AccountId: 011433970860
ContactId: a7fa27e3-6ae4-4428-a43c-1fe043c72d56
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 176039 ms
Total Talk Time (AGENT): 54601 ms
Total Talk Time (CUSTOMER): 62028 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/a7fa27e3-6ae4-4428-a43c-1fe043c72d56_20250605T16:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm with the Regents of the University of Michigan trying to get clarification on a process claim, please.
[AGENT][NEUTRAL] OK. May I please have a callback number?
[CUSTOMER][NEUTRAL] My direct phone is [PII].
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] 02296933
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy you're calling in for status. May I please have the date of service and total bill?
[CUSTOMER][NEUTRAL] [PII] charge amount is $262.
[AGENT][NEUTRAL] And I did pull that claim up for you and you were just needing clarification on that?
[CUSTOMER][NEGATIVE] Right, the EOB we received shows 0 paid.
[CUSTOMER][NEUTRAL] Um, with a comment this product does not have a part provider participation network benefits have not been reduced.
[CUSTOMER][NEGATIVE] Um, it just shows paid of zero. It doesn't really say.
[CUSTOMER][NEUTRAL] If like what to do with the balance is it supposed to go to the member? I'm not really clear.
[AGENT][NEUTRAL] That's not one of our EOBs.
[AGENT][NEUTRAL] The way our EOBs are worded.
[CUSTOMER][NEUTRAL] It says American Public Life Insurance company at the top.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm pulling up the uh EOB that we sent to you.
[AGENT][NEUTRAL] So there's 2 pages to the EOB and it is showing
[AGENT][NEUTRAL] It says the remark is D2H001, which is saying office visits are not covered by the above numbered policy.
[CUSTOMER][NEUTRAL] OK, I only have one page.
[CUSTOMER][POSITIVE] That was scanned into my system so that is very helpful information thank you.
[AGENT][NEUTRAL] Would you like for me to fax this EOB over to you?
[CUSTOMER][POSITIVE] Oh no, that's not necessary. Thank you though.
[AGENT][POSITIVE] You're welcome. I do wanna thank you for calling American Public Life. [PII] have a great rest of your day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you bye.