AccountId: 011433970860
ContactId: f1954795-e7b1-495e-9176-a4bccce1d9f7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445140 ms
Total Talk Time (AGENT): 162871 ms
Total Talk Time (CUSTOMER): 220200 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f1954795-e7b1-495e-9176-a4bccce1d9f7_20250121T19:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, and um, hi, my name is [PII] calling with Doctor [PII]'s office. Um, I am trying to even know what the name of the insurance was because the hospital face sheet only said other insurance plan. I'm like, I know it's not the other insurance plan.
[AGENT][POSITIVE] Well, I'll be more than happy to help you. So you're, I'm just wanting to know like our company name or?
[CUSTOMER][NEUTRAL] Yes, just the company name so I can add your insurance and the payer ID number and we can send this claim off for this uh patient that was seen in the hospital.
[AGENT][NEUTRAL] OK, well, I'll be.
[AGENT][POSITIVE] OK, well, I'll be more than happy to give that information to you. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, of course, [PII], it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, the policy number that is listed on our hospital face sheet.
[CUSTOMER][NEUTRAL] Yes, certificate number 272813.
[AGENT][NEUTRAL] Um, let me see if that's a group number.
[CUSTOMER][NEUTRAL] Um, I can tell you right now that this patient is incarcerated.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, I, I'm just going by what's on the face sheet of the hospital to build the fracture that he sustained.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I am
[CUSTOMER][NEUTRAL] Like I said, all they have here at [PII] is a stated other indemnity plan.
[CUSTOMER][NEUTRAL] And I'm like I know that's not the name of this ladies and I'm like really?
[AGENT][NEUTRAL] Do you have a, well, well, hold on, let me see if that's the group first.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, he is incarcerated, so we are calling from [PII], so.
[AGENT][NEUTRAL] No, that's not a group.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, do you have the social? I can try to look it up with the social. I don't know what the, OK.
[CUSTOMER][NEUTRAL] Mm, that
[CUSTOMER][NEUTRAL] No, no, they don't have a social. I can give you his name.
[AGENT][NEUTRAL] OK, I can try with the first and last name.
[CUSTOMER][NEUTRAL] It last name is [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] First name is [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm let me see, I do have his date of birth, that's a plus.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know I, I'm just going by the and the and they I was lucky that they even had your telephone number listed otherwise, you know.
[AGENT][POSITIVE] Oh, you're totally fine. You are fine. I hold on one second.
[AGENT][NEUTRAL] I guess I.
[AGENT][NEUTRAL] Yeah, we don't have a policy with that name, um.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, we don't have a, um, I was just checking to make sure, but yes, there's no policy with that name.
[CUSTOMER][NEUTRAL] OK, so I called the [PII] and they have listed.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Other insurance plan [PII].
[AGENT][NEUTRAL] That is our claims mailing address, um.
[AGENT][NEUTRAL] I mean, if we can get a, because I can't search my date of birth, I can only see the date of birth once I'm in the policy, so I can't use that.
[AGENT][NEUTRAL] But um,
[AGENT][NEUTRAL] If we can get maybe the social, I don't know how it works, um, but
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Just with the name and I tried to use that number that you gave as a policy number, but that's too short. It's usually 7 to 8 digits. It will start with the 01 or 02 though.
[CUSTOMER][NEUTRAL] 7 or 8 digits and starts with.
[AGENT][NEUTRAL] A 01 or 02?
[CUSTOMER][NEUTRAL] I'm sorry, 01
[CUSTOMER][NEUTRAL] Or 02.
[AGENT][NEUTRAL] And it uh it may have
[CUSTOMER][NEUTRAL] So it's not like it's not like [PII]?
[AGENT][NEUTRAL] Well, it's 7 to 8 digits.
[CUSTOMER][NEUTRAL] OK, so if I put a 01 in front of that, maybe that's what the hospital was doing. I don't, I, I'm just looking at the face sheet.
[AGENT][NEUTRAL] And it usually
[CUSTOMER][POSITIVE] I, I just, I, I love it. Uh, you know, I'm supposed to, I am supposed to just drop this claim and they're like.
[AGENT][NEUTRAL] I can try. Hold on one moment.
[CUSTOMER][POSITIVE] I'm like there's no payer ID number. There's nothing on here, people. What, uh, you know, I'm, I'm, I'm ready to win the lottery and retire. That is what I'm ready to do.
[AGENT][NEUTRAL] Um, let me try with 02. For 01, it was another member.
[AGENT][NEUTRAL] Yeah, 02 it is as well. Um, let them know it may have an ML 7 or 8 at the end if it is American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because they have on here it's an ALLOP.
[CUSTOMER][NEUTRAL] I have no idea that's just a service type that they had.
[CUSTOMER][NEUTRAL] I'm just reading whatever I can I can give you for any kind uh whatever information I can give you with whatever they have for me.
[AGENT][NEUTRAL] A L L O P.
[AGENT][NEUTRAL] Um, I mean, OP may be outpatient, the ALL, I don't know.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, OK, I, I'm gonna send this back right back to them and they can once they find the information, I do need a payer ID number though, um, [PII].
[AGENT][NEUTRAL] So, depending on for APL just American Public Life, our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK, so that's American Public Life?
[AGENT][POSITIVE] Mhm. That's correct.
[CUSTOMER][NEUTRAL] OK, which is the APL.
[CUSTOMER][NEUTRAL] Is there a different payer ID for a different?
[AGENT][NEUTRAL] Depending on the type of policy that they that, depending on the policy that they have, it may be sent to IMA which is like which is like a repricing service before the claim is processed to try to get like additional benefits.
[CUSTOMER][NEUTRAL] Group or?
[AGENT][NEUTRAL] So, um, that has a different payer ID, but I don't know what type of policy to tell you which one.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I, I don't know what type of policy this is either.
[CUSTOMER][NEUTRAL] Other than he's in jail, and he, uh, yeah, he's in jail and was injured because my doctors went to the hospital and repaired a fracture, so.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] All right, I'm gonna see what else we can do. I appreciate your help very much though thank you [PII]. Could I just get a reference number?
[AGENT][POSITIVE] You're very welcome, [PII].
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][POSITIVE] OK, that's what I will do. Thank you, [PII]. I hope you have a great day.
[AGENT][POSITIVE] You also, and thanks for calling APL.
[CUSTOMER][NEUTRAL] Uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.