AccountId: 011433970860
ContactId: 6c58dcca-34ca-4061-8ab6-e709b87a61fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 607570 ms
Total Talk Time (AGENT): 145312 ms
Total Talk Time (CUSTOMER): 142081 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/6c58dcca-34ca-4061-8ab6-e709b87a61fc_20250409T21:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hello, are you there?
[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] Hi, this is [PII] from Proos.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, [PII], do you have the policy number?
[CUSTOMER][NEUTRAL] No, I just called you for asking the general claim status.
[AGENT][NEUTRAL] A dental claim status?
[CUSTOMER][NEUTRAL] Yes, for general information.
[AGENT][NEUTRAL] OK so we have to have the policy number.
[AGENT][NEUTRAL] Or so you're a provider, right?
[CUSTOMER][NEUTRAL] Yes, I'm a provider.
[AGENT][NEUTRAL] OK, so do you have the policy number or the patient's first and last name?
[CUSTOMER][NEUTRAL] Yeah, yeah, I have a patient's first name and the last name.
[AGENT][NEUTRAL] OK. And then what is the first name?
[CUSTOMER][NEUTRAL] [PII], and the last name is [PII].
[AGENT][NEUTRAL] OK, and can you spell that for me, please?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, hi. I think you cut out. Um, can you spell that for me?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Ma'am, I just, uh,
[CUSTOMER][NEUTRAL] Ma'am, I just need uh.
[CUSTOMER][NEUTRAL] PSL to submit the claim.
[AGENT][NEUTRAL] So I can't
[CUSTOMER][NEUTRAL] As you are secondary, I just need to submit the claim.
[AGENT][NEUTRAL] So I can't give you.
[CUSTOMER][NEUTRAL] Primary paid the payment.
[AGENT][NEUTRAL] I cannot give you claim status.
[CUSTOMER][NEUTRAL] I just need these details alone, ma'am.
[CUSTOMER][NEUTRAL] I just need the TFL to submit the claim as a secondary, ma'am.
[CUSTOMER][NEUTRAL] As Prime is paid the payment. We just need to submit the claim as a secondary. Upon checking from my end, you are a secondary insurance.
[AGENT][NEUTRAL] Yes, we are a 2nd.
[CUSTOMER][NEUTRAL] So, to submit the claim,
[CUSTOMER][NEUTRAL] Yes, ma'am. I just need the TFL to submit the claim as a secondary time finding limit.
[AGENT][NEUTRAL] OK, there is no filing limit with APL.
[CUSTOMER][NEUTRAL] There's no time filing limit.
[AGENT][NEUTRAL] OK, so we need the policy number.
[CUSTOMER][NEUTRAL] Then how I can uh submit the claim as a secondary, ma'am?
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] That's your secondary, sorry, how I can submit the claim? Because primary has paid the payment.
[AGENT][NEUTRAL] Do you need
[CUSTOMER][NEUTRAL] We need to submit the claim.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] So I need to verify the patient first.
[CUSTOMER][NEUTRAL] Uh, ma'am, just a minute.
[AGENT][NEUTRAL] Yes, I cannot give you claim status without verifying the patient.
[CUSTOMER][NEUTRAL] Um, just a minute, just a minute.
[CUSTOMER][NEUTRAL] And the patient's name is [PII].
[AGENT][NEUTRAL] OK, and can you spell her first and last name for me?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII] the last name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] OK. So, I am not finding the patient under [PII]. Can you have the, can you call the patient and get their policy number for me?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Ma'am, I have a member ID. Could you please check with that?
[AGENT][NEUTRAL] Yes, what is the member ID?
[CUSTOMER][NEUTRAL] It's 000008473257.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, so unfortunately, this is not the APO policy number. Nothing is popping up.
[CUSTOMER][NEUTRAL] American Republic Insurance Company.
[CUSTOMER][NEUTRAL] Am I right, ma'am?
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am, but the first and last name you're giving me and the policy number, that member number is not.
[AGENT][NEGATIVE] It's not working.
[CUSTOMER][NEUTRAL] Could you please check with the SSN number of the members?
[AGENT][NEUTRAL] Do you have, do you happen to have a policy, uh, there, it should say policy cert number on it.
[CUSTOMER][NEUTRAL] Yeah, ma'am
[CUSTOMER][NEUTRAL] I'm just saying the member ID ma'am.
[AGENT][NEGATIVE] Yes, ma'am, and that number is not working, um.
[AGENT][NEUTRAL] You could ask American Republic or American Public Life.
[CUSTOMER][NEUTRAL] American Republic Insurance Company.
[CUSTOMER][NEUTRAL] You're the 2nd insurance.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Ma'am, I just need to submit the claim as a secondary, ma'am. Could you please provide me the TSL to submit the claim?
[AGENT][NEUTRAL] I cannot provide you with claim status if there is not a policy number.
[CUSTOMER][NEUTRAL] Could you please check with the member's social security number?
[AGENT][NEUTRAL] Are you saying the number on the insurance, are you saying the name on the insurance company? Does it say American Republic on it?
[CUSTOMER][NEUTRAL] Yes, ma'am. American Republic Insurance Company is a secondary insurance. We need to submit the claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we are a.
[AGENT][NEUTRAL] We're APL that we're a different company than American Republic.
[AGENT][NEUTRAL] You will have to call American Republic.
[CUSTOMER][POSITIVE] No problem, ma'am.
[AGENT][NEUTRAL] Yes, you'll need to call American Public.
[CUSTOMER][NEUTRAL] Yes, ma'am. American Republic Insurance Company.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, this is APL, not American Public Company.
[AGENT][NEUTRAL] So you will have to give them a call.
[AGENT][NEUTRAL] Any other questions?
[CUSTOMER][NEUTRAL] It's all, ma'am.
[CUSTOMER][POSITIVE] Thank you for the assistance.
[AGENT][POSITIVE] Yes, thank you for calling APL. Have a good day.