOMER][POSITIVE] So that's a good question. I pretty hard.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. [PII] or [PII], right? OK. That is, that is the good news for us as well because if you are going, going to uh uh will be off, we are also going to off.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Wonderful.
[AGENT][POSITIVE] That works for both of us.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Yeah, yeah. And, and, and one more thing which I need to also ask you. The [PII], on which day it will become, I guess it was, it was on Monday, right?
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] OK, it's going to be on the [PII], [PII], we are.
[CUSTOMER][NEUTRAL] No, yeah, but it will be, yeah.
[CUSTOMER][NEUTRAL] But it will come on Monday, right?
[AGENT][NEUTRAL] Right, it will be on a Monday, correct.
[CUSTOMER][NEUTRAL] That is more appropriate for us.
[CUSTOMER][POSITIVE] That would, that would be the more, more joyful for us.
[AGENT][POSITIVE] Exactly, I agree.
[CUSTOMER][NEUTRAL] Because Saturday
[CUSTOMER][NEUTRAL] Yeah, yeah, Saturday, Sunday, and Monday.
[AGENT][POSITIVE] Exactly, yes, definitely.
[CUSTOMER][POSITIVE] Yeah, uh, OK. Thank you, thank you so much, [PII]. It was fantastic talking to you, wonderful day. Bye. Take care.
[AGENT][NEUTRAL] Well
[AGENT][POSITIVE] You as well. Thank you, [PII], and thank you for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Sir, I'll, uh, I'll give you, I'll give you 10 to 10. Bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye.