AccountId: 011433970860
ContactId: b629518f-b0f9-44aa-ae43-15d3c52ac663
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1022950 ms
Total Talk Time (AGENT): 307736 ms
Total Talk Time (CUSTOMER): 234679 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b629518f-b0f9-44aa-ae43-15d3c52ac663_20250204T19:57_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling from Alexander Shenara trial attorneys, uh, calling today to follow up with a claim that I recently, um, sent in a letter of rep for, uh, but I don't, I don't have a claim number. That's what I was kind of calling today. Maybe, um, if you guys need any additional information, I'm happy to go over that.
[AGENT][NEUTRAL] OK, so you said that, what is your name again? I'm sorry, I didn't understand your name. I, I apologize.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Can you spell your name for me?
[CUSTOMER][NEUTRAL] Yes, ma'am. That's [PII]
[AGENT][NEUTRAL] OK, thank you. And what is your callback number please, [PII]?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And which, um, who do you work for?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Trial attorneys.
[AGENT][NEUTRAL] And spell [PII] to make sure I have it correct.
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're wanting to know if we've received your, tell me again exactly what you're trying to find out really. I'm sorry.
[CUSTOMER][NEUTRAL] So I sent in a letter of rep for one of our clients. Uh, they were in a motor vehicle accident, and I just wanna make sure that you guys received my letter of rep and that, um, I wanted to get the claim number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or finalize a claim being set up.
[AGENT][NEUTRAL] OK, and what is your um so you're wanting to verify if we received your letter of representation, is that correct?
[CUSTOMER][NEUTRAL] Yes, and finish setting up the claim if if you guys need more info.
[AGENT][NEUTRAL] OK, and I can partially help you with this, [PII]. What is the member's policy number?
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] I don't have a policy number. Can we go off of their social?
[AGENT][NEUTRAL] Is your client the subscriber on the policy?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. And what is that social?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so any information provided would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Hello, are you still there?
[CUSTOMER][NEUTRAL] Hi [PII], can you hear me?
[AGENT][NEUTRAL] [PII], can you hear me? Yes, I can now. I couldn't. Yes, I, I could not hear. I heard his first and last name, but not his date of birth.
[CUSTOMER][NEUTRAL] I can hear you.
[CUSTOMER][NEUTRAL] That was [PII].
[AGENT][NEUTRAL] OK, thank you. Now this number for the type of plan that he had, um, there is another company that you would actually speak to and that is Web TPA.
[CUSTOMER][NEUTRAL] Web TPA.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh, let me just make a note of that real quick.
[AGENT][POSITIVE] We're and there, sure, and I'll give you their phone number. I can also connect you with them.
[CUSTOMER][NEUTRAL] OK, so are they the ones handling the subrogation?
[AGENT][NEUTRAL] They would handle anything related to this medical policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And their number is [PII].
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] They would verify any type of eligibility or anything for this particular type of plan.
[CUSTOMER][NEUTRAL] So the letter rep that I sent over to you guys, would they have received that? Would you guys have forwarded that to them?
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] Uh, I don't show whether there's been anything received by APL.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] I mean, even in.
[AGENT][NEUTRAL] Let me double check one more thing.
[AGENT][NEUTRAL] Uh, give me just
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Give me just a moment to look at a few things on this policy.
[CUSTOMER][POSITIVE] Yeah, for sure.
[AGENT][POSITIVE] Uh-huh, thank you.
[AGENT][NEUTRAL] Do you mind letting me place you on a brief hold?
[CUSTOMER][POSITIVE] Yeah, no problem.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] [PII], thank you for your patience. I'm still checking on something for you, OK?
[CUSTOMER][POSITIVE] Yes ma'am, of course. Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you so much. So we did receive the documents and yes, it was sent to Web TPA.
[CUSTOMER][POSITIVE] Oh, great, great, that's gonna save me another step.
[AGENT][NEUTRAL] Yes, yes, so, mhm, yes, so we did receive it. It was sent over there, um, but you will have to talk to them regarding, you know, any additional questions related to it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you guys did receive the LOR and HIPA, uh, and I need to reach out to CPA now.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yes, they handle anything right so it was basically just sent to APL.
[AGENT][NEGATIVE] In error.
[AGENT][NEGATIVE] Um, it should have gone to web TPA.
[CUSTOMER][NEUTRAL] OK, so when I spoke with our client, um.
[CUSTOMER][NEUTRAL] It it
[CUSTOMER][NEUTRAL] He said he had APL health insurance through his employer, and he actually called them when we were on the phone.
[AGENT][NEUTRAL] He has
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. Now, the gentleman has coverage?
[AGENT][NEGATIVE] But it's not this, yes, but not this policy. This medical limited benefit plan that he had, that is administered, all of the benefits are handled, I can't even access that information.
[CUSTOMER][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that is.
[CUSTOMER][NEUTRAL] Alright, well let me
[AGENT][NEUTRAL] But I, again, I can transfer you over to them.
[CUSTOMER][POSITIVE] Yeah, yeah, I'd appreciate that.
[AGENT][NEUTRAL] If you would like, and then if we for something, for some reason the call were to be dropped, um, let me give you the correct on his ID card for this plan.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It on the front of it.
[AGENT][NEUTRAL] Has the name and PO box for web TPA?
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] uh what was that?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Great
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, that information is on the front of his ID card.
[CUSTOMER][NEUTRAL] Would you be able to provide me with a policy number or anything like that?
[AGENT][POSITIVE] I can't provide, yes, you're gonna have to speak to Web TPA regarding any questions on this member's coverage. Uh, I'm just trying to get you connected to the right place. OK. All right. Well, if that's all I can help you with today, we're here to thank you again for calling APL and thank you for your patience and me getting the information that you needed. So if you will, um, if there's nothing else I can help you with, I'll be happy to connect you over with them.
[CUSTOMER][POSITIVE] OK, yeah, sounds good.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, thank you so much. I appreciate your help.
[AGENT][POSITIVE] You are absolutely, you're very welcome. It was my pleasure and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Welcome to Web TPA, the administrator for the limited benefit health insurance program underwritten by American Public Life Insurance Company. If this is an emergency, please hang up and dial [PII].
[CUSTOMER][NEUTRAL] If you are a member calling about your premium billing or need to make changes to your account such as an address change, add or drop a dependent, or wish to modify your coverage in any way, please call American Public Life at [PII]. If you are a physician or hospital calling to verify medical eligibility, please press 1. For information and phone numbers for the Beach Street PPO network, please press 2.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For questions concerning pharmacy services, you may contact Caremark at [PII].
[CUSTOMER][NEUTRAL] Please note, your call may be monitored or recorded for quality assurance. The information provided during this call is only a description of benefits and is not a guarantee of payment. Benefits are based upon eligibility at the time services are rendered and all plan provisions.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Thank you for calling customer service. This is [PII]. Can I get the member ID number?
[AGENT][NEUTRAL] [PII], this is [PII] with with APL and the member ID number is 01982042.
[CUSTOMER][NEUTRAL] And what's the name and date of birth?
[AGENT][NEUTRAL] We have it as [PII] [PII].
[AGENT][NEUTRAL] And I have an attorney's office on the line. The gentleman's name is [PII].
[AGENT][NEUTRAL] And he's with Alexander Shira trial attorneys, and he's calling regarding the letter of representation that was sent for s subrogation.
[AGENT][NEUTRAL] On this member and it's got some questions on that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And, uh, you're welcome. Do you want [PII]'s callback number in case something happens?
[CUSTOMER][NEUTRAL] Sure, go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] OK, you can transfer him thank you.
[AGENT][POSITIVE] Thank you so much. Have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you. Mm bye-bye.