AccountId: 011433970860
ContactId: 1050e620-173b-41ca-a480-530ff0c31d5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 595239 ms
Total Talk Time (AGENT): 254180 ms
Total Talk Time (CUSTOMER): 274608 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/1050e620-173b-41ca-a480-530ff0c31d5b_20250117T15:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and I'm calling regarding a bill that I got, um.
[CUSTOMER][NEGATIVE] Cause I, I, I think I spoke with your company and you fixed that problem and now it's, they're sending me another bill. Um, do you need, yeah, do you need my
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] A patient number or like the group number?
[AGENT][NEUTRAL] Uh, yes, ma'am. First, can I get, first, can I get your name and
[CUSTOMER][NEUTRAL] To check.
[CUSTOMER][NEUTRAL] What I did.
[CUSTOMER][NEUTRAL] Yes, what did we sign all back.
[AGENT][NEUTRAL] Yes ma'am. First, can I get your name? What was it again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then what is your policy number?
[CUSTOMER][NEUTRAL] The policy number is um
[CUSTOMER][NEUTRAL] Let me see. I don't know where to look.
[CUSTOMER][NEUTRAL] I have the group number, the payer ID.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Does it say inpatient or outpatient certificate?
[CUSTOMER][NEUTRAL] It says
[CUSTOMER][NEUTRAL] I have an inhospital benefit number, outpatient benefit number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So that one?
[AGENT][NEUTRAL] Yes, ma'am. Yes, can you give me one of those, please?
[CUSTOMER][NEUTRAL] Uh, yeah, 02483428 ML 7.
[AGENT][POSITIVE] OK, thank you so much let me pull that policy in real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're very welcome. OK, and I say your name [PII]?
[CUSTOMER][NEUTRAL] Yeah, the rosa, yeah.
[CUSTOMER][NEUTRAL] You can call me [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] [PII], I like that.
[CUSTOMER][POSITIVE] It's easier. Yeah, it's easier.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'll call you [PII]. OK, Miss [PII], can you verify your date of birth for me please?
[CUSTOMER][POSITIVE] Don't worry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then I'll also need for you to verify your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Phone number [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And, and I don't remember what else you asked me.
[AGENT][NEUTRAL] The last uh verification is your email.
[CUSTOMER][NEUTRAL] Yes, it's uh my, my first name and last name [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy for me. So the um bill that you received.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was it from um American Public Life or was it from a doctor's office?
[CUSTOMER][NEUTRAL] It was from Holy Cross emergency physicians, like $300 in amount of $300.
[AGENT][NEUTRAL] From a
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the data service or the do you have a claim number or data service?
[CUSTOMER][NEUTRAL] Yeah, there is, there are actually like 2.
[CUSTOMER][NEUTRAL] And it's like one is.
[CUSTOMER][NEUTRAL] Um, initial [PII].
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] March
[CUSTOMER][NEUTRAL] And one is [PII] April.
[AGENT][NEUTRAL] March and April, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, did you file the claim yourself? I see one that was filed by you on [PII].
[CUSTOMER][POSITIVE] Yeah, I, I, yes, I called and I called and the lady helped me and then I got $500 back.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] From the, from the hospital. And then now they, I look at my uh document, my files, and it says I don't owe anything and they kept sending me this $300. And they say, you guys, you didn't approve that for some reason.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the last payment we made to hold.
[CUSTOMER][NEUTRAL] It's for electrocardiogram.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The last payment that we made to Holy Cross Hospital.
[AGENT][NEUTRAL] Was for data service of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it was for $500.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see, let me.
[AGENT][NEUTRAL] Look at your policy real quick.
[AGENT][NEUTRAL] And it was an outpatient procedure. So on your policy, your maximum benefit amount for an outpatient procedure is $500 and that $500 goes towards a deductible co-pay or co-insurance. This policy only covers the deductible, the co-pay, or the co-insurance.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the last payment of $500 was made on [PII] and we paid the facility by check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] Do I, how do I know that I have still to pay those $300 that they are asking me for? Where, where should I, who should I call?
[AGENT][NEUTRAL] I would call Holy Cross Hospital.
[AGENT][NEUTRAL] Let them know that we paid them. I'll give you the check number.
[CUSTOMER][NEGATIVE] And also they are saying something about uh that I wasn't insured by the time one of the procedure was done. I wasn't covered by you guys.
[AGENT][NEUTRAL] It is
[CUSTOMER][NEUTRAL] So, uh, so I, I don't know. Can you please, uh, first give me the, sorry for interrupting, the check number?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The check number that we paid them with.
[AGENT][NEUTRAL] Let me pull it up real quick.
[AGENT][NEUTRAL] Check number is 201.
[AGENT][NEUTRAL] 4356.
[AGENT][NEUTRAL] It was for $500.
[AGENT][NEUTRAL] And the date of service was [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And uh, can I repeat like 2014356? I think I missed the number. 201.
[AGENT][NEUTRAL] No, that's correct, 4356.
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] And it was in the, yes, and it was in the amount of $500 paid to Holy Cross Hospital.
[CUSTOMER][NEGATIVE] Yeah, so they gave me those money back, but now they're asking me again for $300 and they say I wasn't covered by you guys when that happened, because I have another like uh in [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] March
[AGENT][NEUTRAL] March, OK.
[CUSTOMER][NEUTRAL] I had another electrocardiogram, yeah.
[AGENT][NEUTRAL] OK, so we need to look for March now.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so if you had the electrocardiogram done in March.
[AGENT][NEUTRAL] Your policy didn't become effective until April.
[AGENT][NEUTRAL] The month later, so your effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you had it in March then you weren't covered by the insurance until April.
[CUSTOMER][NEUTRAL] Oh, I understand.
[CUSTOMER][NEUTRAL] I, I understand, but the thing is like they they, they also, so in March, I'm charged with $150 which they say this is my.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My, my, to pay, my amount to pay. But then they added another 150.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And it's like $300 they added another $50 for the day that you guys you paid for already for April, so they put those together, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yes, OK, so let them know April was paid and give them that check number for.
[AGENT][NEUTRAL] $500 anything after what we paid if if you still owe anything after we paid the $500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Talk to them and see if they can work work with you on that.
[CUSTOMER][POSITIVE] Mhm mhm. I understand, I understand. OK, thank you so much for your help. You're very kind and nice.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're welcome, [PII].
[CUSTOMER][POSITIVE] Thank you. Thank you. I hope you have a beautiful weekend.
[AGENT][POSITIVE] We appreciate you being an APL customer.
[AGENT][POSITIVE] Yes you too have one thank you. You're welcome [PII] you have a blessed weekend thanks for calling APL yes ma'am bye bye.
[CUSTOMER][POSITIVE] Thank you so much for your help.
[CUSTOMER][POSITIVE] Take care. Bye-bye.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] OK, bye, [PII].