AccountId: 011433970860
ContactId: 753a108d-11f9-40b2-b01b-78e9c4a4ce76
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 814940 ms
Total Talk Time (AGENT): 235154 ms
Total Talk Time (CUSTOMER): 152471 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/753a108d-11f9-40b2-b01b-78e9c4a4ce76_20250129T14:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII], and I'm calling in regards to, well, I'm calling from an office of agents.
[CUSTOMER][NEUTRAL] Um, and I'm calling in regards to 3 separate claims.
[CUSTOMER][NEUTRAL] Just to get the status of them and I think yeah all three show processed on the site so I was just calling to get the payment amount and when it was processed.
[AGENT][NEUTRAL] OK, [PII], so you're calling from an agent's office, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Is that what you said?
[AGENT][NEUTRAL] OK, and you're needing to check claims service. Is it for 3 different members?
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] OK, yes, I can help you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you. And what is the first policy number?
[CUSTOMER][NEUTRAL] It is 244-498-2.
[AGENT][NEUTRAL] OK, thank you, [PII]. So what I'll need to do on each one is I'll have to verify several things with you first for security purposes and then we can go from there, OK?
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] And any information that I provide for you will be a verification of benefits and not a guarantee of payment.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] Alright, give me just a moment, [PII], it's taking a moment to pull something up for me.
[CUSTOMER][POSITIVE] You're good take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] I apologize for any background noise, uh, for office today.
[AGENT][NEUTRAL] Oh, that's, uh, that's nothing compared to.
[AGENT][NEUTRAL] I don't actually hear anything. OK, so what is the first off, what is the.
[CUSTOMER][NEUTRAL] Oh, I can only imagine the things here.
[AGENT][NEUTRAL] Uh, what is the name of the group for this member?
[CUSTOMER][NEUTRAL] Um, it should beer incorporated.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] What is it again?
[AGENT][NEUTRAL] But this gentleman?
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] For this insured, who's the employer?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It should be serving for [PII]
[AGENT][NEUTRAL] No, no, no, no. Who does the subscriber work for?
[CUSTOMER][NEUTRAL] Uh, serve incorporated should be the group.
[AGENT][NEUTRAL] Serve incorporated.
[CUSTOMER][NEUTRAL] Yeah, S E R V E.
[AGENT][NEUTRAL] OK, now that's not the name of this group that we have in our system.
[CUSTOMER][NEUTRAL] You, you're talking about the policy holder that I called on, right? that I gave you the policy for?
[AGENT][NEUTRAL] Yeah, what group are they under?
[CUSTOMER][POSITIVE] Uh, er, uh, yeah, it should be serving corporate, um, it should, it might be secure rehab and vocational.
[AGENT][NEUTRAL] That's not how
[AGENT][NEUTRAL] OK. All right. And then.
[CUSTOMER][NEUTRAL] Enterprises, yeah, sorry, that was the.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's what I was looking for. And who is the agent of record?
[CUSTOMER][NEUTRAL] Um, [PII] RMB Insurance Services.
[AGENT][NEUTRAL] OK, and then what is your email address, please, [PII]?
[CUSTOMER][NEGATIVE] Should be claims at
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And then what is your, what is the insured's date of birth?
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, and do you have the claim number or the date, what is the data service and total bill amount that I'm looking for?
[CUSTOMER][NEUTRAL] Um, the data service was 4-16-2024, and I don't have a build amount. I can give you the claim number though.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Just a
[CUSTOMER][NEUTRAL] No, it was for a dental exam. We just don't have any documentation for the bill for it.
[AGENT][NEUTRAL] This OK.
[AGENT][NEUTRAL] Is this a screening claim?
[CUSTOMER][NEUTRAL] Uh, yeah, it should have been a critical in our cancer wellness.
[AGENT][NEUTRAL] And what is the claim number?
[CUSTOMER][NEUTRAL] It is 355-66997.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So yes, this claim has been processed.
[AGENT][NEUTRAL] And this claim was, there was a benefit paid in the amount of $50 and that claim was processed on yesterday.
[CUSTOMER][POSITIVE] Great
[AGENT][NEUTRAL] And it should go direct deposit to the insured.
[CUSTOMER][POSITIVE] Ready.
[AGENT][NEUTRAL] Give me just a moment to finish my note on this one, [PII], before we move on to the next one.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you say something, [PII]?
[CUSTOMER][POSITIVE] Oh no I was just saying no problem you're good take your time.
[AGENT][NEUTRAL] Oh, OK. OK, thanks.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Sorry, it's taking a minute, [PII].
[CUSTOMER][POSITIVE] No you're good.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] Wouldn't be technology if it worked so.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and what is the next policy number?
[CUSTOMER][NEUTRAL] And 246.
[CUSTOMER][NEUTRAL] 4225
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And the patient's name and date of birth on this one?
[CUSTOMER][NEUTRAL] Is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] They provided on any of these claims all of them would be a verification of benefits and not a guarantee of payment. So what is the data service for her in total bill amount or if you don't have that the data service.
[CUSTOMER][NEUTRAL] Um, it is a, this was a dental exam on [PII] and the claim number is 3556685.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this claim was processed yesterday as well.
[AGENT][NEUTRAL] And the benefit has been paid in the amount of $50.
[AGENT][NEUTRAL] And that will be via check to the insured.
[AGENT][NEUTRAL] And do you need anything else on this one?
[CUSTOMER][POSITIVE] Um, no, I think that one is all good.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And the next member's policy number, please.
[CUSTOMER][NEUTRAL] It's 2291621.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], well, the policy holder is [PII]. It was for [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And what's his date of birth?
[CUSTOMER][NEUTRAL] Um, his birth date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And his date is [PII]?
[CUSTOMER][NEUTRAL] Is [PII] 2025.
[CUSTOMER][NEUTRAL] For a testicular ultrasound.
[AGENT][NEUTRAL] OK, I don't say that we have a claim.
[CUSTOMER][NEUTRAL] And then I have the claim number as well.
[AGENT][NEUTRAL] OK, we do not have a claim on this policy under his name for that data service.
[AGENT][NEUTRAL] For [PII] 112025.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Uh, 121 2025 sorry.
[AGENT][NEUTRAL] 121, OK.
[AGENT][NEUTRAL] And the claim number that you have?
[CUSTOMER][NEUTRAL] 355-6034.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so there was also, there was a benefit paid in the amount of $50 to the insured on this. It was processed on $127 and that is also going to be for direct deposit.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] All [PII]. Well, is there anything else?
[CUSTOMER][NEUTRAL] And that is the last one I have.
[AGENT][POSITIVE] OK, well, if that's all, [PII], then I can help you with this morning. Thank you again for calling APL and I hope that you have a great day.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] Yes, sir. Thank you very much.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye bye.