AccountId: 011433970860
ContactId: 19a07c85-92d0-4bc3-8aed-78cdaa110fba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353179 ms
Total Talk Time (AGENT): 83530 ms
Total Talk Time (CUSTOMER): 213464 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/19a07c85-92d0-4bc3-8aed-78cdaa110fba_20250512T19:49_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, um, I had sent in some, um, some, uh, bills that I had received from my, from a procedure I had. I, I was, um,
[CUSTOMER][NEGATIVE] I had to have a surgery last week. Um, I had been I had been diagnosed, I have been diagnosed with stage one breast cancer and I had to have some additional um surgery last week. And, but for my first surgery was a lumpectomy um back in the beginning of April. Um, I received two bills that I gave them my, I gave them my gap insurance, but they never billed them.
[CUSTOMER][NEUTRAL] And then on this surgery that I just did, I paid, um, I had to pay out of pocket for my, for a nuclear injection and the outpatient thing. And I only have the receipts for those because that was my co-pay that I had to pay even though again, I gave the gap insurance, they didn't, they didn't take it. So I need, and I got a letter today saying that um you guys, I guess, need more information on stuff. So I just kind of a little bit confused on how I proceed with this.
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yeah, mhm, it's [PII].
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, 01749478.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][POSITIVE] Mhm. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. And I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] Mhm it's [PII] and my email is [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And you had a question about some claims.
[CUSTOMER][NEUTRAL] Right. So what I did was, um, I forwarded, um, last week. I downloaded and I uploaded, downloaded and uploaded, um, two hospital bills that I have received. But the first, I had two surgeries. I had the first surgery I had was um on [PII]. And um I received um two bills regarding that surgery and I forwarded them to, I uploaded them on the, on the portal last week.
[CUSTOMER][NEGATIVE] And when I went last week on, on, on [PII], I had another surgery, and I had to pay a $200 co-pay for outpatient surgery and a $350 copay for a nuclear medicine that I needed to have performed because I was having some of my lymph nodes removed to be tested and I paid those. I don't have all I got from those two, those two charges on [PII] was the receipts that I paid them.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The other two that I sent were 2 hospital bills that I had received.
[AGENT][NEUTRAL] OK, um, 4, 1025 for the facility bill, we need your explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] OK, so which one is that for?
[AGENT][NEUTRAL] That is for 40, 25 for the facility bill.
[CUSTOMER][NEUTRAL] Because I have
[CUSTOMER][NEUTRAL] OK, hold on, I because I have to do, oh, OK, so that, that's from the one from the Miami Cancer Institute.
[AGENT][NEUTRAL] Hold on just a moment, and I can tell you who it is.
[AGENT][NEUTRAL] This is for Baptist Hospital.
[CUSTOMER][NEUTRAL] OK, the pathology?
[AGENT][NEUTRAL] It was for $7680.
[CUSTOMER][NEUTRAL] Yeah, OK, so, OK, so it's the pathology. OK, so you, I'm sorry, what do you need from me here?
[AGENT][NEUTRAL] The explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] So I would get that off of Blue Cross Blue Shield.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then the other one was for $100 for the mommy Cancer Institute.
[AGENT][NEUTRAL] What date of service was that?
[CUSTOMER][NEUTRAL] Uh, [PII], no, I'm sorry, the service was
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. I have one for.
[CUSTOMER][NEUTRAL] This is for physicians. Yeah, for physician services.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right, mhm, that's the one.
[AGENT][NEUTRAL] And we need the explanation of benefits as well.
[CUSTOMER][NEUTRAL] OK, and so I'm assuming then on the other 3 ones that I sent to you that with the receipts of the 2 surgery I had last week, you would need those 2.
[AGENT][NEUTRAL] Yes, ma'am. Looks like everything that we process, we need explanation of benefits for.
[CUSTOMER][NEUTRAL] Cause I paid uh
[CUSTOMER][NEUTRAL] OK, let me see if I can get them from Blue Cross then because on Blue Cross I couldn't find them. They, it was hard for me to get them. All right, let me look for that on Blue Cross and I will um resend the link to you guys.
[AGENT][POSITIVE] Yes, ma'am. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK, no, that's it. I just wanted because then I got like I said I got this statement today and it was like saying that I did, so I just wanted to verify exactly what I need to get for you guys so that I can go ahead and take care of it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, perfect. Thank you so much. I appreciate your help.
[AGENT][POSITIVE] Thank you, Ms. [PII] for calling APL. You have a good day.
[CUSTOMER][POSITIVE] OK. You're welcome bye bye.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye