AccountId: 011433970860
ContactId: d83a395a-cf17-404a-8e70-ccc2a4a617bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 784919 ms
Total Talk Time (AGENT): 299219 ms
Total Talk Time (CUSTOMER): 282473 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/d83a395a-cf17-404a-8e70-ccc2a4a617bb_20250606T16:16_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] I'm a member service representative. I have [PII], a provider on my line who's calling in regards to benefits to be verified.
[AGENT][NEUTRAL] OK, sure. I can assist with that. And Miss [PII], do you have a um a callback number or a policy number for Miss [PII]?
[CUSTOMER][NEUTRAL] Mhm, the member ID number I have is 20348032.
[AGENT][NEUTRAL] OK. And do you have a callback number for Miss [PII]?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] I would have.
[CUSTOMER][NEUTRAL] [PII]. And do you do claim status?
[AGENT][POSITIVE] Mhm, yes, I do.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's what that's what she's calling for, uh, claim status.
[AGENT][NEUTRAL] OK. Um, you can go ahead and put her through, Miss [PII].
[CUSTOMER][POSITIVE] OK, uh thank you. Here you go.
[AGENT][POSITIVE] You're welcome. Have a good day. Good weekend. Bye bye.
[AGENT][NEUTRAL] Good morning Ms. [PII]. This is [PII] with APL and the care team. He was transferred over to us to get claim status. Is that correct?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK. Um, may I have the policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's 203-480-32.
[AGENT][NEUTRAL] OK, that's too many numbers to be one of our policy numbers. Do you have the copy of the cards currently?
[CUSTOMER][NEUTRAL] No, I don't.
[AGENT][NEUTRAL] You don't. OK, um, a callback number for you is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Very
[CUSTOMER][NEUTRAL] Yes, and I'm on this Carrington solutions we excuse me, I'm on this Carrington website solutions.
[AGENT][NEUTRAL] OK, and.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, I just did a, a printout of the member's ID number.
[CUSTOMER][NEUTRAL] You know, it says status active, effective date [PII].
[AGENT][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] I mean this guy's been with you guys for almost 20 years.
[AGENT][NEUTRAL] With Miss [PII], we're not Carrington. This is APL. This is American Public Life.
[CUSTOMER][NEUTRAL] And then what
[CUSTOMER][NEGATIVE] All I can tell you, dear, is I've been on, you are now my 5th person that I've been on the phone with in the last hour and um I just keep getting transferred so I don't even know what the phone numbers are at this point.
[AGENT][NEUTRAL] Oh gosh.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, um, let me see what I can do, OK? Um.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Can you try this this number?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Go ahead with the numbers. Let me, let me try that.
[CUSTOMER][NEUTRAL] Try [PII], yeah, it will be [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, that's definitely not ours.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] OK, uh, what's the name and date of birth of the patient? Let's do a name search.
[CUSTOMER][NEUTRAL] Yep, his first name is [PII]
[CUSTOMER][NEUTRAL] His last name is [PII]
[AGENT][NEUTRAL] What's his date of birth?
[CUSTOMER][NEUTRAL] He's [PII].
[CUSTOMER][NEGATIVE] So everyone I've spoken to has taken this information and then they say oh I'm sorry we don't handle this account oh I'm sorry we don't handle claims and I I've been all over the country.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I'm sorry for that. OK. Um, yeah, I did find him with that information and uh, um, the policy number is gonna be, um, that last number you gave me but not with all the zeros, just 20s in front, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Sure, yeah, it's printed out with 60s.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh, OK. I'm so sorry for that. Yeah, it's gonna be 00736401 if you wanna just write it down for your records, you can do that. Um, OK, and uh you said you're looking for a claim status. What is the date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] OK, the [PII]. How much is it for?
[CUSTOMER][NEUTRAL] $73.83 dollars.
[AGENT][NEUTRAL] OK, so the
[CUSTOMER][NEUTRAL] Two different procedures.
[AGENT][NEUTRAL] They're both for the same date or they're.
[AGENT][NEUTRAL] One for each date.
[CUSTOMER][NEUTRAL] Yes, [PII] is procedure 0150 and procedure 1110.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for calling Doctor [PII]'s office this is.
[AGENT][NEUTRAL] OK, so we don't have a claim for that date of service [PII].
[CUSTOMER][NEUTRAL] no
[CUSTOMER][NEUTRAL] make
[CUSTOMER][NEUTRAL] Verify the mailing address and the payer ID.
[AGENT][NEUTRAL] OK. And you said the next one is from [PII]?
[CUSTOMER][NEUTRAL] OK, and then
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. OK. Yes, we have not received any claims for this year. Where are you sending it to?
[CUSTOMER][NEUTRAL] Yeah it's been sent multiple times so I'm.
[CUSTOMER][NEGATIVE] Not received
[CUSTOMER][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] In the same envelope as on the other two.
[CUSTOMER][NEUTRAL] Oh, they were sent paper yeah we've sent it electronically a number of times and this last time we sent it on paper.
[AGENT][NEUTRAL] OK, can I verify the information just to make sure it was sent to the correct place.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yep, I have [PII].
[CUSTOMER][NEUTRAL] In [PII].
[AGENT][NEUTRAL] Mm. That's not our address. No.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] And what payer ID you're using?
[CUSTOMER][NEGATIVE] That's not correct.
[CUSTOMER][NEUTRAL] Some someone just gave that to us over the phone with another girl here at the front desk with me.
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] That's Carrington. It's just that this particular policy, let me explain a little bit this way because it's kind of hard to understand and I do apologize and I do understand, um, so basically this type of policy, um, if the provider participates with Carrington they can use their fee schedule but it is not required because we're not contracted with Carrington. So you can call to Carrington to get information and they're gonna give you like saying that you are in network with them, but it doesn't mean that we are contracted.
[AGENT][NEUTRAL] So all claims need to come to us and it cannot go to Carrington. So if you call Carrington, they're gonna give you their address and their payer ID, but it needs to come to us.
[CUSTOMER][NEUTRAL] Are you able to see a physical copy of his card?
[AGENT][NEUTRAL] Um, let me see if I got 11 moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Documents. You're welcome, and I can also send you a fax back of benefits on this number if you need that for your records, OK?
[AGENT][NEUTRAL] Let's see, OK, I'm waiting on the documents to pull up.
[CUSTOMER][POSITIVE] You know, we have the benefits. We've had them since [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then what's the name of your company who administers the benefits?
[AGENT][NEUTRAL] The policy is through American Public Life, APL, American Public Life.
[CUSTOMER][NEUTRAL] You said like APR or something?
[CUSTOMER][NEUTRAL] American Public Life.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, um, let's see the card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah I'm still searching for that card, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] The all policies more managed a little bit different, so.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] Uh, let me open a correspondence and see if it's there.
[CUSTOMER][NEUTRAL] of
[AGENT][NEUTRAL] Yeah, these old policies didn't have a card.
[AGENT][NEUTRAL] Mm mm. There's no cards. Mhm.
[CUSTOMER][NEUTRAL] That's probably part of the problem, right?
[AGENT][NEUTRAL] Yeah, it, it is, yeah, this all policies, they were managed totally different. That's why we don't carry them no more. This is an old policy. Uh, we have switched to a new policies that they do carry cards and everything, but um, yeah, this one didn't back then.
[CUSTOMER][NEUTRAL] OK, so what would be the address, what would be the address for American Public Life for us to physically send you a claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, the address to submit claims is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and can I just repeat that back to you? [PII] and that's in [PII] and the zip is [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK, and then for claim status, what phone number would a provider call for this policy?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] And then um is there an electronic ID for to file electronically dear?
[AGENT][NEUTRAL] Yes, we do have a payer ID. The payer ID is 60801.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 60801. Let me see if I can find that.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, when is your.
[CUSTOMER][NEUTRAL] S
[CUSTOMER][POSITIVE] I mean if they're asking for it I definitely.
[CUSTOMER][NEUTRAL] You said 60801.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] Probably
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK and um what's your first name again?
[AGENT][NEUTRAL] My name is [PII] last initial [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] That's a pretty name. OK, all right, so thank you very much for your help today.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can thank you for calling.
[CUSTOMER][POSITIVE] Have a good day bye bye.