AccountId: 011433970860
ContactId: 09ae84b9-4ac4-4377-9afb-a3cdcf9dd149
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 600630 ms
Total Talk Time (AGENT): 193787 ms
Total Talk Time (CUSTOMER): 292785 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/09ae84b9-4ac4-4377-9afb-a3cdcf9dd149_20250416T19:22_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Hi, how are you? I'm [PII].
[AGENT][NEUTRAL] I'm good, [PII]. How are you?
[CUSTOMER][POSITIVE] Good good thank you and yourself? Good.
[AGENT][POSITIVE] I, yeah, I'm doing good.
[CUSTOMER][NEUTRAL] Good, good. I was calling to see if um I went to the doctors, right? My insurance.
[CUSTOMER][NEGATIVE] Pay a little bit of the bill. I paid the deductible and now they're calling me saying that I owe $35 or $79 something like that. Is that something that you might cover?
[CUSTOMER][NEUTRAL] The difference between the deductible and the bill that I not doesn't want to pay?
[AGENT][NEUTRAL] We could, let me look into your policy first. Do you have the policy number on you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the group number or the payer's ID?
[AGENT][NEUTRAL] Uh, let's try the payer's ID. It usually says member ID or policy cert number.
[CUSTOMER][NEUTRAL] OK, try this.
[CUSTOMER][NEUTRAL] 60801
[CUSTOMER][NEUTRAL] Was that too short?
[AGENT][NEUTRAL] Yeah, I think that's the group number.
[CUSTOMER][NEUTRAL] No, the group number is 25,490.
[CUSTOMER][NEUTRAL] They have an outpatient benefit center number.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Which is long.
[AGENT][NEUTRAL] Does it have letters in it as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I just need the numbers that are in there.
[CUSTOMER][NEUTRAL] OK, for outpatient benefit certificate number is 02485246 M as in Mary, L as in Larry number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And I do see your policy. Can you verify your last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, perfect. And the mailing address we have on file in your email, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh email [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The address [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] see
[AGENT][NEUTRAL] OK. So you went to the doctor and you said that you owe
[CUSTOMER][NEUTRAL] For a physical.
[AGENT][NEUTRAL] Oh, for physical?
[CUSTOMER][NEUTRAL] Yeah, I work for a one year physical and it's weird because I think they will pay the physical completely.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm, I haven't called Aetna, but the lady's been been calling me and saying, hey, there's a difference that they don't want to pay on some tests, and I go, I didn't do any special tests. All I did was regular blood tests. I haven't even didn't do any X-ray, MRIs or anything like that.
[CUSTOMER][NEUTRAL] Just did my one year physical.
[CUSTOMER][NEGATIVE] And Aetna is charging so much, um, I paid the, the, you know, the office visit for the physical, and there's like $70 something dollars outstanding or $35.
[CUSTOMER][NEGATIVE] But I find it ridiculous that I have to pay anything more. I mean, the deductible when I go to the clinic is $40. So, and uh they gave me the most expensive.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Visit, you know, I have to pay every time I go to a doctor $40. That's crazy. I had a, a cheap uh clinic there and all I had to do was $25 every visit.
[AGENT][POSITIVE] Wow. Yeah, it really does.
[CUSTOMER][NEUTRAL] And then I'm not uh.
[AGENT][NEUTRAL] Yeah, it really does matter where you go. I don't, I don't understand why they all charge differently.
[CUSTOMER][NEGATIVE] Yeah, I mean, I never last year wasn't charged for it. I don't know why they're charging me this year.
[CUSTOMER][NEUTRAL] That's possible
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] But you know how they are.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] They just bill you and you, if you don't pay, you know, we report you to the credit, you know, whatever to your credit.
[AGENT][NEGATIVE] Yeah, I've been there. It's not fun.
[CUSTOMER][NEGATIVE] No, not pretty soon I'm gonna be going to, what do you call this? Obamacare because this is a slowed down compared to when the COVID was around. So it's no use for me paying that kind of money for the same coverage that I could get through um.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Obamacare.
[CUSTOMER][NEUTRAL] For less money.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, I'm looking at your policy really quick. Let me see.
[AGENT][NEUTRAL] OK. So it looks like for office treatment.
[AGENT][NEUTRAL] The benefit amount is 200 per covered person per calendar year.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What I would do is give this to um the.
[AGENT][NEUTRAL] The office that you went to?
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] For the blood test and your physical. Um, I would give them this card as well.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh, I haven't contact you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, and see if.
[AGENT][NEUTRAL] Uh, under your policy that this is covered.
[AGENT][NEUTRAL] Um, because this is a secondary policy, so I can't guarantee payment. I, I can just give you the verification of coverage, yeah.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Oh, OK, OK, who would, um, who would be the one doing it? I mean, if they call they would talk to somebody like you, right? Or is there another number that, you know, like I know they asked me if I was a doctor's office, so I would take him somewhere else and then.
[AGENT][NEUTRAL] So they would call us and then.
[CUSTOMER][NEUTRAL] Instead of someone like you.
[AGENT][NEUTRAL] Yes, so they would call us and.
[AGENT][NEUTRAL] What they would do is send us the documentation.
[AGENT][NEUTRAL] Um, in that states how much you owe and then it would go into our claims department and then our claims department will go over your benefits for your policy, and they determine if it's covered or not.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me ask you something. They sent me the that statement. Could I send it to you guys instead of them, or it has to be them?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can send it in if you like. Um, I can give you our fax or our mailing address.
[CUSTOMER][NEUTRAL] Uh, mailing address would be better. Is there any way you could, um, email me that email address, please?
[AGENT][POSITIVE] Yeah, I can do that is.
[CUSTOMER][NEGATIVE] Because I'll probably get a wrong letter.
[CUSTOMER][NEUTRAL] like
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Go ah[PII]
[AGENT][NEUTRAL] Is it the address or the email that we have on file?
[CUSTOMER][NEUTRAL] Yeah, [PII] to [PII].
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'll send it over quickly. What I need to put down the policy number that thing that you asked me the ID, my name, anything else?
[AGENT][NEUTRAL] No, that, that'll be it. Um, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it, so is your email, is there [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. I, I can't really tell on here. OK.
[CUSTOMER][NEGATIVE] No, I know it's, I don't know why I still have it. I should have changed that a long time ago. I've had it for more, I mean more than 25 years, the same email.
[AGENT][NEUTRAL] Yeah, that's OK.
[CUSTOMER][NEGATIVE] And people, and they misunderstand the underscore and I don't know why I never changed it and kept it like that.
[AGENT][NEUTRAL] Yeah, your email is like.
[CUSTOMER][NEUTRAL] I always have to tell everybody underscore underscore.
[AGENT][NEUTRAL] Yeah, it's like in a box, so the underscore just kind of like hides in there.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. I can send you over that email to your, or sorry, that address to your email and then what's a good callback number in case I have any questions?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And then I'll do that right now.
[CUSTOMER][POSITIVE] Thank you. You have a great day. Bye bye.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. Goodbye.