AccountId: 011433970860
ContactId: b7dd4930-1f51-43ce-a55e-0907fab1b00f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 362369 ms
Total Talk Time (AGENT): 100758 ms
Total Talk Time (CUSTOMER): 186100 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/b7dd4930-1f51-43ce-a55e-0907fab1b00f_20250604T22:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, Ms. [PII], this is [PII] um with the care team. I have Mr. [PII] on the phone. He is, um, policy number 253-6896.
[CUSTOMER][NEUTRAL] He's calling about claim number 356-6139. He's been completely verified.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] He is calling because he has he knows the remarks he's received the letter but he still has further questions about the claim.
[AGENT][NEUTRAL] Alright, send him on over.
[CUSTOMER][POSITIVE] All right, thank you, Ms. [PII]. Bye bye.
[AGENT][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I just wanted to, uh, go over, uh, my policy that my wife had, and we have a claim from Providence and I just need to make sure it continues to move forward when I called last, uh, last time they said that uh my wife wasn't covered during that period and that's why the the claim stalled, but I'm like, no, I double checked she was covered during that period.
[AGENT][NEUTRAL] OK, and can I get the date of service, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, 1 2nd.
[AGENT][NEUTRAL] OK, it looks like the uh the effective date, I'm sorry, for the policy was [PII].
[AGENT][NEUTRAL] So anything prior to that date will not be covered.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, you, you gave you the wrong information. I talked to BWA for that claim with [PII]. They were, it was covered. They actually already paid 300 of it. We're just trying to get it down even further. So if you need to call BWA, I can give you their number and you can confirm that with them.
[AGENT][NEUTRAL] Give me 1 2nd, it looks like you have another policy. Give me 1 2nd.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 249.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so she had her own policy, but we still, there's no change on that one either.
[AGENT][NEUTRAL] Were you able to contact your employer to to verify if she should have had coverage?
[CUSTOMER][NEUTRAL] No, it was, no, we, no, we're self-employed. I mean, everything was, uh, active like I said, I called BWA on her, uh, her number, her old membership number, which is the one that was applied or used to pay the hospital. That was an old number. They're just I think there's just some numbers getting confused, um, but BWA say that she was covered. My wife was covered during that time.
[AGENT][NEUTRAL] OK, well did they send something over that you know if they was gonna send something over to APL so that we can go ahead and correct it on this end?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, they said they, well they said they already did. That's why she said something's getting missed in the work, so she said to have you call them and you guys can get it squared away.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll reach out to whoever I don't know. I'm sure you have a way of reaching the BWA, but I have an 800 number if you need to use that.
[AGENT][NEUTRAL] OK, is there any way I can get your telephone number and I can get with our billing department in the morning to verify?
[AGENT][NEUTRAL] If we have received anything.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Sure, yeah, I mean whatever you need to do, yeah, that's fine. I mean, I've sent you a bunch of just like uh what do you call that? uh UW 40 forms and all that kind of fun stuff, you know, um, or UB 40, whatever those are, yeah, giving you guys a lot of information that you needed, yeah, and everything was moving ahead and then, yeah, for some reason when I called last and it's like oh no that's she wasn't covered we have nothing and I'm like no no it was and so something happened.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, I will
[AGENT][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Yeah, it's weird, yeah.
[AGENT][NEUTRAL] OK. And what's the, what's a good callback number for you?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, Mr. [PII], OK, let, I'm gonna get with our billing department in the morning to see if they have anything.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that we can um.
[AGENT][NEUTRAL] Figure out how we need to move forward with this one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, and did you have any other questions?
[CUSTOMER][NEUTRAL] Sounds great. Yeah, but I, I did, yeah, but I did, uh, no, I just want to say I did confirm with BWA that my wife was covered under, uh, again, a certain membership number that canceled the next month when we added her to our family plan. You know what I mean? So it's a long, it's a long story, but she was covered at that time.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I think I remember talking with you about this one.
[AGENT][NEUTRAL] Um,
[CUSTOMER][MIXED] Really? How funny. Yeah, it's a little, it's a little bit of a mess and I, it's, you know, it's nobody's fault. It just is what it is, but, uh, yeah.
[AGENT][NEUTRAL] Yes, sir. Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There's just a lot of moving parts on this one.
[AGENT][POSITIVE] OK, uh, I'll get with billing and then I'll give you a call back on this one.
[CUSTOMER][POSITIVE] OK, that sounds great I appreciate it.
[AGENT][POSITIVE] OK, all right, thank you and have a great rest of your day.
[CUSTOMER][POSITIVE] You too ma'am thank you.
[AGENT][NEUTRAL] All right bye bye.
[CUSTOMER][NEUTRAL] Alright bye now.