AccountId: 011433970860
ContactId: dca6401d-ca13-41f1-804c-2b7fec60b1e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406739 ms
Total Talk Time (AGENT): 199593 ms
Total Talk Time (CUSTOMER): 139521 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/dca6401d-ca13-41f1-804c-2b7fec60b1e1_20250516T14:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] This is [PII] at um Atrium Medical Center and I'm calling to check on the status of a claim.
[AGENT][NEUTRAL] OK, I can check on a claim for you. Uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] It's D as in David 42032214.
[AGENT][NEUTRAL] OK, so that's not one of our policy numbers, [PII], that is through, uh, they're called 90 degree benefits. Um, I can give you their information and transfer you to them, uh, or if you have the member's social, I could see if they have a policy with us.
[CUSTOMER][NEUTRAL] OK, their social is [PII].
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And what was the name for the number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Do you have his date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and this was this for medical, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so I did find a, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Uh, and
[CUSTOMER][NEUTRAL] Well, I'm looking at the EOB and it's got an ID number of 02580380 OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that is his policy number with us. I know it's a bit confusing. It's a part of a multi plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so were you just needing a clarification regarding a claim?
[CUSTOMER][NEUTRAL] So is, is
[CUSTOMER][NEUTRAL] Yes, because we have, um, uh, we have the same address as [PII].
[CUSTOMER][NEUTRAL] But it looks it looks like it's addressed to IMA incorporated, but when we build it to that address.
[AGENT][NEUTRAL] That is 90 degrees, yes.
[CUSTOMER][NEUTRAL] OK, when we built the address, we got a response from American Public Life and a payment of $50.
[AGENT][NEUTRAL] Right, I know it's again it's confusing, um, so as part of the multi plan IMA is essentially 90 degree they do have that policy number you gave me, the one that began with a D that is theirs that they have exclusively through uh 90gree or IMA. Well they do have one through us, a limited indemnity medical plan, um, and it is.
[CUSTOMER][NEUTRAL] So is this indemn?
[AGENT][NEUTRAL] We can view it we process it, but it's, you know, the correspondence and such that is usually handled through um IMA.
[CUSTOMER][NEUTRAL] OK, so, so they.
[AGENT][NEUTRAL] Were you just want to make sure that information is accurate?
[CUSTOMER][NEUTRAL] I'm just trying to figure this out. I, I mean.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] We got a $50 payment through American Public, so that is an indemnity plan, right? So they're only gonna get a flat $50.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so that.
[CUSTOMER][NEUTRAL] So then do they have another plan through.
[CUSTOMER][NEUTRAL] Through
[CUSTOMER][NEUTRAL] 90 degree that we should.
[CUSTOMER][NEUTRAL] Because when we go with the ID number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It came out with this, does it just get.
[CUSTOMER][NEUTRAL] Channel to where the payment should come from? I'm confused.
[AGENT][NEUTRAL] Yes, typically I know, and it is very confusing. I apologize. Uh, it's, it's even worse explaining this to the actual insured. Um, so it's in short, the policy that this member has with us, the limited indemnity, is going to be more for, um, accident, hospital, surgical, things like that. The policy that they have with uh 90 degree, I believe it's more along the lines of wellness benefits.
[AGENT][NEUTRAL] Um, and if you'd like, I can transfer you to them to get more clarification on their benefits that they have through 90 Degree.
[CUSTOMER][NEUTRAL] OK, because I'm just trying to figure out.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, I'm assuming if we build it to them and they channeled it to the American public that they weren't gonna cover it.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And, and that's that's what I'm thinking but I wanna make sure that.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Definitely yes and like you said before they are really good about um channeling like you said um where uh that benefit is supposed to go and who is supposed to process that.
[CUSTOMER][NEUTRAL] OK, so do you think it's safe in saying that the $50 payment is probably all we're gonna get on this because that's a wellness plan?
[AGENT][NEUTRAL] Are you looking at just so that I make I'm understanding, are you looking at the claim, uh, is it 357-461-3?
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] For uh Kettering Health Main campus.
[CUSTOMER][NEUTRAL] No, this is for Atrium Medical Center for it's for a building out $7,225.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Oh, I see.
[AGENT][NEUTRAL] I see. OK, yes, I found it. OK. um.
[AGENT][NEUTRAL] I mean, like I said, you can always I can transfer you to them and you can ask uh what other if they have any applicable benefits most of the time though it is going to be this um just the $50 but I, I'm not 100% what all they do offer.
[CUSTOMER][NEUTRAL] OK, well I guess if you could transfer me but um do you give reference numbers?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, it would be my first name, last initial, and today's date. Uh so my name is spelled [PII]
[AGENT][NEUTRAL] And did you want me to give you their phone number before I transfer you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, uh let me know when you're ready for that.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK it is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] and to speak with IMA or 90 degree you would select option one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Alrighty, alright, are you ready for me to transfer you now?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, I'm just gonna put you on a brief hold while I get them on the line. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling 90 Degree. If you would like to