AccountId: 011433970860
ContactId: ca5fe8cd-2e36-46e2-8cde-931ac2909a96
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 433470 ms
Total Talk Time (AGENT): 127128 ms
Total Talk Time (CUSTOMER): 138422 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/ca5fe8cd-2e36-46e2-8cde-931ac2909a96_20250613T19:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I'm calling from a behavioral health, um, or mental health facility, um, well, it's a group practice.
[CUSTOMER][NEUTRAL] Um, so one of our clients has the IMA incorporated, um, insurance plan.
[CUSTOMER][NEUTRAL] American Public Life Insurance.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Is this the correct number to call?
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with benefits. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Uh, the member ID.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Sure. It's D like David, 462-05676.
[AGENT][NEUTRAL] OK, that's not one of our policy numbers. Um, do you see a number that begins with 01 or 02, or I can look them up by the social or name and date of birth?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Let me look at the ID card.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I think.
[CUSTOMER][NEUTRAL] I'm wondering maybe we're sending it to the incorrect.
[CUSTOMER][NEUTRAL] Let's see at the back of the card.
[CUSTOMER][NEUTRAL] The payer ID that we have is [PII].
[AGENT][NEUTRAL] Yes, that's the correct payer ID to submit claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] What's the last name? I can look them up by name.
[CUSTOMER][NEUTRAL] Medical
[CUSTOMER][NEUTRAL] Yeah, so his last name is, well, he, it looks like he's got two last names, uh [PII].
[CUSTOMER][NEUTRAL] And then it's [PII]
[AGENT][NEUTRAL] OK. And the first name?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And you said the last name is [PII]?
[CUSTOMER][NEUTRAL] Uh, the last, the first one is [PII]
[AGENT][NEUTRAL] OK, and then [PII].
[AGENT][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's what it has on his member ID card.
[AGENT][NEUTRAL] Yeah, I think I found him. One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] Um, on [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. I found him in our system. Let me give you his policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you're ready for the policy number?
[CUSTOMER][POSITIVE] Yeah, whenever you're ready.
[AGENT][NEUTRAL] OK, it's 026.
[AGENT][NEUTRAL] 19614.
[CUSTOMER][NEUTRAL] So that would that be in place of his member ID then that's on the card?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] That's the top number you'll use to file claims, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, and then I also have another question because we received denials on it stating that um the provider.
[CUSTOMER][NEUTRAL] Um, is not listed as a physician and it's out of network. Can, are you able to look up the provider for me to see.
[AGENT][NEUTRAL] OK. And actually,
[CUSTOMER][NEUTRAL] What the issue is.
[AGENT][NEUTRAL] Yeah, and actually under this policy, I will need to get you over to a different department um to verify providers and status of claims for this particular policy. If you don't mind holding, I'll get you transferred.
[CUSTOMER][NEUTRAL] Do you have a phone number for them as well?
[AGENT][NEUTRAL] Um, it'll be the [PII]. Is that the number you called?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, yeah, yeah.
[AGENT][NEUTRAL] OK, yes, that's fine.
[CUSTOMER][NEUTRAL] There's just a bunch of different prompts, but that's fine.
[AGENT][NEUTRAL] Yes, the same one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, no, that was it.
[AGENT][POSITIVE] OK. Well, I thank you, [PII], for calling APL. In one moment, I'll get you transferred.
[CUSTOMER][POSITIVE] Great, thank you.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Um, hi, [PII]. This is [PII] and Medlin Claims.
[CUSTOMER][NEUTRAL] Hey, how are you doing?
[AGENT][POSITIVE] Good. How are you?
[CUSTOMER][POSITIVE] I'm good.
[AGENT][NEUTRAL] Yeah, it's Friday, huh.
[CUSTOMER][NEUTRAL] It is a whole Friday.
[AGENT][NEUTRAL] Well, I have a provider on the line. She's calling to check on the status of some hospital indemnity claims, and she need information regarding a provider being in network or not. Would you be able to assist her?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, what's the callback number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the callback number is [PII] and her name is [PII].
[CUSTOMER][POSITIVE] Thank you and the um.
[CUSTOMER][NEUTRAL] Well, she's the provider. Did they give you a policy number?
[AGENT][NEUTRAL] Yes, she gave me the policy number. It is.
[AGENT][NEUTRAL] 02619614 for [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Here we go, OK, uh, you can send her over.
[AGENT][POSITIVE] OK, here she comes. Thank you.
[CUSTOMER][POSITIVE] You're welcome.