AccountId: 011433970860
ContactId: f39d6990-2947-4777-995d-9da2abdc5618
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455980 ms
Total Talk Time (AGENT): 186324 ms
Total Talk Time (CUSTOMER): 155008 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/f39d6990-2947-4777-995d-9da2abdc5618_20250505T20:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. I'm calling because um
[CUSTOMER][NEGATIVE] I'm reading some mail where I had uh a doctor's office had tried to call in a claim and they're they're, they're saying they're not getting paid. So I'm trying to figure out what's going on and why my insurance is not working for me.
[AGENT][NEUTRAL] OK, I can help with the claim, Ms. [PII]. Can I please get your callback number, ma'am, just in case the call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your policy number?
[CUSTOMER][NEUTRAL] Oh, hold on, let me grab my purse real quick. Oh man, I'm just sit in the car.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yeah, take your time.
[CUSTOMER][NEUTRAL] Um, let's see if it's gonna be.
[CUSTOMER][NEUTRAL] It might be on the bill. I just get. Well, it's not a bill, but it.
[CUSTOMER][NEUTRAL] What's the claim number, the policy number. Give me 1 2nd.
[AGENT][POSITIVE] OK, take your time, please.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] So, my policy number is 0.
[CUSTOMER][NEUTRAL] 025
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 844-52
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII] and uh what was the other question?
[AGENT][NEUTRAL] Your email address
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying your policy for me. OK, do you know when they sent in the claim?
[CUSTOMER][NEUTRAL] I've seen him. I just got a, I was.
[AGENT][NEUTRAL] Or what the data services.
[CUSTOMER][NEUTRAL] And they sent in one on.
[CUSTOMER][NEUTRAL] 02425
[CUSTOMER][NEUTRAL] Um, the claim number was 356-760.
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me look at that one real quick I.
[CUSTOMER][NEUTRAL] Um, but they said that every time that I can, huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, I've got it pulled
[CUSTOMER][NEUTRAL] And then I got another
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I do see that they did send one in on that date that you gave me and it does have a remark on it. Let me see what the remark says real quick.
[AGENT][NEUTRAL] OK, so this is the remark that is on the claim.
[AGENT][NEUTRAL] The outpatient rider only allows payment for outpatient surgery in an outpatient hospital or physician's office. Therefore, no benefits are payable. Please refer to section 5.
[AGENT][NEUTRAL] Of the benefits or you can contact our office with questions.
[CUSTOMER][NEGATIVE] Well, they're telling me that that this is not even an insurance company. They're telling me it's life insurance, it's not even medical insurance. So I, I can't figure out.
[AGENT][NEUTRAL] No, we have
[AGENT][NEUTRAL] No, we have all kinds of insurance and our company is called American Public Life, but it's not just life insurance, we have all types of insurance, short term disability, medical, dental.
[AGENT][NEUTRAL] Many different types of coverage.
[CUSTOMER][NEGATIVE] OK, so what do I need to do cause they won't see me, cause they said they're not getting paid, so now they won't see me.
[CUSTOMER][NEGATIVE] And I need to see a doctor. I don't feel good. I've been sick for 3 weeks.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Yes ma'am, I understand um.
[AGENT][NEUTRAL] Let me see something real quick.
[AGENT][POSITIVE] You can actually go um I'm going to give you a number and I'm gonna transfer you on over to uh benefits and a card multi plan and they can give you providers in your area that you can go to.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That accept your insurance if you would like.
[AGENT][POSITIVE] I can do that for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I mean, I I hate to switch my doctor. I've been with my doctor for 10 years, so little scary switching up your doctor when you know your doctor and your doctor know you.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yes, I understand.
[CUSTOMER][NEUTRAL] But I gotta do something. I see a doctor.
[AGENT][NEUTRAL] Yeah, um, let me give you, um, the phone number.
[AGENT][NEUTRAL] For multi plan just in case the call is disconnected while I'm transferring you.
[AGENT][NEUTRAL] The number is [PII]. Yes, ma'am.
[CUSTOMER][NEUTRAL] 01 sec.
[CUSTOMER][NEUTRAL] One second, I'll get my ETN.
[AGENT][NEUTRAL] OK, I'll hold on.
[CUSTOMER][NEUTRAL] Uh-huh. Oh, that's.
[CUSTOMER][NEUTRAL] You said [PII]?
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 457.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 1403.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm gonna transfer you.
[CUSTOMER][NEUTRAL] And with this also,
[AGENT][NEUTRAL] Uh-huh. Go ahead.
[CUSTOMER][NEUTRAL] Uh, I it's one. OK, so I was trying to make me a dentist appointment, but on my cards I don't, I see visioned, but I don't see dental. So do I use one of the same numbers that's on this card for my dental?
[CUSTOMER][NEUTRAL] Cause I got 2 cards.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] No, ma'am, I can give you your um policy number for your dental insurance.
[CUSTOMER][NEUTRAL] OK, could you give me that so I can get that back information to the dentist office.
[AGENT][NEUTRAL] Yes. Yes, ma'am. It's 25[PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if they want to verify your coverage.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am. If they want to verify your coverage, they can call the same number you did and we'll give them all your benefits and eligibility over the telephone for them.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright, is there anything else I can help you with before I transfer you on over?
[CUSTOMER][NEUTRAL] No, ma'am, that's it.
[AGENT][POSITIVE] All right. Well, you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] OK, thank you, you too.
[AGENT][NEUTRAL] Mm bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Questions