AccountId: 011433970860
ContactId: ccc50d8c-00e9-4a19-87db-ac711c886cfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314320 ms
Total Talk Time (AGENT): 133270 ms
Total Talk Time (CUSTOMER): 137392 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/ccc50d8c-00e9-4a19-87db-ac711c886cfd_20250404T19:17_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Um, that's about $200 for absolutely.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I'm calling from a provider's office to check claim status.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], can I get a good callback number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] 02596142.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] [PII] [PII]. It's like it's probably dependent under the mom.
[AGENT][POSITIVE] OK, thank you for verifying that.
[AGENT][NEUTRAL] Yeah, OK, thank you. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] That is gonna be [PII].
[AGENT][NEUTRAL] OK, do you have that billed out?
[CUSTOMER][NEUTRAL] $4,112 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we have not received a claim for that amount, [PII], for that date of service.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I was just looking at the insurance card. The front says American Public Life.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And then the back says send claim attention IMA incorporated um.
[CUSTOMER][NEUTRAL] So we send it to, let me double check.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] It is possible, um, if you'd like, I can give you their information to see if it might have been sent to them.
[CUSTOMER][NEUTRAL] Who needs to process it because I know uh American public life is like a little different. I, I don't know, it's kind of confusing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It is confusing, um, very especially these kinds of policies as they're a part of a multi plan, uh, so they've got all kinds of different carriers, different policies and such, um, so this one is their limited indemnity medical plan, um, what was it that they were seen for?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Emergency room visit.
[AGENT][NEUTRAL] OK, so you would likely send that to us.
[CUSTOMER][NEGATIVE] Uh, it looks like the baby was sick.
[AGENT][NEUTRAL] OK, so I'll go ahead and give you our uh billing information, [PII], and then I can also transfer you to IMA uh to see if they have received that because if they have it's possible they they could have processed it as well.
[CUSTOMER][NEUTRAL] Hm, so who will they?
[CUSTOMER][NEUTRAL] So this APL is the hospital indemnity plan, would that be under, would the emergency room visit be under that?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I would think so. This is where the confusing part is is that again as it's part of a multi plan they could have additional coverage on top of uh besides this policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, OK, OK, OK.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] No claim with American public life.
[CUSTOMER][NEUTRAL] OK, yeah, we sent it to the address for, uh, it says [PII], so we did send it to them so it's possible they have it, um.
[AGENT][NEUTRAL] IMA.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, do you want me to get you with them?
[CUSTOMER][NEUTRAL] So if if they.
[CUSTOMER][NEUTRAL] Yes, so, um, what's their number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, OK, so their phone number is [PII].
[AGENT][NEGATIVE] [PII] and to get to them you would select option one. The message prompts are a bit confusing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so if they processed it, um, and will we just go off of whatever they processed it as or if it's denied, go to y'all or how does that work?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I would get clarification from them um and see what they recommend as they'll be able to see all of their plans.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Got you. OK, alright, uh, can I get your name and
[AGENT][NEUTRAL] Alrighty, did you want me to go ahead and transfer you? Oh, sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, reference number, a reference number would just be my first name, last initial, and today's date and so my name is spelled [PII] last initial is [PII]
[CUSTOMER][NEUTRAL] But um.
[CUSTOMER][POSITIVE] Yes, yes, yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, yep, and if you don't mind transferring me, I will see what they say thank you.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Absolutely alrighty, yes, of course I I'm just gonna put you on a brief hold while I get them on the line for you. Hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][POSITIVE] Thank you for calling 90 Degree bed. If you would like to participate in a quick