AccountId: 011433970860
ContactId: 0860d9e4-6152-482e-9e7a-72cea6896c3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 724039 ms
Total Talk Time (AGENT): 201162 ms
Total Talk Time (CUSTOMER): 456358 ms
Interruptions: 7
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/0860d9e4-6152-482e-9e7a-72cea6896c3c_20250107T18:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII].
[CUSTOMER][NEUTRAL] And I can give you my policy number if you need it now, or.
[AGENT][NEUTRAL] OK. Yes, go ahead and give me that, [PII].
[CUSTOMER][NEUTRAL] And it's
[CUSTOMER][NEUTRAL] 0256
[CUSTOMER][NEUTRAL] 7382
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And verify the patients, verify your date of birth and your mailing address for me, please.
[CUSTOMER][NEUTRAL] [PII] at [PII].
[AGENT][NEUTRAL] And your email address, uh, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thanks for verifying the information for me. How can I help you today?
[CUSTOMER][NEUTRAL] I'm calling because, um, first of all, I went to the emergency room.
[CUSTOMER][NEGATIVE] Back in November, and I don't got a bill for my X-rays for $900 some dollars and now they recommended me to go to a hand doctor, which I'm at now, but they can't find this insurance in their system nowhere and they, they, they billing me and my insurance ain't working.
[CUSTOMER][NEUTRAL] They don't know if it's Blue Cross Blue Shield or who, who is this insurance company through.
[AGENT][NEUTRAL] American Public Life.
[CUSTOMER][NEGATIVE] OK, when they type it in their system, nothing comes up.
[AGENT][NEUTRAL] OK, then they would just simply need to contact us at the number that you called and we can verify your benefits and give them your policy information.
[CUSTOMER][NEUTRAL] Cause I'm, I'm just, I'm at the doctor's office.
[CUSTOMER][NEUTRAL] OK, so we gotta walk back in here so.
[AGENT][NEGATIVE] They're probably not. I don't know why when you say they're not coming up in your system I don't know where they're looking.
[CUSTOMER][NEUTRAL] Yeah, well, I mean she just don't know like I said, she ain't never heard of this insurance and they don't know where is this company? Where y'all out of where y'all from? [PII]?
[AGENT][NEUTRAL] Jackson, Mississippi.
[CUSTOMER][NEUTRAL] [PII] because she pulled up something saying it was in [PII] or something. So, like I said, I don't know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But if, if that's what I need to do there.
[AGENT][NEUTRAL] Mhm. What, what number did you dial?
[CUSTOMER][NEGATIVE] I, I didn't dial no number. I gave them this insurance card and when they put in my information, it's not showing that I have no insurance.
[AGENT][NEUTRAL] When you called us today what phone number did you dial?
[CUSTOMER][NEUTRAL] I, I dialed the [PII] number.
[AGENT][NEUTRAL] Correct. And so what you can do is give your provider that phone number. It's option 2.
[CUSTOMER][NEUTRAL] Customer service.
[AGENT][NEUTRAL] And that will bring them to the benefits team and we can verify your benefits and give them your policy number. Did you do have an emergency room benefit and you said you have a follow-up visit with your specialist, a hand doctor?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEGATIVE] Yes, yes, ma'am. That's where I'm at now cause I, I have a 2 o'clock appointment, but they can't get no information on me and they're gonna bill me and and my bill is already almost $1000 for the X-ray. And she said they might do another X-ray today.
[AGENT][NEUTRAL] You have an
[AGENT][NEUTRAL] Right. Are you able to put them on the phone now?
[CUSTOMER][NEUTRAL] I walked out of the building, but let me walk back in here and get back upstairs and I'll let them know what you said and I'll get them to call you guys back but she the one who gave me the number, so I don't know why she didn't call you while I was in there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] That's a good question, [PII]. Let me see, yeah, and I don't show any calls. Um, but do you, do you have a copy of your ID card?
[CUSTOMER][NEUTRAL] Oh no, she, she is.
[CUSTOMER][NEUTRAL] Yeah, I got my, that's, that's what I'm using is my ID card. That's how I gave you my policy number off of it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, OK, got it.
[AGENT][NEUTRAL] So
[CUSTOMER][NEGATIVE] But see the emergency room and uh when I went to the emergency room, I gave them my information too, but they still didn't, I mean, they didn't never call me and say my insurance didn't go through. All they did was bill me, but now I know why the bill is so high because they can't verify that I have insurance.
[AGENT][NEUTRAL] Correct. OK, that makes sense. So then.
[AGENT][NEUTRAL] Um, and tech and also someone from the, uh, emergency room or the hospital can call us as well and we can verify what your benefits are and they can get a claim filed, you know, to APL.
[CUSTOMER][NEUTRAL] Yeah, yeah, well, all of them is connected because as you see health and all of it is connected to the, you know, so once I can get it in here and at this place can get it confirmed it'll, yes ma'am, so that's what we need to do is just get it in the system.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Everybody can see it. Mhm.
[AGENT][NEUTRAL] OK, so do you wanna at least wait until you get up there and let them know that you had the insurance company on the phone?
[CUSTOMER][NEUTRAL] If you wanna wait that long because I'm walking back in the building now if you want, OK, OK, sounds good. I'm, I'm.
[AGENT][NEUTRAL] I can hold, I can wait.
[AGENT][NEUTRAL] Since your appointment is, is today.
[CUSTOMER][NEUTRAL] Yeah, it's at [PII], but when I came out of the building, I canceled it because I didn't know how long this was gonna take and.
[AGENT][NEUTRAL] Ah.
[CUSTOMER][NEUTRAL] You know, but I don't, I ain't gotta be there till [PII], and it's just 1:45.
[AGENT][NEUTRAL] Is it 1:45? Are you Eastern?
[CUSTOMER][NEUTRAL] Yes ma'am, so I got 15 minutes. So either way it go, I still need to give him this information for that other bill.
[AGENT][NEUTRAL] Eastern time, OK. Hopefully they can.
[AGENT][NEUTRAL] You know, maybe they'll go ahead and see you today.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So I'll, I'll wait until you get there.
[CUSTOMER][NEUTRAL] Yeah, yeah, I'm almost.
[CUSTOMER][NEUTRAL] OK, I'm at the elevator now and I just gotta go up to the 2nd floor.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Go ahead, take your time. Thanks. Thanks. Go ahead soon. All right.
[CUSTOMER][NEUTRAL] Yeah, we go on at [PII].
[CUSTOMER][NEUTRAL] Yeah, we on the elevator now, yeah.
[AGENT][POSITIVE] OK, you're good.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] You can go ahead. Thank you. Yes ma'am.
[CUSTOMER][NEUTRAL] OK, ain't nobody on that.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Here you go right here, ma'am. This is my insurance. Hi.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hi, this is [PII] with American Public Life. To whom am I speaking?
[CUSTOMER][NEUTRAL] [PII] at the ACC Orthopedics.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I can give you [PII]'s policy number, and he does have benefits with through American Public Life. I can give you that information if you would like.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So when I um type it in, do I, do I put it under a generic or what? Because when I type that American y'all uh company in and nothing comes up. The American Public Life.
[AGENT][NEUTRAL] What did you type in?
[AGENT][NEUTRAL] Insurance company that's that's us.
[CUSTOMER][NEUTRAL] Yeah, nothing pops up. What's the last name again?
[CUSTOMER][NEUTRAL] They might have canceled your appointment. I don't know.
[CUSTOMER][NEUTRAL] Uh, what's your phone number? [PII]
[CUSTOMER][NEUTRAL] OK, have you traveled outside the [PII] in the past 21 days or that a positive for, right? Yes.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] I'm gonna go to his.
[CUSTOMER][POSITIVE] And so I'm typing in American Public Life if you don't mind just reading um answering them for me.
[CUSTOMER][NEUTRAL] Yeah, nothing pops up when I type that in, so I don't know.
[CUSTOMER][NEUTRAL] I don't know what to type.
[AGENT][NEUTRAL] OK, so I'm not familiar with your system, but I mean he has a policy with us and I can get, well I think he has his card, but I can give you the policy number.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEGATIVE] Yeah, I have the policy number and everything on this car. I just don't know, like we, I ran it through RTE using Epic and nothing's coming back and he's being billed for everything because we can't get the insurance in here.
[AGENT][NEUTRAL] OK, so when you call to verify information or benefit information.
[AGENT][NEUTRAL] Uh, I'm a little confused.
[AGENT][NEUTRAL] So because APL is not pulling up in your system.
[CUSTOMER][NEUTRAL] I, I, I don't.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] No, I'm just trying to help the gentleman get his insurance verified.
[CUSTOMER][NEUTRAL] Yeah, I, I'm trying to help him too, but when I try to put the insurance in, like the insurance is not in his chart at all.
[CUSTOMER][NEGATIVE] It's, it's nothing's coming up for your American public life.
[AGENT][NEUTRAL] Would you have to enter it into his file for it to pull up?
[CUSTOMER][NEGATIVE] That's what I'm trying to do. I'm trying to go in and put the insurance in and nothing's coming back. Like you know how you type in like UnitedHealthcare or something? That, that comes automatically up. This American Public Life, nothing comes up. It says no results, no results found.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So if it's new coverage, do you not key in the information on his card to to get it housed in your system?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes ma'am, I do. I, we key it in. We, we just can't find your, your insurance.
[AGENT][NEUTRAL] OK, well, I mean, he
[CUSTOMER][NEUTRAL] And he said he was seen at another hospital with UNC and they weren't able to get it in either, so, cause it's, it's not in here.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, he has coverage with American Public Life and he has emergency room and office visit benefits under his plan, so.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Beyond that point, I don't know as far as your systems what what what to do.
[CUSTOMER][NEUTRAL] Hold on one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, you caught the tail in it though. You, you, yeah, no, what you got? Have you ever heard of this before? Hold on for a minute.
[CUSTOMER][NEUTRAL] PR staffing services insured. Cause when I type it in Epic, nothing's coming back to be found. No, I ain't never heard of this. So do I put it in as a generic I don't, can you come help me because I don't know how to do that. What in the in as a generic I see? She don't know how to do it either. I don't do insurance.
[CUSTOMER][NEUTRAL] I don't like I put it in a generic but it's not coming back. But she says he, the lady, the insurance lady just said that he has it.
[CUSTOMER][NEUTRAL] But we might not take it though.
[CUSTOMER][NEUTRAL] Yeah, true, are y'all in network with uh UNC?
[AGENT][NEUTRAL] A multi-plan is the, the, uh, network of contracted providers.
[CUSTOMER][NEUTRAL] OK, um, scan it, scan it in, and then he's like he's racking up bills. His bill is almost at 1000 right now.
[CUSTOMER][NEUTRAL] OK, so. Cause he went to [PII] and they saw him in [PII]. What did they say in [PII]? It's not in there because they couldn't get in there and he's just steady racking up bills and I don't want him to keep doing that if he got insurance, we gotta like I need to figure out how to get this in here. OK.
[CUSTOMER][NEUTRAL] You might need to just uh standing in there and then talk to [PII] because I don't know I don't, I don't do that part. I don't know. I, I don't know put it is generic because there's a list of providers and that's I know that's not on our, that's not on our, uh, one of our acceptance providers.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Do you, do you know how to get this in here? Have you seen this before?
[CUSTOMER][NEGATIVE] Yeah, she told me to put it in as a generic, but I don't, it's not coming back.
[CUSTOMER][NEUTRAL] And the insurance lady said.
[CUSTOMER][NEUTRAL] That he has it. Here's your phone but.
[CUSTOMER][NEUTRAL] We're trying to figure it out because I don't want to um, if I need to call you guys back, I will. They're trying to figure it out now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so when you call that [PII] number back, uh, [PII], be sure to select option 2, and then I'll document the call that way the next person, if it, if I don't answer, they'll know kind of what's going on and can pick up from there.
[CUSTOMER][NEUTRAL] So like
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sounds, yes, ma'am, sounds great.
[AGENT][POSITIVE] And I hope you're able to get treated today.
[CUSTOMER][NEUTRAL] No,
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] No, you're welcome, [PII]. Did you have any other questions?
[CUSTOMER][NEUTRAL] Not at this time, I don't.
[AGENT][POSITIVE] Alrighty, thank you [PII] for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Yeah, ma'am.