AccountId: 011433970860
ContactId: c2d5f790-fb31-4c1c-a337-1b4e0006b6b4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 645640 ms
Total Talk Time (AGENT): 225856 ms
Total Talk Time (CUSTOMER): 303264 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/c2d5f790-fb31-4c1c-a337-1b4e0006b6b4_20250618T17:06_UTC.wav
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[AGENT][NEUTRAL] An American Public Life, this is. How may I assist you?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Uh, hi, [PII]. Yeah, my name is [PII]. Um, uh, why don't I give you my policy number to start that way they can kind of get that out of the way.
[CUSTOMER][NEUTRAL] It's 02536896.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And may I have your date of birth, please?
[CUSTOMER][NEUTRAL] Um, my date of birth is [PII]. My wife's is [PII].
[AGENT][NEUTRAL] OK, so this call is for the spouse listed on the policy?
[CUSTOMER][POSITIVE] Uh, correct, yes.
[AGENT][NEUTRAL] OK. May I have your name, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And I do need to verify the mailing address and email address on file.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, the email address you should have is [PII].
[CUSTOMER][NEUTRAL] And the address should be [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying your policy. How may I assist you?
[CUSTOMER][NEUTRAL] Sure, yeah, um, I'm trying to get you guys on the same page with the, the actual insurance company that had, um, coverage for my wife. You guys are saying that she wasn't covered at the time, and I think probably because you had the wrong member number, but the company said no, she was covered at that time and they actually were working with you guys and had sent you guys some information, but when I talked to somebody last week or the week before, um, they said they didn't have it.
[CUSTOMER][NEUTRAL] And so the company BWA, they're the ones that have all the information that you guys need um to try to process this and to kind of get the bill down and I just and she said and they said BWA said to have you guys call them directly and that way you guys can just communicate easier and faster because I'm trying to be the middle man and it's just really really hard and um and it just becomes a.
[CUSTOMER][NEUTRAL] I think there's just been some communication gaps there that are kind of messing everything up so.
[AGENT][NEUTRAL] OK, so are you talking about the claim that was denied saying that the member was not active at the time of service?
[CUSTOMER][NEGATIVE] Uh, correct, yeah. And I checked with BWA she was covered. She was active. So there's something going on because I talked to you guys before and you were working with BWA you asked me to get some things. I did, I provided it. And then when I call back again to follow up, they're like, we don't know what you're talking about, that one's been denied. I'm like, OK, what happened? Something, something fell to the cracks, you know, so just trying to make it easier for everybody to communicate.
[AGENT][NEUTRAL] OK, so I'm looking into this. Now, the only thing that I can advise you of is that with the policy, it is showing that the effective date is in June and that claim is showing in May.
[CUSTOMER][NEUTRAL] Right. And I'm, and I, you're looking under a different, uh, something. I'm not sure what happened, but BWA because my wife had a different policy in May before she came on to ours.
[AGENT][NEUTRAL] Let me check that for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see if I can find an active policy under her name at that time.
[CUSTOMER][NEUTRAL] I have her old ID number, her old member number. I don't know if that'll help, but.
[AGENT][NEUTRAL] Sure. May I have that?
[CUSTOMER][NEUTRAL] Yeah, it was 682-5.
[CUSTOMER][NEUTRAL] 42457.
[AGENT][NEUTRAL] OK, so that member number is not one of our member numbers.
[AGENT][NEUTRAL] So that's possibly that she was under a different.
[AGENT][NEUTRAL] Insurance other than us.
[CUSTOMER][NEUTRAL] No, it was still BWA, which is the same company we have now that she actually joined our family member. So it's all the same insurance company, nothing changed there.
[CUSTOMER][NEUTRAL] But for some reason, like when I first start talking to you guys.
[AGENT][NEUTRAL] OK, but that's not
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] But I was gonna say that's not one of our policy number, the number that you just gave, that's not one of our policy numbers.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, that's no, no, that's not, it's not a, it's not a policy number, it's a member number. That's the membership that she was covered under. It's not a policy number. I don't have a policy number other than the one I gave you that that that's the only one I've been given from you guys.
[AGENT][NEUTRAL] Co
[CUSTOMER][NEUTRAL] But I know in the beginning they said yeah we're working with BWA please send us a better breakdown of, you know, the medical bill I sent over a UBW40 whatever some kind of weird thing like that and um.
[CUSTOMER][NEUTRAL] That's and everything was moving along, you know, fine.
[CUSTOMER][NEGATIVE] And then all of a sudden it was like, oh no, that, that's, that's not, that's no longer active or whatever. I'm like, yeah, it was, and BW said, yeah, we, they weren't talking to you guys. They just haven't heard from anybody and they said, have them call us directly so that we can get on the same page.
[CUSTOMER][NEUTRAL] So I'm like alright I'll see if they can do that.
[CUSTOMER][NEUTRAL] I mean, can I give you their number and then you guys call them and try to figure this out because she was covered by the same insurance company that, you know, we currently have now.
[AGENT][NEUTRAL] OK, so with the member ID number that you gave me ending in 457.
[AGENT][NEUTRAL] That policy is showing that the term date was 4:30 of 24, so she was not active at that time with that member number.
[AGENT][NEUTRAL] So we can't, we don't contact them, they have to contact us or send us the documentation we don't do the calling, that's just the information that we will receive from them with the effective date.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Well that
[CUSTOMER][NEUTRAL] That's right. That's what I'm saying though. They said they already sent that to you. She was active. You guys already have that. You should because they've been communicating with you guys in the beginning.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] So I'm not sure what happened there.
[AGENT][NEUTRAL] Let me see up under this policy if they received anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Maybe there was another policy number. I don't know. Maybe something changed, uh, like, you know, I don't know. I'm not sure what happened or how.
[AGENT][NEUTRAL] OK, so I'm seeing that they stated that.
[AGENT][NEUTRAL] This policy had turned at that time because there was no premium that had been paid.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] They told you to reach out to the.
[CUSTOMER][NEGATIVE] Yeah, no, that's not true, yeah, yeah.
[AGENT][NEUTRAL] They told you to reach out to the group because the the group has not sent anything stating that a premium was made. Then we did receive the premium which would have her effective up under your policy, so we just, we only thing we can do is wait on the group to submit something. We haven't received anything.
[AGENT][NEUTRAL] So just like we made her active up under your policy when the group submitted us the documentation, as long as we receive that, she would have been entered in at that time.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] So we just haven't received that information.
[CUSTOMER][NEUTRAL] OK, I mean, all right, well, I see what you're saying, but I mean something, yeah, like I said, something's gone wrong here because the insurance company already paid an initial $3400 because she was covered. So the information you have is incorrect. So I'm not sure. I'm gonna try and see if I can get BWA back on the phone and if they can give me something that I can give you guys. Is that what we need to do?
[AGENT][NEUTRAL] Now if you can, if you can get them on the phone when you do, you're more than welcome to call back and see if they would discuss that with us over the phone, but other than that, they will have we, it's really nothing that we can do until we receive that information in.
[CUSTOMER][NEUTRAL] OK, and what information do you need? Just proof that she was covered at the time?
[AGENT][NEUTRAL] Yes, they would know what documentation would need to be submitted in because they will have to be submitted in a back premium for them to submit the premium payment to us so we haven't received anything from them.
[CUSTOMER][NEUTRAL] OK, alright, yeah, that doesn't make sense because they said they sent it to you. Um, alright, I'm gonna have to try to get them back on the phone. There's, so you're not, you can't call them and try to help out that way you all you can do is receive.
[AGENT][NEUTRAL] No, I can't call out to speak with any other.
[AGENT][NEUTRAL] Person, they will have to contact us.
[CUSTOMER][NEUTRAL] That yeah, that's what I'm saying.
[CUSTOMER][NEUTRAL] They would have to contact you, OK, alright, well let me see if I can get them to do that maybe, but alright, OK, well we'll have to get this figured out one way or the other this is so frustrating. Alright, well thank you so much for answering my questions. I'll, I'll see what I can do.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, and, and when you call.
[AGENT][NEUTRAL] And when you call back just try to get in touch with billing or customer service they would be able to assist you with any premiums because claims can't assist you we just process and give details on the paid claims.
[CUSTOMER][NEUTRAL] OK, and what number do you guys have for billing and you're at [PII]?
[AGENT][NEUTRAL] It's a different option, you would just listen to the option prompt and you would just choose the option for customer service.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Or billing.
[CUSTOMER][NEUTRAL] Oh, for customer service OK all right can you transfer me to them by any chance or no?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm, I can't do, we, we don't do the transfer in-house so that's what I'm saying so whenever you were to call back with BWA on the phone, that's who they would, you would have to speak with in regards to your premiums and billing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Sounds good.
[AGENT][NEUTRAL] OK. And is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's it.
[AGENT][POSITIVE] Thank you so much for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you, bye.