AccountId: 011433970860
ContactId: 11b0402e-560e-4ca0-838f-ca09097795aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318690 ms
Total Talk Time (AGENT): 87417 ms
Total Talk Time (CUSTOMER): 190717 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/11b0402e-560e-4ca0-838f-ca09097795aa_20250221T20:30_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL speaking. May I help you?
[CUSTOMER][NEUTRAL] Hello, good afternoon. This is [PII] speaking. So I called yesterday about a
[CUSTOMER][NEUTRAL] What am I gonna say this? Hey, a bill that I had with a urgent care that I went to.
[CUSTOMER][NEUTRAL] Do do do do do do do I have this insurance as well as Admet and I think this APL should cover for my copay based on what I was told over the phone with the person who I spoke with yesterday.
[AGENT][NEUTRAL] OK. And do you have a policy number, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do. My policy number is 02450168.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] Excuse me, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][NEUTRAL] OK, and verify your date of birth, mail address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII] um [PII] and email [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Give me a moment. And you say you received a bill from the provider?
[CUSTOMER][NEUTRAL] Oh, so basically what happened is I went to an urgent care and um.
[CUSTOMER][NEUTRAL] They charged me, but I have a balance. I went 2 times, so they charged me on both times, but I still have a balance of $100 that was supposed to be covered for what IMed copay. So what I was told when I spoke to AMed, uh, is it admed? I think.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I told you, I think you guys told me yesterday that IMed should have sent over that information so you guys could have taken care of it, but I always thought I this was under the one insurance. I didn't even realize I had two different insurances, so I didn't know APL and AMed was a totally different insurance. I just thought one would cover for whatever cost the other one did not cover for.
[CUSTOMER][NEUTRAL] So I'm just trying to get this bill that I have resolved to see what's going on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because when I spoke to the, um, whoever I spoke to yesterday, they say my I basically I have never used my my policy as yet.
[CUSTOMER][NEGATIVE] But I'm paying for something that I'm not, I'm my, my, my health insurance is almost like a car payment for the month, so I should not be owing any money when I go to anywhere.
[AGENT][NEUTRAL] Well, um, under your policy, it does cover urgent care. It is covered as outpatient on the plan. Um, I would say you can contact that urgent care facility and let them know you have a secondary and ask them.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] If I just told you this, I just literally did that. I was told to con just what you said. I contacted them. Then they're telling me to contact you guys so I could get a they gave me attitude, so I gotta get a reference number this and that, and I'm not trying to do this today. I'm literally just trying to pay my bills, so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I'm, I'm not, I, I'm not sure if I wanna contact them again because they're saying I gotta contact you to get this reference number and also is there a way I could get a reference number so they could how does this works?
[AGENT][NEUTRAL] Well, we don't give reference numbers. If you like, and use my name and today date, but most times if you give them your second day, uh, secondary insurance, most places will contact our company, we verify benefits and let them know what you claim.
[CUSTOMER][NEUTRAL] That's what I was trying to tell them and know they're trying to tell me that I got it, so I, I'm confused right now and you guys won't be able to call and verify that you, um, you see what I'm saying?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I understand. Yeah, either they can submit the claim or you can submit the information needed to be reimbursed any benefits, but um.
[CUSTOMER][NEUTRAL] And that's what I'm gonna come through.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEGATIVE] I'm genuinely con I'm genuinely confused, uh.
[CUSTOMER][NEGATIVE] I'm confused.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what I'm, what do you say I should do?
[AGENT][NEUTRAL] Uh, you can submit the claim if they don't want to. Uh, we will need the billing and the primary EOB so we can process the secondary and any payable benefit will go to you. Um, I was gonna ask, do you have their phone number? We can do a conference call.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] That's what that's literally what you thank you you're smart. That's what I wanted to hear. OK, so I do have their number. I just literally got off the phone with them. I shouldn't have hanged up, so let me call them back right now and you could stay on the line.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, and I can verify with them your benefits and everything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Hold on, I called the wrong number. Let me call this.
[CUSTOMER][NEUTRAL] Uh