AccountId: 011433970860
ContactId: 9c86d972-08bc-446b-88de-08ad1d37c641
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 493410 ms
Total Talk Time (AGENT): 212780 ms
Total Talk Time (CUSTOMER): 151291 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/9c86d972-08bc-446b-88de-08ad1d37c641_20250605T20:17_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from provider's office. The call is regarding claim.
[AGENT][NEUTRAL] OK. Did you say your name is [PII]?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] OK, [PII], and you're needing claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yes. So then I can help you with that. And what is your callback number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] Yeah, sure, and the member ID is L as in Lima 6 I A screen D delta 32.
[AGENT][NEUTRAL] OK. OK, let me, I, oh, I'm so sorry, [PII], let me just stop you right there because that's not our policy number for American Public Life Insurance.
[CUSTOMER][NEUTRAL] OK, but I do have one, yeah, so you have only numeric, uh, member ID, right?
[AGENT][NEUTRAL] I need the member's policy number for American Public Life Insurance. Is that the company you were trying to reach?
[CUSTOMER][NEUTRAL] Yes, it's [PII] at it. Uh, well, uh, can you check with the patient name instead?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Do you, you, you don't have a copy of the ID card, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, right now I'm checking my software, uh, uh, if I do have, I can provide you that, but, um.
[CUSTOMER][NEUTRAL] One minute.
[CUSTOMER][NEUTRAL] Uh yes, I do. I'm sorry for that, uh, the policy number which I do have is 01.
[CUSTOMER][NEUTRAL] 554894.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Yes, one minute. I just need to close this check. Thank you for it, uh.
[CUSTOMER][NEUTRAL] [PII] with [PII] on [PII] is patientD number.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the date of service and total bill amount?
[AGENT][NEUTRAL] Hello, [PII], are you still there?
[CUSTOMER][NEUTRAL] 33. I was on a mute. Sorry for that. And uh yes, I'm there. I was speaking so uh the date of service is June, sorry, it's [PII] total charge of $120.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So [PII] and the bill amount?
[CUSTOMER][NEUTRAL] $120.
[AGENT][NEUTRAL] 120. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] OK, so the most recently received claim was denied as a duplicate. Do you need the original claim status?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the original claim was received on [PII].
[AGENT][NEUTRAL] And it was denied on [PII].
[AGENT][NEUTRAL] And that claim number is 351-8716.
[AGENT][NEUTRAL] And the reason for the denial on this claim, [PII] states.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Office visits are not covered by the above numbered policy. The members supplemental policy does not cover office visits.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So offices are not uh covered under the member's plan, right?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And if you need a copy of this explanation of benefits, [PII], with that remark on there now that you have the claim number, you should be able to print that from our portal by going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, so I'll just take the.
[AGENT][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] Thank you for that. And uh before going to next station, what will be the contact number?
[AGENT][NEUTRAL] My name and today's date, and you said that you had one patient. How many patients do you have?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I do one more patient, uh, totally 2 patients with 1 and 1 more idea.
[AGENT][NEUTRAL] Um, I'm sorry. You have two different patients, is that correct?
[CUSTOMER][NEUTRAL] No, I do have only one more. Yeah, yes.
[AGENT][NEUTRAL] OK [PII], so the same information will apply. It'll be my name in today's date that you would use as call reference number, any information that I provide for you a verification of benefits and not a guarantee of payment. And if the claim is on file once I provide you with the claim number, you should be able to print that from our portal if you need a copy of the explanation of benefits by going to that website that I gave you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So what is
[AGENT][NEUTRAL] One moment. What is the next member's policy number?
[CUSTOMER][NEUTRAL] 31551671.
[AGENT][NEUTRAL] I'm sorry, your voice, I'm not, I'm having trouble hearing you, [PII]. Say that again.
[CUSTOMER][NEUTRAL] Well, can you hear me?
[AGENT][NEUTRAL] That's better. Mhm.
[CUSTOMER][NEUTRAL] Uh, but the issue is that, uh, my system gets stuck so I cannot move on for the next claim that you have, so it will take some time to, uh, resolve my system. So can I call back once the issue is resolved?
[AGENT][NEUTRAL] So you're having a technical issue with your system. Is that correct, [PII]?
[CUSTOMER][POSITIVE] Yes, yes, yes, you're right.
[AGENT][NEUTRAL] Uh, yes, sir. I mean, if, if you need to call back, I mean if.
[AGENT][NEUTRAL] I can wait if you think it's going to be just a moment or two. If you want to call back, then, you know, that's fine as well. It's up to you.
[CUSTOMER][NEGATIVE] Uh, yes, so, uh, it just that I cannot do anything since I'm checking on it. I don't know when it could be resolved, so I don't want you to want, uh, waste your time. So at least just give me a call. Is it OK, [PII].
[AGENT][NEUTRAL] OK, well then that's fine if you want to call back.
[AGENT][NEUTRAL] Is there anything else, [PII], I could help you with at the moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that's it. So, uh, from my end, I cannot, uh, discredit the card, so can you do that for me?
[AGENT][POSITIVE] OK, well if that is all I can help you with at the moment, [PII], thank you for calling APL and then should I not be the person that you reach when you call back, it was nice speaking to you today and I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Uh-huh. Bye-bye.