AccountId: 011433970860
ContactId: 01c8391c-bb8b-4468-87ec-28c09df36c84
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 683820 ms
Total Talk Time (AGENT): 111426 ms
Total Talk Time (CUSTOMER): 501097 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/01c8391c-bb8b-4468-87ec-28c09df36c84_20250319T17:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? Uh my name is [PII]. My last name is [PII]
[CUSTOMER][NEGATIVE] Um, I am on the other line with um, with, um, I had a service on the Gastro Health and um they keep sending me the bill and this bill actually was supposed to to be submitted to you guys. The claim was was supposed to to be submitted to you, but they never did and I just spoke like 1010 minutes ago with one of your colleagues and I was verifying with them to see if the bill was submitted and they told me that they never got this.
[CUSTOMER][NEUTRAL] Bill, so I'm on the other line, so we are all 3 of us here on the, on this phone call with the, with the Gastro Health basically that they keep sending me this bill that's supposed to get to you guys, but they don't believe me that basically you guys never received that that claim from them. So I just wanna verify all this information while you, while, while she's with me as well so that she can see that there was no claim made.
[CUSTOMER][NEUTRAL] For this amount that they keep sending me the bill for. So, um, I'm gonna give you the information of my APL.
[CUSTOMER][NEUTRAL] And I want you to tell, tell them exactly when my APL uh gap insurance finished with you guys because this bill, it's from last year from April, and I know that the last time that I had this insurance with you guys was June. So basically, I'm covered by, by APL because the service was done in April.
[CUSTOMER][NEUTRAL] And my insurance with you guys, the gap insurance, the APL finish sometime in June. So if you can check this information, I'll give you the in-hospital uh benefit certificate number, which is 02219206 M for Mary, L for Larry and number 7.
[CUSTOMER][NEGATIVE] And if you can tell them now, yes, if you can tell them when it actually stopped the insurance that I had with you guys, and also to tell them that, you know, that this bill was never submitted.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you, [PII], can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] Sure. [PII]. The email address is [PII].
[AGENT][NEUTRAL] And your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And can I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. And may I have the date of service?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, the date of service was [PII].
[AGENT][NEUTRAL] And do you have the total bill amount for that?
[CUSTOMER][NEUTRAL] Yes, it's 14,870.
[AGENT][POSITIVE] Thank you. We'll get this pulled up.
[AGENT][NEUTRAL] And the provider is Gastrohealth.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And as of today, I'm not seeing we did receive claim 4 17 2024.
[AGENT][NEUTRAL] The policy was active, but I'm not showing we ever received the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Now, just give me one second, [PII]. Did you hear that?
[CUSTOMER][NEUTRAL] Um, actually, [PII], yes, um, hello representative for APL, um, I am [PII] from billing department of cash or Health, so.
[CUSTOMER][NEUTRAL] You mentioned already that you will be not receive a claim from us, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. So, can you please check, uh, the total charges of the bill is $2,788. And this bill is regarding for the um Doctor [PII], which is for the procedure of the patient for the colonoscopy and endoscopy for [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, listen, the amount, the amount that you just mentioned, [PII], that it's for the whole service which was mainly covered by my primary insurance. This remaining balance is usually supposed to be covered by the.
[CUSTOMER][NEUTRAL] By the gap insurance. So the balance is 148.70 which actually this needs to be covered by the gap insurance and this is what you're billing me for. You understand that? Um, I understand, ma'am. I just needed to be double-checking by your APL insurance the complete charges of the bill.
[CUSTOMER][NEUTRAL] OK, don't worry if this will be something wrong we can go ahead and resubmit. [PII], I am very worried because this is the 2nd time I have this conversation with the 3 person, the same thing that I'm having with you and the ones from the APL and another 10 conversations with the APL alone and we.
[CUSTOMER][NEGATIVE] You guys alone and nothing has been fixed so I'm kind of worried because I, it feels like whatever I do, you guys don't take care of the job so I'm kind of frustrated after 10 calls 1 year later that you're not able to submit the bill. So I am kind of concerned if you understand my position that I have to waste this time.
[CUSTOMER][NEGATIVE] Calling you 10 times, calling the other people that, that, that, and, and I am frustrated. So please don't tell me that because I'm, I'm gonna come out of my skin for, for what you're telling me now.
[CUSTOMER][POSITIVE] Um, I'm just trying to help you, so that's why I need like everybody else you are trying, you're trying, but you're not succeeding, you're trying, you're trying, but you're not succeeding because you guys don't do your job this is what it is, you know, some people work hard and do their job, ma'am. Yes, you are that's why I still have this bill and there is no no claim submitted to the APL because you do your job. I understand. OK, let's carry on.
[AGENT][NEUTRAL] I'm sorry, can I suggest that we have the claim faxed over so that we can get this processed?
[AGENT][NEUTRAL] I'm not showing any claims in history.
[CUSTOMER][NEUTRAL] Yes, sure, I'm sorry, I'm sorry, I'm sorry, [PII], but, but I, I have so much frustration because it's one year already that I'm dealing with this. I'm sorry.
[AGENT][NEUTRAL] And I apologize, I understand, but if she would like
[CUSTOMER][NEUTRAL] It's not your, it's not your fault, yeah.
[AGENT][POSITIVE] You can actually, I'll give you the fax number.
[CUSTOMER][NEUTRAL] OK. Um, so, Miss,
[CUSTOMER][NEUTRAL] Um, we don't have any fax number. We can, uh, we don't have an option to send this one. But, however, do you have the correct address of this American Public Life Insurance?
[AGENT][NEUTRAL] Yes, the mailing address will be
[CUSTOMER][NEUTRAL] The correct address to be submitting the claims. Um, hold on, hold on.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me just double check here.
[CUSTOMER][NEUTRAL] And can you please verify to me also the member ID of the patient here?
[AGENT][NEUTRAL] Yes, the policy number will be 02.
[AGENT][NEUTRAL] 219206.
[CUSTOMER][NEUTRAL] That's all.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Um, I mean that's all the member ID.
[AGENT][NEUTRAL] Yes, 02219206.
[CUSTOMER][NEUTRAL] Thank you and what is the address?
[AGENT][NEUTRAL] It will be American Public Life.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, just for a second, let me just double check the address for this one, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So I think there is something wrong about for this one. So, [PII], um, since the, um, your insurance will be provided already the address and also the member ID. So for your member ID, um,
[CUSTOMER][NEUTRAL] This one, it will be correct, but there's a three letter that will be included on there. So that's why that will be your insurance will be not receiving the claim. So this is our mistake, we apologize. And also the address, it will be um incorrect too. So, as long as we have the address right now since your insurance will be provided this one.
[CUSTOMER][NEUTRAL] We can go ahead 1 2nd, 1 2nd, [PII], let me tell you something. I just send you the copy, the front and the back copy with all this information that the APL just provided you, so don't tell me that was wrong because exactly I can.
[CUSTOMER][NEUTRAL] Tell you again the address that I have in the back of this card that I just sent it to you since last year and today I resend it to you again. It's exactly all the information that you see that this lady told you you have them on the card that I already sent you the photos of.
[CUSTOMER][MIXED] So please do not tell me that the information is wrong because this is exactly the same information I provided to you from my card and I send you the copy, the pictures of the card. So, there is nothing wrong with that, OK? The only thing that I think that may have been wrong is that the member.
[CUSTOMER][NEUTRAL] I, I gave the member ID with the M for Mary, L for Larry 7 because I did not know that that's not the number, but all the other informations are there. Everything that that was provided to you right now are on the card and you have the copies of pictures of this card.
[CUSTOMER][NEUTRAL] OK, sure, no problem, ma'am. We will be go ahead and to double check that one to once we will, uh, that we, uh, we already received it, but as long as we have the correct information right now, we can go ahead and resubmit the claim, uh, to your APL insurance. So this one, it will takes 30 to 45 days. So if you will be still receiving a bill, please disregard the bill, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can assist you ladies with today?
[CUSTOMER][POSITIVE] No, thank you so much for your help and for your kindness.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] And [PII], is there anything else that I can help you better.