AccountId: 011433970860
ContactId: c4b43b2b-c783-47c9-9cfc-0cc43c99e4d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 601750 ms
Total Talk Time (AGENT): 231848 ms
Total Talk Time (CUSTOMER): 176643 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/c4b43b2b-c783-47c9-9cfc-0cc43c99e4d6_20250305T19:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling on behalf of Poplar Bluff Regional Medical Center, and I am calling about a claim just to verify um some payment here.
[AGENT][NEUTRAL] OK, yeah, let's take a look. Do we have a policy number, claim number?
[CUSTOMER][NEUTRAL] I have a policy number. It's D as in dog 43,302,180.
[AGENT][NEUTRAL] All right. Unfortunately, [PII], I can't pull the policy with that number. Um, do we have their name or social?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um, I have the name is [PII].
[AGENT][NEUTRAL] Yeah ID.
[CUSTOMER][NEUTRAL] Let's see,
[CUSTOMER][NEUTRAL] Let me see if I can get a social pulled up real quick.
[CUSTOMER][NEUTRAL] OK, I have a social if you're ready for that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK here.
[AGENT][NEUTRAL] And then what is the date of service?
[CUSTOMER][NEUTRAL] Uh, data service [PII].
[AGENT][NEUTRAL] And it was a medical claim, dental claim, I'm sorry.
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] It was medical, OK, cause they had a couple different policies.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, and then what do we have for the bill amount?
[CUSTOMER][NEUTRAL] The billed amount was $19,248.11.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like we did receive this claim card. It looks like on [PII]. Uh, the claim was processed on [PII]. There was a benefit payment sent in the amount of $250. Uh, this was sent in a single check and it looks like that was um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] There was a payment
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of 250.
[CUSTOMER][NEUTRAL] OK, because the EOB I have on file doesn't show a payment. It just says that there was a contractual of $2,502.25.
[AGENT][NEUTRAL] Do you have a claim number on your EOB?
[CUSTOMER][NEUTRAL] Yeah, let me give you that it's 2025.
[CUSTOMER][NEUTRAL] Um, 01070121.
[AGENT][NEUTRAL] That must be
[AGENT][NEUTRAL] Not one of our claim numbers.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] That's strange.
[CUSTOMER][NEGATIVE] Weird.
[AGENT][NEUTRAL] Yeah, I, I mean, the, the member could, the insured could have other insurance. I mean we wouldn't have that information because our claim numbers are.
[AGENT][NEUTRAL] Let's see 37 digits.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] But I can send you this EOB for this if you need it, um.
[CUSTOMER][NEUTRAL] Yeah, yeah, go ahead and do that. Is this, this is 90 degree benefit, right?
[AGENT][NEUTRAL] This is American Public Life Insurance.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Because the card I have on file is for 90 degrees.
[AGENT][NEUTRAL] Let me look at their card. Give me just a second, um.
[CUSTOMER][POSITIVE] Yeah, no problem.
[CUSTOMER][NEUTRAL] And that's the phone number I called too.
[CUSTOMER][NEGATIVE] This is very odd.
[AGENT][NEUTRAL] I know, right?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] Yeah, because when I pull up their card.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, I see that medical ID, the D4.
[CUSTOMER][NEUTRAL] Yeah, that's [PII].
[AGENT][NEUTRAL] Yeah, I wonder if it's like an older card. So the does the card say APL anywhere on it cause I see APL on their card, huh, it must maybe it's an old card.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I see it says Oxford there's Oxford on here.
[AGENT][NEUTRAL] Yeah, Oxford Global Resources LLC, that's their employer.
[CUSTOMER][NEUTRAL] OK, OK, that makes sense then that's the only other name on here.
[AGENT][NEUTRAL] Um, yeah.
[AGENT][NEUTRAL] Huh.
[AGENT][NEUTRAL] Strange. OK.
[AGENT][NEUTRAL] Yeah, I mean the [PII] is a good number for like verification or you know um because they do have a a plan with us like I said but.
[AGENT][NEGATIVE] That claim number isn't for us for sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, can you go ahead and fax the EOB to me?
[AGENT][POSITIVE] Mhm absolutely what's a good fact?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 479.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 784
[CUSTOMER][NEUTRAL] 3107.
[AGENT][NEUTRAL] OK. And then did you wanna take down the claim number, check number, any of that information?
[CUSTOMER][NEUTRAL] Yeah, I'll take down the claim number.
[AGENT][NEUTRAL] Claim number is 355.
[AGENT][NEUTRAL] 1380.
[CUSTOMER][NEUTRAL] OK, and then you said there's a check number too?
[AGENT][NEUTRAL] Mhm. Would you like that?
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Um, it's 202.
[AGENT][NEUTRAL] 2878.
[CUSTOMER][NEUTRAL] OK, and then you said there was a different phone number you just gave me that other than the one I called so I must have gotten to you through the automated system. what was the phone number that that you have?
[AGENT][NEUTRAL] So our number um to contact us to is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] Yeah, so that's that was a different that was different than the number that I act than I actually called so I got to you from the automated system.
[AGENT][NEUTRAL] Oh, OK. But yeah, that's, I thought that was the number you called, but that's, um, that's our um
[AGENT][NEUTRAL] Our number and that's what I was shown on the card, so.
[CUSTOMER][NEUTRAL] Um, see, I show a different number on the card. This is so weird. Yeah, this must be an old card.
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] It must be. I can only, let's see how far I can, I only have access to their [PII] and [PII] card. So, yeah, I mean, if hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's
[AGENT][NEUTRAL] It must be. That's the only thing.
[CUSTOMER][NEUTRAL] Let me see if I can tell when it was uploaded.
[CUSTOMER][NEUTRAL] Uh, looks like that was uploaded on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Weird
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, EOB.
[CUSTOMER][NEUTRAL] Huh, OK, well, let me, I'll take a.
[AGENT][NEUTRAL] Oh, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Go ahead sorry.
[CUSTOMER][POSITIVE] No, you're fine, absolutely.
[AGENT][NEUTRAL] I was just gonna let you know I sent the EOB so you should have it in about 5 minutes.
[CUSTOMER][POSITIVE] Oh perfect thank you so much for your help. Let me get a call reference can I get one real quick?
[AGENT][NEUTRAL] Yeah, absolutely. So call reference is my name with my last initial than today's date. Uh my name again is [PII], which is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great, thank you for your help, [PII].
[AGENT][POSITIVE] Yeah, you're welcome have a good rest of your day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][NEUTRAL] Uh huh bye bye.
[CUSTOMER][NEUTRAL] Bye bye.