AccountId: 011433970860
ContactId: 1c4e2edf-608a-4847-b1ef-acdcb557200f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 354390 ms
Total Talk Time (AGENT): 149829 ms
Total Talk Time (CUSTOMER): 178771 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/1c4e2edf-608a-4847-b1ef-acdcb557200f_20250205T19:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. Um, my company, um, is Pola Pharmacy, and I have the, the APL card.
[CUSTOMER][NEGATIVE] Um, I just want to know how do I go about like, um, something that my insurance didn't pay and I can use that $2000 that I have for y'all to pay towards a bill that has a different. Do I need to send that in to y'all? because when I show these cards to people, they don't know what they never seen it before and they don't act like they don't know how to process it to use it.
[AGENT][NEUTRAL] OK, may I have your policy number please?
[CUSTOMER][NEUTRAL] Um, 02538256.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And could you please verify your date of birth with me, Miss [PII]?
[CUSTOMER][NEUTRAL] I like
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I do have to verify a callback number, and email address, and a mailing address.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Email [PII]. And what else did you need?
[AGENT][NEUTRAL] OK, now that's not the email address that we have on file.
[CUSTOMER][NEUTRAL] [PII] or you or is it my work email? That's [PII].
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, now that's the one we have now did you want that one to be changed?
[AGENT][NEUTRAL] To your personal
[CUSTOMER][NEUTRAL] Well, I, I didn't know which one you use that's my work um email. They must have did it that way. Um, my other one is just my personal email.
[AGENT][NEUTRAL] OK, so is it OK to leave it as your work or would you like it for your personal?
[CUSTOMER][NEUTRAL] Can I just add it as an additional?
[AGENT][NEUTRAL] OK, now once if we change it, it's just going to change to your personal which anything that you want to receive will come to your personal email.
[CUSTOMER][NEUTRAL] Let me send it to my personal because I don't want them sending up at my job. Yeah, let me change that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. May I have that?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Again, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I will get that updated for you and may I have a callback number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so in regards to this policy, this policy is what is considered your supplemental or gap, so it's your secondary insurance.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And the way that it works, once you go to whichever facility, office visit or anything, they have the option to verify with your primary and then they will contact us as your secondary to verify the benefits.
[AGENT][NEUTRAL] If they do not submit the documentation, go ahead.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Oh yeah, that's what I was gonna ask you because so say um we, we, my husband, he got it too on there with me say he um
[CUSTOMER][NEUTRAL] Went to the doctor. They already pressed the insurance and I'm selling him a balance. Can I get that paid through this, this APL for the amount that he has and I have.
[AGENT][NEUTRAL] It's according to what procedure or anything that he's rendering, if it's done within an office setting outpatient, then I will be able to pull up to see what benefits that you all do have, but you do have the option if the provider don't submit it in, you can submit the documentation in, but it has to go to your primary insurance first to say that it was applied to your deductible insurance copay, OK.
[CUSTOMER][NEUTRAL] OK, that's, it's already done.
[CUSTOMER][NEGATIVE] Yeah, the, yeah, the primary is already doing. I already used my primary insurance. It's just this is a balance that I still owe that the insurance didn't pay.
[AGENT][NEUTRAL] OK. So if you have that EOB showing that there was a deductible co-insurance or co-pay, you can submit that in, but the only thing that is also needed, you will have to call that provider to get that diagnosis code for that date of service.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And I, I can double check and see if it's written on the bill.
[AGENT][NEUTRAL] Normally, normally it's not listed. The diagnosis code is normally not listed on the bill due to HIPAA.
[CUSTOMER][NEUTRAL] As well, wouldn't it be on the bill?
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just when you call them, just ask them for an ICD 10.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Are
[CUSTOMER][NEUTRAL] ICD 10.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And then if and then they'll give me that and if I have the diagnosis on the bill I just mail it to this address and a copy of the bill that's on the back that's [PII].
[AGENT][NEUTRAL] Yes, now you have the option to mail it or you can submit it online at the secure portal or fax it.
[CUSTOMER][NEUTRAL] Is that that that that secured OK and a [PII]?
[AGENT][NEUTRAL] Yes, you will go in there, set up a username and password and you can submit it there and you can also check any statuses as well on your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, OK, alright then. OK, that'll work. Well, I'll do that with some bill back. Alright then, and I know they already been submitted to my insurance. I'm just getting the balance that I have to pay. So I was just wanted to use this and wanted to know more detail because alright then, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. Thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Mm OK bye bye.