AccountId: 011433970860
ContactId: 056b3f3d-3e16-40de-bf12-47e79da7f119
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251360 ms
Total Talk Time (AGENT): 119993 ms
Total Talk Time (CUSTOMER): 107976 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/056b3f3d-3e16-40de-bf12-47e79da7f119_20250131T20:05_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] Yeah, I have APL coverage, and I went to the doctor a few weeks ago, and I went to an office visit. I paid my uh co-payment, uh, with my insurance, which happens to be United Healthcare, and I also gave the um, uh, I also have APL with you and um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I, I, I was told that, uh, I have a $105 deductible, uh, but I have to pay for my insurance, and I was under the impression that APL was a supplemental insurance that would take care of this.
[AGENT][NEUTRAL] Correct. I mean, yes and no. We, we do apply to the co-pay, deductible and co-insurance after primary of covered charges, but I can look into the claim for you.
[CUSTOMER][NEUTRAL] Thank you and, and they asked me for the member number and I don't have the member number. I just know I, I work for my company that that that provided me the, the coverage and I just don't I just have the group number, not the member number, and they needed the member number.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can give you your policy number. Um, what group number do you have?
[CUSTOMER][NEUTRAL] 25578
[AGENT][NEUTRAL] OK, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's um my name is [PII]
[CUSTOMER][NEUTRAL] And my number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that. Hold on one moment.
[AGENT][NEUTRAL] And you said the last name is [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Oh, [PII], OK.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] And I just found your policy and I just need you to verify your date of birth, your mailing and email address.
[CUSTOMER][NEUTRAL] 6158
[CUSTOMER][NEUTRAL] Date of birth, uh, what else do you need my address [PII].
[CUSTOMER][NEUTRAL] What else did you need?
[AGENT][NEUTRAL] And your email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And let me go ahead and give you your policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it is 221.
[AGENT][NEUTRAL] 6481.
[CUSTOMER][NEUTRAL] 221-6481
[AGENT][NEUTRAL] Yes, ma'am. That's the policy number or they may call it the member ID.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, um, so for your claim, yes, for your Medlink policy, we do pay towards the copay, deductible and co-insurance. So if they made you pay a $150 deductible or you know, whatever amount it is, if they made you pay it, when we received the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We'll see because they send the explanation of benefits from UnitedHealthcare. So we'll see what was charged, what you paid, and and what's left over. If we need to reimburse you, we can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, I haven't paid it yet. They just sent me the bill and I told them about it and they said no, you still have to pay it so I haven't paid it. I'm gonna go back and give them the policy number that you gave me and hopefully that will help. Thank you very much.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, you would still have to pay, OK.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] You would still have to pay. We, we don't come in until the the back end once the claim is filed. So that's why we need that explanation of benefits from United Healthcare, so that we can reimburse if you've already paid. Or it could be they say they'll bill it, you know, some places don't bill anymore, you have to pay now, but if there is an option to bill, then you wouldn't have to pay, they'll bill us and we'll handle it on the back end.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much let me get back to them then thank you very much for your help.
[AGENT][POSITIVE] All right. You're welcome. You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.