AccountId: 011433970860
ContactId: 5f7527ad-0f57-4e19-965c-322d463d1f41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318609 ms
Total Talk Time (AGENT): 152410 ms
Total Talk Time (CUSTOMER): 86603 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/5f7527ad-0f57-4e19-965c-322d463d1f41_20250113T19:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. Um, I keep getting a, uh, explanation of benefits about my son.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have, I'm not sure what this is for.
[AGENT][NEUTRAL] OK, I can help you spell your first name for me.
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] OK, [PII], do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02.
[CUSTOMER][NEUTRAL] 33
[CUSTOMER][NEUTRAL] 5151.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And did you say the policy is for your son?
[CUSTOMER][NEUTRAL] Yeah, uh, it says provider of service, uh, regions of University of, uh, uh, Michigan.
[AGENT][NEUTRAL] OK, [PII], which you're the policy holder, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what is your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And what's your son's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] And did you say that you received something from American Public Life in the mail?
[CUSTOMER][NEUTRAL] Yeah, I keep getting these letters. I don't know what they're for.
[AGENT][NEUTRAL] Is it like an explanation of benefits just showing you how the claim was processed?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and so the last one that you received, there should be a claim number on there.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What number is that?
[CUSTOMER][NEUTRAL] Um, 35.
[AGENT][NEUTRAL] What is that number?
[CUSTOMER][NEUTRAL] OK it's 3541.
[CUSTOMER][NEUTRAL] 438
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Take a look at that one for you.
[AGENT][NEUTRAL] OK, so we processed this claim on the [PII]. Uh, we received it from Regents of University of uh.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] It looks like the provider may be submitting these claims to the incorrect insurance company because your policy termed in 23. Let me pull up that claim real quick.
[AGENT][NEUTRAL] It could be a matter of contacting this location. We have several.
[AGENT][NEUTRAL] From this location, or more than several.
[AGENT][NEUTRAL] And let's see, I think they may be just sending them to the wrong insurance company for payment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I'm gonna get, I'm gonna get the full name.
[AGENT][NEUTRAL] Uh, Res University of Michigan, uh, Doctor [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Services were done at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And so it looks like they may be sending them to if you have other coverage do you have other coverage?
[CUSTOMER][NEUTRAL] Yeah, that's why I, I'm not understanding what's going on.
[AGENT][NEUTRAL] OK. Well, it appears that they may be sending them to the wrong insurance company.
[CUSTOMER][NEUTRAL] OK, is there a number I can call you guys?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I don't see I don't see a number where I can call this uh doctor.
[AGENT][NEUTRAL] Are, are you getting a, uh, are you getting invoices from this doctor?
[CUSTOMER][NEUTRAL] No, I, I just, like I said, it just tells me explanation of benefits.
[AGENT][NEUTRAL] OK. I have a phone number on their claim. Are you famili affiliated? I mean, are you uh familiar with the office Regents of University of Michigan?
[CUSTOMER][NEUTRAL] American public.
[CUSTOMER][NEUTRAL] I, I'm not my wife usually deals with that stuff.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My ex-wife
[AGENT][NEUTRAL] I'm showing a phone number of [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is there an extension?
[AGENT][NEUTRAL] And so,
[AGENT][NEUTRAL] It doesn't give an extension. Um, you may just wanna ask for the billing department when you dial that number. Um, the latest claim was date of service [PII], and it goes all the way back to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] March
[AGENT][NEUTRAL] [PII] they've submitted several cla well quite a few claims to this address, so you may wanna have them go back that far and maybe get those submitted to the correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll do that right now.
[AGENT][NEUTRAL] OK. Any other questions, [PII], I can help out with today?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] All [PII]. Thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK bye bye.