AccountId: 011433970860
ContactId: a0618f35-6317-4bf8-aa32-536533dee52d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447589 ms
Total Talk Time (AGENT): 174345 ms
Total Talk Time (CUSTOMER): 170087 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/a0618f35-6317-4bf8-aa32-536533dee52d_20250114T18:58_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Good afternoon [PII]. My name is [PII]. I'm calling on behalf of my um husband. I believe I spoke to a rep. I don't know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what you need so that I can give it to you. The policy number is 01.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 4.
[CUSTOMER][NEUTRAL] 3092.
[AGENT][NEUTRAL] 01463092 did I hear that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Wonderful thank you and.
[AGENT][NEUTRAL] Would you be able to verify for me, Miss [PII], your fir uh your last name and your date of birth?
[CUSTOMER][NEUTRAL] My last name is [PII], and my date of birth, my date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you I appreciate that and do you mind if I also just grab a quick call back number from you in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Perfect. And you, um, I just need to verify a couple more things with you and then I'll be able to write. I cannot talk. I'm so sorry, Miss [PII]. I'll be able to move on. Um, could you verify for me please your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and then just the email on file will be fine.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful I really appreciate that and you said you're calling on behalf of your husband. Was there something I could help you with?
[CUSTOMER][NEUTRAL] Yes. Um, I spoke to a rep, I believe, on December.
[CUSTOMER][NEUTRAL] I spoke to a red because I, I just came back from out of the country regarding um
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] An outstanding bill from Cleveland Clinic.
[CUSTOMER][NEUTRAL] And even that day I have the Cleveland Clinic posting online that we spoke to the rep, and now they are saying it's office visit. It's not an office visit. It's for the ultrasound that the hospital is charging him, and that's the purpose of the gap. It's not an office visit.
[AGENT][NEUTRAL] OK, um, so I do see that claim on file that you were talking about, um, unfortunately.
[CUSTOMER][NEUTRAL] Like, um, I received something, yeah.
[AGENT][NEUTRAL] Yeah, I was about to say unfortunately I don't process claims um I so I wouldn't be able to like look at the claim and figure out what's going on but if you'd like I can go ahead and put in a request to have an examiner give you a call back um and then they would be able to look at the claim with you.
[CUSTOMER][POSITIVE] You know, I really wanted to do this.
[CUSTOMER][NEUTRAL] I really wanted to do this today because I go back to work tomorrow. I'm a nurse practitioner. By the time you guys call I cannot answer the call because that was so if I can have somebody, if I can speak because I go back to work tomorrow and by the time I finish at [PII], you guys are done. So it's always that's that's why I wanted to do it today because I'm looking at all the mails.
[AGENT][NEUTRAL] Oh, I understand. OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And I, it's, I mean, it's so upsetting that we spent like an hour, my sort of what they have everything wrong, like it was me, it wasn't me.
[CUSTOMER][NEUTRAL] I mean this is from [PII]. This is [PII].
[AGENT][NEUTRAL] Yeah, I understand, um.
[CUSTOMER][NEGATIVE] And I mean, I have a gap on him for 1000. That money is just gonna go to waste.
[AGENT][NEUTRAL] OK, yeah, um, I can definitely if you don't mind I can put you on a brief hold and see if I have an examiner available um that's able to speak right now, OK?
[CUSTOMER][POSITIVE] Yes ma'am, I will really.
[CUSTOMER][POSITIVE] Yes, I will really appreciate it. Thank you.
[AGENT][POSITIVE] Yeah it's my pleasure. I'm gonna put you on a quick hold but I will be right back with you OK?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] That I
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hey this is [PII] with the care team. How are you doing today?
[CUSTOMER][POSITIVE] I'm doing good how about you?
[AGENT][POSITIVE] Hey, I'm doing wonderful. I do have an insured on the line um who is um needing to speak to somebody today about a claim that was denied.
[CUSTOMER][NEUTRAL] OK, may I have the policy number?
[AGENT][NEUTRAL] Yes, I'm looking at policy number 1463092.
[CUSTOMER][NEUTRAL] And the caller?
[AGENT][NEUTRAL] Um, it's Miss [PII], the insured part one.
[CUSTOMER][NEUTRAL] OK, and may I have the call back number?
[AGENT][NEUTRAL] Yes, absolutely it is um the [PII] that she's calling from.
[CUSTOMER][NEUTRAL] And what and what was the claim number again?
[AGENT][NEUTRAL] Yes, it's for her husband claim number 3541035.
[CUSTOMER][NEUTRAL] OK, so what question did she have on this client?
[AGENT][NEUTRAL] Um, yeah, so she, um, stated that she spoke to somebody in December and they spent like an hour on the phone with her an examiner and somebody from the hospital and that this, um, claim here was from a hospital, not from an office visit and so she can't understand why it's being denied for an office visit, um, because it was like for.
[AGENT][NEUTRAL] A procedure done at the hospital?
[CUSTOMER][NEUTRAL] I'm pulling that image up as well.
[CUSTOMER][NEUTRAL] OK, you're more than welcome to transfer because what we received in this is an office visit, so denied correctly.
[AGENT][POSITIVE] OK perfect I will um send her to you, Ms [PII], and I'll introduce you when we join. Is that OK?
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][POSITIVE] Thank you so much. 1 2nd.
[AGENT][NEUTRAL] Hi, Ms. [PII]. Are you still there with us today?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Hey, thank you so much for your patience. I do have Ms. [PII] on the line with us. She's one of our examiners and she's gonna be able to talk to you about that claim, OK?
[CUSTOMER][POSITIVE] Alright, thank you so much, ma'am. You have a blessed day.
[AGENT][POSITIVE] Thank you you too take care.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Hello?