AccountId: 011433970860
ContactId: e8c6c49d-e80e-498c-a41d-ad7a156a4af2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 565780 ms
Total Talk Time (AGENT): 175755 ms
Total Talk Time (CUSTOMER): 151556 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/2025/04/02/e8c6c49d-e80e-498c-a41d-ad7a156a4af2_20250402T14:53_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, hi, I'm sorry, what was your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And how do you spell that?
[AGENT][NEUTRAL] Can I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] How can I assist you today, [PII]?
[CUSTOMER][NEUTRAL] Um, I need to check the status of the claim. I'm calling from Multi-care Tacoma General Allen Moore Hospital.
[AGENT][NEUTRAL] I didn't hear anything that you just said. I apologize. Could you repeat yourself?
[CUSTOMER][NEUTRAL] I'm calling from Multi-care Tacoma General.
[CUSTOMER][NEUTRAL] And I need to check the status of the claim.
[AGENT][NEUTRAL] Can I have your callback number and that policy number, and I'll be able to assist you.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Um, policy number is 025650007.
[AGENT][NEUTRAL] Thank you, [PII]. What is this member's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], um [PII].
[AGENT][NEUTRAL] And this is for medical or dental?
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] What is the um data service?
[CUSTOMER][NEUTRAL] Um, [PII] to [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your procedure code?
[CUSTOMER][NEUTRAL] Um, there's 8 of them.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 99211.
[CUSTOMER][NEUTRAL] 96413
[CUSTOMER][NEUTRAL] 85025
[AGENT][NEUTRAL] I don't mean to cut you off. I'm not seeing any of those procedure code. What is the amount of the claim?
[CUSTOMER][NEUTRAL] Um, $57,120.25.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] No, thank you for cutting me off instead of letting me read them all.
[AGENT][NEUTRAL] Because I didn't see him. one moment.
[AGENT][NEUTRAL] You said 1212?
[AGENT][NEUTRAL] Of 2024.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So it looks like we received the claim [PII]. It was processed [PII].
[AGENT][NEUTRAL] There was a payment of $50 which maxed out the benefits.
[CUSTOMER][NEUTRAL] Of how much?
[AGENT][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] 0 $50 OK.
[AGENT][NEUTRAL] If it says with this check, the maximum benefit payable for this date of service has been met.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] Wow.
[AGENT][NEUTRAL] What, what type of services?
[AGENT][NEUTRAL] Was this a facility or something?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I don't think that policy covers the.
[AGENT][NEUTRAL] Like ER visits and stuff it's like they, it's all under the day office visits.
[AGENT][NEUTRAL] And they look like their office visit is $50 per visit.
[CUSTOMER][NEUTRAL] OK, do they have um.
[CUSTOMER][NEUTRAL] Let me see what services.
[CUSTOMER][NEUTRAL] Like la
[AGENT][NEUTRAL] Mm, they have wellness. So, so this is not the correct queue. I could only give you the claim status now if you wanna verify their benefits, I can gladly transfer you over to the correct queue so they can provide you with the benefits.
[CUSTOMER][NEUTRAL] Uh, chemotherapy.
[CUSTOMER][NEUTRAL] OK, would you be able to send me a copy of the ELB?
[AGENT][NEUTRAL] Mhm. I can send you a copy of the EOB. What's your face number?
[CUSTOMER][NEUTRAL] Are you, are you, can you only fax it or are you able to email it?
[AGENT][NEUTRAL] Um, I could see if someone, I could request for someone to send it to you.
[AGENT][NEUTRAL] What is your email address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Give me one moment. I want my stuff not pulling up?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, and then [PII] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, and is this um IMA Inc?
[AGENT][NEUTRAL] No, this is American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know why we have it down there.
[CUSTOMER][NEUTRAL] I am
[CUSTOMER][NEUTRAL] America or American?
[AGENT][NEUTRAL] American public life.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So would you like for me to transfer you over to the HRQ so they can assist you with the benefits?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, yes, please, and do you have a call reference number or do you guys have call reference numbers?
[AGENT][NEUTRAL] We don't provide reference numbers, but you can use my name and today's dated for your reference.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I get the card. Would you like me to spell my name for you?
[CUSTOMER][POSITIVE] Um, no, I got it. Thank you.
[AGENT][POSITIVE] Alrighty well it was a pleasure speaking with you thanks for calling APL and have a great day. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Furring
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hello, so, how you doing?
[CUSTOMER][POSITIVE] I'm good, thank you.
[AGENT][NEUTRAL] So, so I have a, I'm good, thanks for asking. I have a provider on the phone by the name of [PII]. She's calling to verify benefits for this uh HR policy. I'm not sure if you're able to assist with that or not.
[CUSTOMER][NEUTRAL] How about you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. Yes, I can. Um, so her name.
[AGENT][NEUTRAL] Let me know when you're ready for the policy.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] [PII] is the um provider.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] And she's calling for policy 256-5007. It's 256500007.
[CUSTOMER][NEUTRAL] OK, do you have a callback number for [PII]?
[AGENT][NEUTRAL] I do. Her callback number is [PII].
[CUSTOMER][POSITIVE] OK. All right. Thank you. I'm ready for her.
[AGENT][POSITIVE] All righty. Thanks so. Have a good one.
[CUSTOMER][POSITIVE] You're welcome. You too. Bye-bye.
[AGENT][POSITIVE] Hello [PII], I'm gonna transfer you over to Soul, and she's gonna assist you further. Thanks for calling APL. Have a great day. Goodbye.
[CUSTOMER][POSITIVE] Thank you.