AccountId: 011433970860
ContactId: 6dda7fd9-c660-42a2-b7de-7fc76919876e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 153000 ms
Total Talk Time (AGENT): 69290 ms
Total Talk Time (CUSTOMER): 65439 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/6dda7fd9-c660-42a2-b7de-7fc76919876e_20250618T14:12_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, so I'm just needing to get status on a claim that was submitted.
[AGENT][NEUTRAL] Sure, I can assist you with that. Are you the insured or the provider?
[CUSTOMER][NEUTRAL] No, I'm with the provider's office.
[AGENT][NEUTRAL] Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII].
[CUSTOMER][NEUTRAL] Direct line [PII].
[AGENT][NEUTRAL] [PII], what is the policy number of the member that you're calling to verify claim status for?
[CUSTOMER][NEUTRAL] 01907883
[AGENT][NEUTRAL] Could you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And on your calling to check the status of the claim for [PII]. What is the date of service?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII] build amount was $125.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 1722.
[AGENT][NEUTRAL] 1722.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I know, are you, are you aware that this is the gap insurance? This is the gap insurance.
[CUSTOMER][NEUTRAL] Um, that's pretty much what I was figuring it was, um, so that's one of the things that was kind of out of place on my end, um, and I just need to verify that, yeah.
[AGENT][NEUTRAL] So the policy this
[CUSTOMER][NEUTRAL] Because it processed ahead of what should have been her, yeah, commercial policy.
[AGENT][NEUTRAL] So this claim was submitted [PII] and it was processed [PII]. There was no payment made because we were requesting a primary EOB.
[CUSTOMER][NEUTRAL] OK, that's kind of what I figured, but I just need.
[AGENT][NEUTRAL] This policy is designed um to pay the deductible co-pay and co-insurance with the primary ELB whatever went towards it, but you have to submit the primary ELB here to American Public Life along with the claim.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yep, OK, that's kind of what I figured. I just need to get that confirmation on it so we can send this back to our registration team, have the coverage entered incorrectly here. They're gonna be in reverse order that they should be so.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] All right, if I can just get a reference number, ma'am.
[AGENT][NEUTRAL] We don't provide those. We don't provide reference numbers, [PII], however, you can use my name as today's date as a reference.
[CUSTOMER][NEUTRAL] Just a reference number for our call.
[CUSTOMER][POSITIVE] That'll work, thank you, ma'am. I appreciate all your help you have a great rest of your day.
[AGENT][POSITIVE] Thanks for calling APA. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Bye.