AccountId: 011433970860
ContactId: 98c5f9de-ecf0-4b21-9905-0fe74d42c6af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 600390 ms
Total Talk Time (AGENT): 302749 ms
Total Talk Time (CUSTOMER): 200481 ms
Interruptions: 10
Overall Sentiment: AGENT=0.7, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/98c5f9de-ecf0-4b21-9905-0fe74d42c6af_20250624T15:27_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] Hi, yes, my name is [PII] and I am checking on a general claim if you could help me, please.
[AGENT][NEUTRAL] And you said your name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I'm so sorry. Can you say that again? There's an echo on our call.
[CUSTOMER][NEUTRAL] Oh, I'm sorry. [PII]. Let's see if that helps. I had it away from my mouth.
[AGENT][NEUTRAL] [PII]. Oh, OK. OK, that's better, [PII]. OK, [PII], and you're needing to check status on a dental claim, is that correct?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] It shows 49,589,000.
[AGENT][NEUTRAL] Hm, OK, so that's not an APL policy number. Were you trying to reach American Public Life?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, let me go.
[CUSTOMER][NEUTRAL] I am, but this is the number that they have on here. Is it the wrong number?
[AGENT][NEUTRAL] Mm, yeah, that is not, yeah, that's not one of our policy numbers, [PII].
[CUSTOMER][NEUTRAL] Well, hold that thought. Let me get into her and let me make sure that that sometimes we don't put the right number in the spot where it needs to be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me get to her.
[CUSTOMER][POSITIVE] Oh, good Lord [PII]. Here we go clicking and you're like, wow.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, what was it?
[CUSTOMER][NEUTRAL] 24579.
[CUSTOMER][NEUTRAL] OK let me.
[CUSTOMER][NEUTRAL] Dental insurance information.
[CUSTOMER][NEUTRAL] OK, that is evidently what she put in. OK, let me see if I've got an actual.
[CUSTOMER][NEUTRAL] For from the insurance company and I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim number, policy number, reference number.
[AGENT][NEUTRAL] Do you have her full social?
[AGENT][NEUTRAL] By chance, [PII]?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] Uh, is, OK, now let's see. And is your patient the subscriber first off?
[CUSTOMER][NEUTRAL] Let me just get in there and get that.
[AGENT][NEUTRAL] Is she the primary policy holder? OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] She is. Her social is [PII]. And I'll just put that as her ID number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So let me, well, if I can locate the policy, I can give you the correct policy number.
[CUSTOMER][POSITIVE] OK, awesome.
[AGENT][NEUTRAL] OK, I just
[CUSTOMER][POSITIVE] I mean I can give you maybe some other information if that will help you.
[AGENT][NEUTRAL] Oh, that's OK. Uh, let's see, I may have located the policy. Um, so in the information that I do provide for you, [PII] will be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Understood.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I did locate a policy in which she is the subscriber and the correct policy number that you should have is 261.
[AGENT][NEUTRAL] 463 4.
[CUSTOMER][NEUTRAL] OK, let me go get that corrected right now.
[AGENT][NEUTRAL] And it is active and the effective date we have is [PII].
[CUSTOMER][NEUTRAL] 61468.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now, let me make sure that I
[AGENT][NEUTRAL] And what is your date of, oh, OK.
[CUSTOMER][NEUTRAL] Oh, our data er my data service is [PII].
[AGENT][NEUTRAL] And the bill amount?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Pretty bad. My brain's tired. 279.
[AGENT][NEUTRAL] 279. OK, thank you. One moment. Let me see if we've received that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] I need to make sure that the claim went where it was supposed to go as well, so.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, so we did receive this claim, [PII]. It was received on [PII].
[CUSTOMER][POSITIVE] OK, so we're, we're supposed to go. Good deal. All right.
[AGENT][NEUTRAL] Uh-huh. There we go. And it was processed on [PII].
[AGENT][NEUTRAL] The claim number is 361.
[AGENT][NEUTRAL] 45. OK. Sure. Uh-huh.
[CUSTOMER][NEUTRAL] Wait, hold, hold that thought for [PII]. I can hold up, hold, hold on.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, good Lord [PII].
[CUSTOMER][NEUTRAL] Don't you hate it when everything was on top of things.
[AGENT][NEGATIVE] That's OK. I couldn't speak this morning. Everything I want to say just came out like completely wrong and I was like, and I know I haven't had too much coffee to make that occur, I haven't had enough coffee.
[CUSTOMER][POSITIVE] Oh, OK. I'm ready for that number now.
[AGENT][NEUTRAL] Alright, claim number is 361.
[AGENT][NEUTRAL] 4501.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] And there was a benefit paid in the amount of $164.80.
[AGENT][NEUTRAL] And that was issued on single.
[CUSTOMER][NEUTRAL] 164.80, correct?
[AGENT][NEUTRAL] Correct. Uh-huh. That was issued on check number 205.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 0577
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when is that set to go out?
[AGENT][NEUTRAL] That, uh, let's see, it went through nightly. It was issued on [PII]. Uh, let me look to see. So that would have been, it would have had to go through nightly processing, so that would have just mailed out this past Thursday.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Possibly not until Friday, but it should have gone on Thursday. So it should be, it just hasn't had quite enough time to reach you all yet.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now there should be an explanation of benefits, [PII] as well that comes along with that check, but we also have a portal that you should be able to use that claim number to print the EOB from.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And the website for the portal.
[CUSTOMER][POSITIVE] I went when I went to the, it just, I'm ready.
[AGENT][NEUTRAL] Uh-huh. Yeah, sometimes you have, it's, yeah, when you go to the portal, it's much easier if you have the claim number. You should be able to access it with the other information, but um, generally if you have a claim number, you can, you can get it. But the website for the portal is secured. [PII].
[CUSTOMER][POSITIVE] I'm ready for the portal.
[CUSTOMER][NEUTRAL] Got it. 3 homework on Friday.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[CUSTOMER][NEUTRAL] Now, when it opens this, it says welcome to OSC and then it has create your OSC account.
[AGENT][NEUTRAL] Correct. Uh-huh. So you would just.
[CUSTOMER][NEUTRAL] OK, that is what I want to do because it's like it was talking about a patient, you know, for their own usage. OK.
[AGENT][NEUTRAL] No, OK, so when you select to create the OSC account on the next screen it's gonna give some different boxes. There's one that says provider.
[AGENT][NEUTRAL] So that's the one you would select.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] And then from there next, and you'll put in the tax ID number.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] And complete your account set up. Awesome, then I will get that set up and I'll have that to go to next time.
[AGENT][NEUTRAL] And it
[AGENT][NEUTRAL] Yeah, and it should, yeah.
[AGENT][POSITIVE] And if you were to like log once she. Oh, well, that's very sweet of you say, but it was my pleasure in helping you today. And [PII], um, in the future, so for example, if you were to try to log into the portal once you get it set up and it can't find a claim for the member, it could be a couple of different things. Like I said, it should find it if you have all the required information that you're looking for for your patient if we have received and processed the claim. If it tells you no claims found, then that
[CUSTOMER][POSITIVE] You are wonderful.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Typically would mean that we haven't received it yet.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Which is why you can't locate it. So we would have to have a claim for that member under that tax ID number.
[CUSTOMER][NEUTRAL] Understood.
[CUSTOMER][POSITIVE] Wonderful. You have been excellent. Thank you so much for your time and trouble. I appreciate it.
[AGENT][POSITIVE] Oh, well, you are certainly very welcome. Is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, you've given me everything I need.
[AGENT][POSITIVE] OK, well then, thank you so much for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.