AccountId: 011433970860
ContactId: 91988c5b-6042-4eb2-8727-a5492166730d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 268100 ms
Total Talk Time (AGENT): 128630 ms
Total Talk Time (CUSTOMER): 118724 ms
Interruptions: 4
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/91988c5b-6042-4eb2-8727-a5492166730d_20250605T15:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning, [PII]. My name is [PII]. I'm with Derm Care Practitioners, and I received from American Public Life Insurance Company an explanation of benefits on one of our patients, and it gave me a number to call and I did and the young lady said that she couldn't help me, she couldn't find the patient, so I'm wondering if you have the patient her name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, are we just needing a clarification regarding um what was on the EOV?
[CUSTOMER][POSITIVE] Yes, yes, please.
[AGENT][NEUTRAL] OK, sure uh let me see if I can find her for you. uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], that is a direct line.
[AGENT][NEUTRAL] OK thank you um now on the, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I have her, I have her policy number, her policy number, would that help? OK, 02466099.
[AGENT][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and this was for [PII], uh, do you have her date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Perfect. OK, thank you so much for verifying that. Alrighty, um, do you have that claim number, [PII]?
[CUSTOMER][NEUTRAL] Uh, there's a reference number. Let me see if there's a claim number on the front of it. Policy number. It's a reference number, no with a 3, no.
[AGENT][NEUTRAL] It should begin with a 3.
[AGENT][NEUTRAL] Um, yes, that would be the claim number. OK, that's all right. Let's see if I can find it another way. Um, what was the, uh, date of service?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Data service.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Uh, that would be.
[CUSTOMER][NEUTRAL] [PII] for $148.
[AGENT][POSITIVE] Got it. OK, thank you one moment.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] OK, and this was with uh germ care practitioners?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, OK, I did find this claim it uh actually looks like it just completed processing, um, just today.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, um, OK, so for this claim we did pay a benefit of $75 and that did meet their maximum, uh, benefit payable for this date of service.
[CUSTOMER][NEUTRAL] OK, and she owes nothing, no copay or co-insurance?
[AGENT][NEUTRAL] So this, right, so this policy, it's a limited indemnity medical plan. So it's it's quite different than traditional major medical. Uh, this was just simply the maximum amount payable, um, no co-pays, no deductibles, nothing like that.
[CUSTOMER][NEUTRAL] OK, OK. And will it come in a check form or EFT?
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Yes, it will be a paper check. Um, I don't have that information just yet as, uh, it's looks like it's in the final stage of processing, um, so either later today or uh latest I would say tomorrow, um, that information should be updated.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It just
[CUSTOMER][NEUTRAL] Oh, that's
[AGENT][POSITIVE] We can get you that check number and everything.
[CUSTOMER][NEUTRAL] OK. Well, [PII], you.
[CUSTOMER][POSITIVE] That's very nice of you to look at this for me. Is there a reference number for our call?
[AGENT][POSITIVE] Oh, absolutely. Happy to help.
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial, yes, my first name, last initial, and today's date. Yes, uh so my name is spelled [PII] And was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] Is there a reference number?
[CUSTOMER][NEUTRAL] And do they
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, I appreciate this. Thank you very much.
[AGENT][POSITIVE] Absolutely all right thank you have a great rest of your day.
[CUSTOMER][NEUTRAL] Mhm bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mm