AccountId: 011433970860
ContactId: 6a45b4c1-d3c1-46dc-8664-cdf0860c3a52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352140 ms
Total Talk Time (AGENT): 96671 ms
Total Talk Time (CUSTOMER): 108145 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/6a45b4c1-d3c1-46dc-8664-cdf0860c3a52_20250110T13:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I got a denial saying that my claim was a duplicate. I was just trying to see if I could find the original claim.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And give me your name and the policy number.
[CUSTOMER][NEUTRAL] Um, I'm a provider. My name is [PII]. Um.
[AGENT][NEUTRAL] Oh, give me the patience.
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII] is his name. His policy number.
[CUSTOMER][NEUTRAL] 001777765
[AGENT][NEUTRAL] And what's a good callback number, [PII] in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I'm pulling up your information.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, so I show that the policy is administered by Web TPA which is a different, um, company. What's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the explanation of duplication that you received, does the number begin with a.
[AGENT][NEUTRAL] What's the policy number? I mean the claim number on there.
[CUSTOMER][NEGATIVE] There's not a claim number, my payment posters are not the best.
[AGENT][NEUTRAL] OK, OK, do you have the EOB in front of you?
[CUSTOMER][NEUTRAL] Yes, it just says that it's a duplicate.
[AGENT][NEUTRAL] Does it say it's from web TPA?
[CUSTOMER][NEUTRAL] That's all I see.
[CUSTOMER][NEUTRAL] It says American public life, that's all it says.
[CUSTOMER][NEUTRAL] OK, I will.
[CUSTOMER][NEUTRAL] I will reach out to web TVPA maybe they can.
[AGENT][NEUTRAL] Is it a is it a is it a medical or dental claim?
[CUSTOMER][NEUTRAL] It's a medical claim.
[AGENT][NEUTRAL] OK, yeah, so it'll come the ELB would come from web TPA.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because they administer the medical. Do you have a phone number for them? If not, I can give it to you and transfer you if you would like.
[CUSTOMER][POSITIVE] Oh, that would be fantastic.
[AGENT][NEUTRAL] OK. The number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] And we can get you connected to that area.
[CUSTOMER][POSITIVE] All right, thank you so much for your help.
[AGENT][NEUTRAL] You're welcome, [PII]. Did you have any other questions before we transfer?
[CUSTOMER][NEUTRAL] Uh, no, that was all.
[AGENT][POSITIVE] OK, thank you for calling APL have a good day and give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Welcome to TPA, the ads.
[CUSTOMER][NEUTRAL] Please note, your call may be monitored or recorded for quality assurance. The information provided during this call is only a description of benefits and is not a guarantee of payment. Benefits are based upon eligibility at the time services are rendered and all plan provisions.
[CUSTOMER][NEUTRAL] Thank you for calling customer service. This is [PII]. May I have the member's ID number please?
[AGENT][NEUTRAL] Hi, [PII]. Uh, the number is 0017.
[AGENT][NEUTRAL] 777.
[AGENT][NEUTRAL] 65
[AGENT][NEUTRAL] And I have [PII] with the providers. Go ahead.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK, I was gonna say that's 4 consecutive 7.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] What is the name of the patient they're calling on?
[AGENT][NEUTRAL] It, it's [PII]. Date of birth is [PII].
[CUSTOMER][POSITIVE] Thank you his information is.
[AGENT][POSITIVE] And she's, you're welcome.
[CUSTOMER][NEUTRAL] You said [PII].
[AGENT][NEUTRAL] Uh, the provider's office. I'm speaking with [PII].
[CUSTOMER][NEUTRAL] Oh, [PII], OK, what is your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] To yeah and you're with APL.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And we have [PII] on the line, OK? And go ahead and transfer. I have the patient's information loaded.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] OK, and she's calling about a claim and I'll get her transferred over. [PII], thank you so much. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too.