AccountId: 011433970860
ContactId: 9e63a333-c824-487e-977c-0a191e165ab5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457510 ms
Total Talk Time (AGENT): 184859 ms
Total Talk Time (CUSTOMER): 151346 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/9e63a333-c824-487e-977c-0a191e165ab5_20250320T21:15_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Progress Office checking and claim status. Can you hold?
[AGENT][NEUTRAL] I can help you with that, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] extension will be [PII].
[AGENT][NEUTRAL] Thank you, [PII] and what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Give me a moment. The policy ID is 021.
[CUSTOMER][NEUTRAL] 13835.
[AGENT][NEUTRAL] Thank you, [PII] and what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. And you said
[CUSTOMER][NEUTRAL] You said your name is [PII], right?
[AGENT][NEUTRAL] [PII] Now that you said policy number 2113835?
[CUSTOMER][NEUTRAL] 2113835 initially it starts with 0.
[AGENT][NEUTRAL] I'm not showing that patient's name.
[AGENT][NEUTRAL] Under that policy number, do you happen to have a claim number?
[CUSTOMER][NEUTRAL] Give me a moment, uh, the name is [PII].
[CUSTOMER][NEUTRAL] With courage 202113-835. OK, we have submitted correct right.
[CUSTOMER][NEUTRAL] Sure, give me a moment. Let me just double check with member ID, OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] See
[CUSTOMER][NEUTRAL] 102113835 yes.
[CUSTOMER][NEUTRAL] 54.
[CUSTOMER][NEUTRAL] OK, for insurance ID I can see that it's registered under [PII].
[AGENT][NEUTRAL] Not under that policy number. Do you have the
[AGENT][NEUTRAL] Do you happen to have a claim number?
[CUSTOMER][NEUTRAL] I do not have claim number.
[CUSTOMER][NEUTRAL] No, I do not have the claim number.
[AGENT][NEUTRAL] OK. Do you have the patient's social, the policy holder's social?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me check that.
[CUSTOMER][NEUTRAL] Relationship
[CUSTOMER][NEUTRAL] I do not have the social.
[CUSTOMER][NEUTRAL] I have the address if you can verify that.
[AGENT][NEUTRAL] You said last name [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Can you spell the first name?
[CUSTOMER][NEUTRAL] It's [PII]. It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And what state is [PII] from?
[AGENT][NEUTRAL] I've got a lot of [PII], so bear with me, let me see if I can.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I did find a policy. Is this for a medical claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me give you.
[AGENT][NEUTRAL] Um, let me give you a.
[AGENT][NEUTRAL] Number to contact for medical coverage and medical claim status, that would be through the third party administrator Webb TPA.
[AGENT][NEUTRAL] And their phone number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Now, it looks like the policy number um that we have on file for [PII], that policy number is 211.
[AGENT][NEUTRAL] 393 4.
[CUSTOMER][NEUTRAL] Um, just to confirm, it's 211-3934 you said?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, and as per insurance card.
[AGENT][NEUTRAL] And I can transfer you to them, yeah. Do you see it? do you see the web TPA on the you have a credit card? I mean, I apologize, do you have an insurance card?
[CUSTOMER][POSITIVE] Alright, yes, no problem.
[CUSTOMER][NEUTRAL] Yes, I have an insurance card for APO.
[AGENT][NEUTRAL] And do you see the web TPA information?
[CUSTOMER][NEUTRAL] Oh let me see that it will, it will be the behind card, right?
[AGENT][NEUTRAL] I'm sorry, can you repeat that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It will be available behind the card. I can see that it's showing for a public.
[CUSTOMER][NEUTRAL] It's not showing TPA.
[AGENT][NEUTRAL] And on that card, do you see that policy number? What's the policy number you see?
[CUSTOMER][NEUTRAL] 02113835.
[AGENT][NEUTRAL] 221.
[CUSTOMER][NEUTRAL] That's what I provided you.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] 1202113885
[CUSTOMER][NEUTRAL] No, it's 01021.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 13835.
[AGENT][NEUTRAL] Now he had a dental policy that was 2113885.
[CUSTOMER][NEUTRAL] OK, so the idea is for dental. OK, got it. All right. And this will be, and this will be for the medical, right, which you provided?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir, that 211-3934.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And would you like for me to transfer you to them?
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK [PII], I'm gonna transfer you to Web TPA and if you'll hold.
[AGENT][NEUTRAL] If if the call gets disconnected, just call them at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you repeat that number again? Sorry for that.
[AGENT][NEUTRAL] Not a problem. It's [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, our web TP right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yes, and before you transfer the call, can you provide me the call reference for this one?
[AGENT][NEUTRAL] It's my name in today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, and I'll be happy to transfer you, [PII]. Anything else I can help you with before the transfer?
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Uh, can you provide me the family filing limit?
[AGENT][NEUTRAL] And they would be able to answer that for you. They handle the claims. This is the third party administrator.
[CUSTOMER][POSITIVE] Alright, no problem.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] All right, well, hope you'll hold for the transfer. I hope you have a wonderful afternoon.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Welcome at TPA.