AccountId: 011433970860
ContactId: 120a26ae-607e-43a6-8b39-8afe65c091e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 487970 ms
Total Talk Time (AGENT): 226534 ms
Total Talk Time (CUSTOMER): 238031 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/120a26ae-607e-43a6-8b39-8afe65c091e9_20250502T15:22_UTC.wav
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[AGENT][POSITIVE] Morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, and what was your name?
[AGENT][NEUTRAL] Uh, yes, ma'am. It's [PII]
[CUSTOMER][POSITIVE] Oh, [PII], that's cute.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Anyway.
[CUSTOMER][NEUTRAL] My name is [PII] and I have y'all um gap insurance. Um, I just, can you kind of just walk me through how it works? I've got um a surgery coming up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, ma'am.
[CUSTOMER][NEUTRAL] In June
[AGENT][POSITIVE] I can definitely verify, uh, how the policy works, and I'm so sorry, it's loud over here. They're cutting grass and we eating in and it's loud. I apologize.
[CUSTOMER][POSITIVE] Oh, I know how that is. That's fine. You're good.
[AGENT][NEUTRAL] OK, and Ms. [PII], uh, you did say [PII].
[CUSTOMER][POSITIVE] Yes, I did. You, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, good deal. And do you happen to have your policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I do. It's uh hang on. 02572564.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you, ma'am. Give me one quick moment, please.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you so much and verify your date of birth, mailing address and email address.
[CUSTOMER][NEUTRAL] OK, it's uh [PII], um, what was the next one?
[AGENT][NEUTRAL] Uh, mailing address and email address.
[CUSTOMER][NEUTRAL] OK, uh, mailing address is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh [PII].
[CUSTOMER][NEUTRAL] I just logged in and put all that information.
[AGENT][NEUTRAL] I'm so sorry. I might have to close this garage door. They are being extremely loud.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, honey, it's no big deal. I work from home, so I get it.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And it's from my brother-in-law's company and his workers. So you decide, oh, let me call in the garage and just, you know, use a.
[AGENT][NEUTRAL] I don't know what to call a blower just a blow garage and it's like come on man, you see him on the phone.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But I apologize. What's that email address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, good deal. Thank you, ma'am. And well, the type of policy you have with us is secondary. What it does, it helps with your primary insurance deductible, co-pay or co-insurance for services in an outpatient facility or inpatient and the surgery that you're having, is it gonna be outpatient or in hospital?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] It's uh it'll be in the hospital, but it's, I'll be going home the same day.
[AGENT][NEUTRAL] OK, um, not a guarantee of payment just, oh, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] No, I was just, I didn't know if I wait and then submit a claim or when I go to the hospital for pre-admitting, do I give him this? I'm just not sure.
[AGENT][NEUTRAL] Uh, yes, ma'am. When you give them your primary insurance information, you can also give them our information and just let them know where you're secondary.
[CUSTOMER][NEUTRAL] OK. All right. So just give it to them. Now, I do have a um
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Balance on.
[CUSTOMER][NEUTRAL] Uh, the lab work that they did.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I've got basal cell on my face. So, anyway.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, I'm just like, you know, can my life get any better? Anyway, um, do there's a balance on here would that be something I would submit to you guys for the labs?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] And what's the billing from? What's the name of, is it from the lab company or from a, a hospital?
[CUSTOMER][NEUTRAL] No, it's from the lab where they did the biopsy and then send it off to the lab and then the lab, uh, insurance paid some.
[AGENT][NEUTRAL] OK. Oh, so is it like Quest Diagnostic or LabCorp?
[CUSTOMER][NEUTRAL] And then there's the balance.
[CUSTOMER][NEUTRAL] It's pathology Laboratory Associates.
[AGENT][NEUTRAL] Oh, OK. Yes, ma'am. So that is a covered place of service, uh, under your policy. You do have a lab writer that covers charges for an independent lab facility. Uh, if you like, you can give them the information, just let them know, hey, I have secondary insurance and they can file, or you can file the claim yourself.
[AGENT][NEUTRAL] And I can let you know what information we would need.
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][NEUTRAL] OK, um, all right, so.
[CUSTOMER][NEUTRAL] Um, yeah, they've already ran it and everything, so I should, uh, file it myself. So what do I need to do? Do I just upload the.
[CUSTOMER][NEUTRAL] Bill or?
[AGENT][NEUTRAL] Uh, we will need the claim form and the itemized bill showing diagnosis and procedure codes and your primary insurance explanation of benefits. Uh, who is your major medical with?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Aetna commercial.
[AGENT][NEUTRAL] OK. I say we, you can contact Aetna and request the EOB or explanation of benefits for that date. Um, and also we will need the billing, showing diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] Got you. OK, EEOB. All right, so it's actually better if uh they're filing it.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][MIXED] It does make it a lot easier though, cause, um, unfortunately, um,
[CUSTOMER][NEUTRAL] Seems like
[AGENT][NEUTRAL] Some providers are hesitant on given billing with diagnosis codes and that could put a delay on processing claims since that information is needed, um, so that's why I say you can always give them our information, let them know where you're secondary, and that way they can file a claim.
[CUSTOMER][NEUTRAL] OK. Yeah, the doctor that's doing the surgery, his office was like, we don't know what you're talking about. And then, but I'm sure the hospital would know.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] When I go to the, you know.
[AGENT][NEUTRAL] Yes, ma'am. And I would say don't tell him it's a gap plan, tell him it's a secondary policy.
[CUSTOMER][NEUTRAL] Anyway,
[CUSTOMER][NEUTRAL] Secondary. OK. All right.
[AGENT][NEUTRAL] Yes, ma'am, because sometimes if you say, oh, I have a gap plan, they won't take it because most gap policies don't pay the provider.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So they'll, they'll just inform the insured, uh, you can file. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I understand so just say I have secondary.
[AGENT][NEUTRAL] Yes, ma'am. Just let them know you have secondary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] All right, [PII], you've been awesome. Thank you. I was just confused. I'm like, oh my goodness. You know, I, I have it. I think it was good. I wasn't expecting to have to need it, but, you know, going into the hospital.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For stuff like that.
[AGENT][NEGATIVE] Yeah, unfortunately, with this day, you never know.
[CUSTOMER][POSITIVE] You know, it's helpful.
[CUSTOMER][POSITIVE] Yes, ma'am. You don't. Well, good luck with the lawn and you have a great day. Thank you very much. I appreciate you.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Oh, yes, ma'am, and thank you so much for calling APL. You have a wonderful day.
[CUSTOMER][NEUTRAL] Uh-huh, you too.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye.