AccountId: 011433970860
ContactId: 080a57e3-109e-4bd5-a2c2-ee04b0d8ced6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1187199 ms
Total Talk Time (AGENT): 327392 ms
Total Talk Time (CUSTOMER): 280809 ms
Interruptions: 5
Overall Sentiment: AGENT=0.3, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/080a57e3-109e-4bd5-a2c2-ee04b0d8ced6_20250130T16:45_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, good, uh, good morning. My name is [PII]. I'm calling because, um, I had, um, an, an emergency admission back in December, and I need to know guys what are you guys covering as my secondary insurance. I need all that paperwork because I'm having issues that I need, uh, I need to know how much do I owe. My, my lawyer asked for that information.
[AGENT][NEUTRAL] OK, so do you have a policy number?
[CUSTOMER][NEGATIVE] No, I don't have my card with you. I actually lost the car a long time ago.
[AGENT][NEUTRAL] Do you have his social or how would I look up the policy?
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, of course, yeah, I know, of course I have my social. I know my social. [PII].
[AGENT][NEUTRAL] Be it to me one more time.
[CUSTOMER][NEUTRAL] [PII]. And I'm sorry, your name?
[AGENT][NEUTRAL] My name is [PII]. Can I have your name and your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII], [PII].
[AGENT][NEUTRAL] And when I asked you for your policy number, you stated that your husband lost it a while ago?
[CUSTOMER][NEGATIVE] I lost the card. I mean, I, my wallet was stolen. I lost everything, so I haven't, I don't know my policy number.
[AGENT][NEUTRAL] So let me give you the policy number. Let me know when you're ready to retrieve the policy number.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It is 205-712-6. It's 205-712-6. And what is the email address that we have, we don't have one. Can I get a call back number for you just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] And I can also give you my email.
[AGENT][NEUTRAL] OK, what's your email address and I can send a copy of your card to your email.
[CUSTOMER][NEUTRAL] It's my first name and last name all together, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what was your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] I'm not sorry that's my work um [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So you were calling in regards to a claim, um, but could you repeat what you were saying in the beginning of the call?
[CUSTOMER][NEUTRAL] Yeah, it's actually, yeah, it's, yeah, sorry, it's several claims. I, I had an admission back in December, an emergency admission. I was at the hospital for a few days, and I need a list of whatever claims you guys been submitted since December and see how much you guys paid and how much is my responsibility.
[AGENT][NEUTRAL] OK, you're talking a little tad faster than I can keep up with, so repeat it one more time if you don't mind.
[CUSTOMER][NEUTRAL] All right. Um,
[CUSTOMER][NEUTRAL] I was admitted at the hospital back in December and uh I need a list.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of the claims that have been submitted to you as my secondary insurance?
[CUSTOMER][NEGATIVE] Because I need to see how much it's my responsibility, how much you guys have been covering.
[AGENT][NEUTRAL] OK, so what do you know the date of service it started from December?
[CUSTOMER][NEUTRAL] Yeah, yeah, I, I, I believe it started around because it was an emergency, you are then was ambulance, I believe it was [PII].
[AGENT][NEUTRAL] OK, so it looks like.
[CUSTOMER][NEUTRAL] All the way to the end of December.
[AGENT][NEUTRAL] So it looks like there's a hospital facility charge from [PII], and we made a payment of $300.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] $800. OK, that's the actual uh facility fee.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We made a payment of $300.
[CUSTOMER][NEUTRAL] Any other claim that you have received at?
[AGENT][NEUTRAL] And let me see what was the full amount.
[AGENT][NEUTRAL] The, the full, we paid that full amount was $300. Then there was one for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We paid $135.68 on that one.
[AGENT][NEUTRAL] And that is for procedure code of 99222, so that's a, a professional fee charge?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Do you know what was the total amount of that claim?
[AGENT][NEUTRAL] The total bill amount was $348. However, once the primary made payments, the, the bill amount was $13568 remaining, and we made a payment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] All right, perfect, that's what I needed to know.
[CUSTOMER][NEUTRAL] Do you have the total charges for the facility, the previous one that you gave me?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] The total facility charge was 11,000.
[AGENT][NEUTRAL] I'm sorry, it's 113,000.
[AGENT][NEUTRAL] $336.
[CUSTOMER][NEUTRAL] Can you a name of that.
[CUSTOMER][NEUTRAL] OK, so, uh, in those two creams that you gave me the C and then the.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] or
[AGENT][NEUTRAL] Repeat that cause you're far away if that's you talking.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I was sending it to you, um, those two that you gave me to pay you guys pay the balance for both of them.
[AGENT][NEUTRAL] Your phone is going, I'm not sure what you just said cause your phone was, I'm not sure if you weren't close to your phone.
[CUSTOMER][NEUTRAL] Is it better now?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] So then there was a payment.
[CUSTOMER][NEUTRAL] But then I was
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] So there was a payment of $101.04 for [PII] for a professional fee. The total bill amount was 299 cents.
[CUSTOMER][NEUTRAL] Alright, that's was [PII] you said, right?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And then there was another bill amount for.
[AGENT][NEUTRAL] 157 29.
[CUSTOMER][NEUTRAL] Was that your payment? 15729?
[AGENT][NEUTRAL] Yes, the 157 29.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you have the date of service for that one?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] That's for [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And the total charge for that one?
[AGENT][NEUTRAL] And the total bill amount for that one is?
[AGENT][NEUTRAL] 3:48.
[CUSTOMER][NEUTRAL] 248. OK.
[AGENT][NEUTRAL] Uh, give me one moment. 2254.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 2254.
[AGENT][NEUTRAL] So this one is for.
[AGENT][NEGATIVE] So this data service that I just gave you, I gave you the incorrect data service is [PII], and the bill amount was 13568 is what we paid, but the bill amount was 348.
[CUSTOMER][NEUTRAL] 135 50 you said?
[AGENT][NEUTRAL] The 135, 6 days what we pay in the total bill amount was $348 and the bill, the billing date was [PII].
[CUSTOMER][NEUTRAL] Yeah, you, you gave me an amount before 157, uh, with 29 cents.
[AGENT][NEUTRAL] Right and I I just repeat, I just stated that to delete that because I gave you the incorrect bill amount for a different date of service that does not go with the inpatient services. I just literally asked you to delete that and replace it with the amount that I just gave you.
[CUSTOMER][NEUTRAL] All right. Just
[CUSTOMER][NEUTRAL] Take it easy. You have me 3 times to repeat myself. I just ask you once, please. I just need the information. No, but please, let's try to speak, uh, calmly. I also do customer service and please, uh, OK, so we have the [PII], the [PII], the [PII], and the [PII]. Is there any other bills prior to that, perhaps an ambulance because I was uh taken by ambulance or anything else that that you guys have received?
[AGENT][NEUTRAL] No, I don't have a problem with it. I just wanna make sure you have the correct information.
[AGENT][NEUTRAL] No, we don't have an ambulance charge. No, we have, so the first bill that I gave you was for the $300 was from [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then the second one was.
[CUSTOMER][NEUTRAL] The facility, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For 13568, it looked like they submitted that twice. That's why I was confusing. So the 13568 and the total bill amount was 348 for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then for [PII], it was 101.
[AGENT][NEUTRAL] 04 $101.04.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] The other date of service that I was giving you is for [PII] that doesn't go with the inpatient hospital bill.
[CUSTOMER][NEUTRAL] OK, OK, uh, uh, that one is probably one of my images following up the surgery, OK, and what about those, the, the amount paid and
[AGENT][NEUTRAL] OK, so for [PII], there was $157.29 paid on that claim.
[CUSTOMER][NEUTRAL] Mm mhm.
[AGENT][NEUTRAL] And the total bill amount was?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] $600 the total bill amount was $600.
[CUSTOMER][NEUTRAL] 600, OK.
[CUSTOMER][NEUTRAL] Any other bill in December that you guys received?
[AGENT][NEUTRAL] No, ma'am, that's all for December. No ambulance charges.
[CUSTOMER][NEUTRAL] That's all. 12345. No ambulance, huh, OK, so let me call the ambulance then.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh right, is there a way that you can send me an email with the EOBs for those things?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I can, however, there is an online website as well where you can retrieve all of your claims on your policy, but I can send them to you to your email.
[CUSTOMER][NEUTRAL] All right, will you send that information to my email please?
[AGENT][NEUTRAL] Mhm. May I place you on a brief hold while I do that?
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][POSITIVE] Thank you. Hold one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding. So I've sent all of those ELBs to you by email. Could you verify if you received them?
[CUSTOMER][NEUTRAL] Yeah, let me take a look.
[CUSTOMER][NEUTRAL] Let me take a look.
[AGENT][NEUTRAL] And I send a copy of your card as well.
[CUSTOMER][NEUTRAL] OK, 12. Shyler [PII], right? I have 4 emails. 123. OK, the first one is the card and then I have 3 emails with EOBs.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that is my [PII]. Yeah, I, I got the email.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, thank you. Have a good day.
[AGENT][POSITIVE] Thanks for calling APO. You have a great one as well. Goodbye.
[CUSTOMER][NEUTRAL] Bye.