AccountId: 011433970860
ContactId: 8ab562fa-1121-4125-8462-8c961645b4a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275839 ms
Total Talk Time (AGENT): 91036 ms
Total Talk Time (CUSTOMER): 69384 ms
Interruptions: 3
Overall Sentiment: AGENT=2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/8ab562fa-1121-4125-8462-8c961645b4a9_20250211T19:28_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII] how may I assist you?
[CUSTOMER][NEUTRAL] Hello, um, I was calling to see if I can get um a claim status.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and the callback number?
[CUSTOMER][NEUTRAL] My name is [PII] and the phone number is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] 01 moment, [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Um, it's gonna be 01638192.
[CUSTOMER][NEUTRAL] On the.
[AGENT][NEUTRAL] Thank you. What is this member's name and date of birth?
[CUSTOMER][NEUTRAL] So the number is um [PII]. Her date of birth is going to be.
[CUSTOMER][NEUTRAL] Well I remember it's [PII], it's her husband, but.
[CUSTOMER][NEUTRAL] Um, [PII]'s is [PII].
[AGENT][NEUTRAL] [PII] is the mem the um
[AGENT][NEUTRAL] Patient, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] This member's policy has been active since [PII] and is currently active. She has a maximum benefit amount of $1500 per calendar year with a $50 deductible that does not apply to preventative services, and this is not a guaranteed benefits, just a disclaimer of the policy's coverage, and I do apologize, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you. Excuse me.
[AGENT][NEUTRAL] Preventative is covered at 100, basic at 80, major at 40.
[CUSTOMER][NEUTRAL] [PII] 40 OK.
[CUSTOMER][NEUTRAL] 40.
[CUSTOMER][NEUTRAL] I do, um, by chance, do you see like any claims on file from June of last year?
[AGENT][NEUTRAL] Give me one moment, so you're calling to check the status of the claim?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what is the date of service for June of last year?
[CUSTOMER][NEUTRAL] Um, it's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Great.
[AGENT][NEUTRAL] And it's for [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, I'm not showing a claim for [PII]. Could you verify how you submitted that claim here to American Public Life?
[CUSTOMER][NEUTRAL] Looks like it was electronic, but I'm not sure if it even made it out.
[CUSTOMER][NEUTRAL] I'm looking at this.
[CUSTOMER][POSITIVE] Very healthy.
[AGENT][NEUTRAL] It's the electronic payer, could you verify that the payer ID?
[CUSTOMER][NEGATIVE] Yeah, I don't think it even made it.
[CUSTOMER][NEUTRAL] Uh, let me, the payer ID that I have is 60801.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] So we have no claim on file. Would you like a fax number?
[CUSTOMER][NEUTRAL] OK, I'm gonna try to resubmit it.
[CUSTOMER][POSITIVE] Yes, if you don't mind.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]. Make sure you give me the right number cause I could give you, I'll be adding my own phone number to the fax number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So bear with me.
[AGENT][NEUTRAL] [PII] that's [PII] attention claims department.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] That the claims department. Alright, thank you so much for your help.
[AGENT][POSITIVE] There's no time to filing. You're welcome. Thanks for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks, goodbye.