AccountId: 011433970860
ContactId: c06257e5-38d9-4db5-aa25-1fe958d9a4a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 498140 ms
Total Talk Time (AGENT): 262399 ms
Total Talk Time (CUSTOMER): 194022 ms
Interruptions: 8
Overall Sentiment: AGENT=0.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/c06257e5-38d9-4db5-aa25-1fe958d9a4a5_20250403T19:54_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] [PII], my name is [PII] and I'm calling from South Haven Internal Medicine regarding uh claims for patients.
[AGENT][NEUTRAL] Sure, [PII], I can assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, the callback number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the policy number is D as in David 46401216.
[AGENT][NEUTRAL] I do apologize [PII], but that's not a policy number here for American Public Life. Do you have that member's social?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I called another actually the number that's on the back of the card and I was transferred to you that um alternate number is.
[AGENT][NEUTRAL] Right, you probably, cause this is a third party administrator.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] 414.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 020071.
[AGENT][NEUTRAL] Thank you. And what is this member's name?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] I'm not, so you said the social is [PII].
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mm wait [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Spell her last name cause that's not pulling up a policy. Spell her last name.
[CUSTOMER][NEGATIVE] You nothing.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII]? Like your name, [PII]?
[CUSTOMER][NEUTRAL] No, no, [PII]
[CUSTOMER][NEUTRAL] Uh, uh, hers is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So and this is for dental, correct?
[CUSTOMER][NEUTRAL] No, is that the is that the benefit, the only benefit she has is dental, because this is a, this is a medical office, primary care.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] So what does it say on the card? Because it looks like you probably gave me a dental policy number. Did it start with a D?
[CUSTOMER][NEUTRAL] OK, see, and I'm not sure about that, yes ma'am, it does.
[AGENT][POSITIVE] Well, that's OK, but I can help you. So we're not gonna make a big deal out of it because I'm gonna be able to help you either way because she has multiple benefits. So don't panic like, oh no, I, I gotta go call somebody else. No, I'm not gonna pass you around like a hot potato. Um, could you verify [PII]'s date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you [PII], and you're calling to check the the status of a claim for a medical claim, so let me give you her policy number for future reference when you contact us here at American Public Life.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] It is 247-452. That's 247452.
[CUSTOMER][POSITIVE] Awesome, OK.
[AGENT][NEUTRAL] And the policy has been active since [PII]. And what is the date of service that you're checking the status of a claim for?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] There's a
[CUSTOMER][NEUTRAL] There's 2 of them, um.
[CUSTOMER][NEUTRAL] The first one is [PII].
[AGENT][NEUTRAL] [PII]. I'm not showing a claim on file for the data service.
[AGENT][NEUTRAL] And what is the next one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm not showing a claim for that one either.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, I will do a paper claim. Is there a fax number? Mhm.
[AGENT][NEUTRAL] Oh, [PII], could you verify where you are, where you're submitting those claims to?
[CUSTOMER][NEUTRAL] Right, yes, ma'am, I will take a look.
[AGENT][NEUTRAL] Because these policies are very.
[AGENT][NEUTRAL] Complex because we're a third party administrator and see when you submit the claim, the claim goes to MI IMA first, which that IMA is to who you submit the claim to first and once IMA verify if it's something that they can pay or can't pay, then they send the claim to us here at American Public Life if that makes sense.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK, yes, OK.
[AGENT][NEUTRAL] So let me give you their [PII] box number and a payer ID.
[AGENT][NEUTRAL] So let me know when you're ready. It's gonna be addressed to [PII].
[CUSTOMER][NEUTRAL] OK, and what's the what's the
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I N M A.
[AGENT][NEUTRAL] No, I as in [PII], M [PII] in [PII].
[CUSTOMER][NEUTRAL] Did you say I?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Got it. OK.
[AGENT][NEUTRAL] IMA. I don't know what that means, IMA.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, PO box, I don't, I'm being honest with you, Ms. [PII], [PII], it's [PII] Egan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Then the city, I mean, the state is [PII]. I guess that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Would you like me to repeat that?
[CUSTOMER][NEUTRAL] No, ma'am, I have it. And also what I was gonna tell you, it has that, but it's the name is not IMA IMA it's BIC and that stands for benefits in a car that I think came off of it.
[AGENT][NEUTRAL] That's the dental, that's benefit in the car. That's for the dental. So let me give you their payer ID as well. Mhm, that's benefit in the car because see this policy.
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It has medical, then it has the dental policy, then it has accidental. It's a couple of policies come with this bundle, but they have different policy numbers and it sounds like you have the dental card instead of the medical card and the payer ID for IMA is 64556. That's 64556.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 645-556. OK, alright, and instead of that D number D6464, the policy number is actually the 247452.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2476452
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] 2476452 OK.
[AGENT][NEUTRAL] Yes, ma'am. Would you like IMA's number?
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Thank you so much. Yes, please.
[AGENT][NEUTRAL] Would you like that number? It's 1800.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] One, yeah, that's the number I dialed and then they transferred me to you for whatever reason, but OK, you've been.
[AGENT][NEUTRAL] [PII] probably because they didn't find a claim so they sent you here to see if you have the we have the claim but we don't have them.
[CUSTOMER][POSITIVE] A great hi
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Well, you know what?
[CUSTOMER][POSITIVE] I really appreciate you taking the time to give me what I need rather than bouncing me on to somebody else. Thank you so much.
[AGENT][NEGATIVE] Cause, cause I have to call individuals for customers, you know, like I have to call my own insurance company or my cable company or a company, and I don't, I don't like to be passed around like a hot potato and have to keep repeating myself repeatedly so.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I don't, I feel you, I understand, so I try to sow a seed so when I get ready to utilize it, I can reap the harvest.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Well, to God, to God be the glory, exactly. Thank you so much. All right, well you have a good day.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, ma'am, you've been a great help. Thank you.
[AGENT][POSITIVE] Well Miss [PII], it was a pleasure speaking with you. Thanks for calling APL, and you have a great day.
[CUSTOMER][POSITIVE] Likewise, thank you, bye bye.
[AGENT][POSITIVE] Thank you.