AccountId: 011433970860
ContactId: 237b7943-f865-4ffe-89a5-0441820134f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 545080 ms
Total Talk Time (AGENT): 180341 ms
Total Talk Time (CUSTOMER): 279273 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/237b7943-f865-4ffe-89a5-0441820134f4_20250307T19:33_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] Hi, I was calling to see if any of my um labs have been submitted to you guys yet.
[AGENT][NEUTRAL] May I have your name and a callback number?
[CUSTOMER][NEUTRAL] Yes, [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII], may I please have your policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 02515497
[AGENT][NEUTRAL] And I do need to verify your date of birth and mailing address please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and it does look like that we have an email address. Could you verify that to make sure it's correct?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And thank you so much for verifying your policy. You were calling to see if we have received any of your lab work?
[CUSTOMER][NEUTRAL] Yeah, so, um, I wanted to see if my, whatever it's called, the claim had gone through for DLO Diagnostic Laboratories of Oklahoma.
[AGENT][NEUTRAL] OK, so it looks like we don't have any claims in for any lab work.
[CUSTOMER][NEUTRAL] OK, do you have any claims in period?
[AGENT][NEUTRAL] We have claims that were submitted in for [PII].
[CUSTOMER][NEUTRAL] For what?
[AGENT][NEUTRAL] It was a claim that was processed on [PII] and it's McBride Orthopedic.
[CUSTOMER][NEUTRAL] OK, do you guys have anything else?
[AGENT][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, any reason what the hold up would be, um, when I called BLO they said.
[CUSTOMER][NEUTRAL] That, um,
[CUSTOMER][NEGATIVE] What did they say? They, they said it was something on y'all's end. So when I call you guys, they say, you say that you never gotten it, so I'm not really sure what to do.
[AGENT][NEUTRAL] When was the services rendered?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Because it does have to go to your primary insurance first before we get it.
[CUSTOMER][NEUTRAL] Yes, so it's gone to my primary insurance already.
[CUSTOMER][NEUTRAL] I see the bill date. I'm not sure. OK, date of service was [PII] on one of them.
[CUSTOMER][NEUTRAL] And then [PII] for the other.
[AGENT][NEUTRAL] OK. So
[AGENT][NEUTRAL] Did they say when they submitted it into us because we don't have anything in our system.
[CUSTOMER][NEGATIVE] Yeah, so I, they resubmitted the claim on [PII]. They said to wait like 90 days. I called back. I still, it hasn't gone through, and then they show that they submitted it, but I forget the phrasing they used that they said on y'all's end that you guys didn't receive it or or I don't remember the words they used, but.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And so I just had them resubmit it again I think maybe a week or 2 ago, probably 2 weeks ago.
[AGENT][NEUTRAL] Do you know if they send me via mail, fax?
[CUSTOMER][NEUTRAL] I'm gonna, I've given them both.
[AGENT][NEUTRAL] And could you verify which mailing address that you're giving them?
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] OK, because that would be odd that we're not receiving them and that's been since last year.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And as you see we received other claims as well, so it wouldn't be anything that would be on our part of not receiving the claim if it's not being submitted.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, because I don't know because when I call back like they show that they've submitted it.
[CUSTOMER][NEUTRAL] So and then I tried to just upload the information myself to like do my own claim, but then it wouldn't let me because of the PDF size it says was too big, so I wasn't able to upload stuff.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so what information are you trying to submit over? What we're needing would be your primary EOB.
[AGENT][NEUTRAL] For just that date of services that shows it was applied to your deductible coinsurance or co-pay.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] If you have that billing statement like you say that you do have a statement that shows the date of service, you can submit that in, but when you're submitting that EOB we don't need all the pages where it's giving us your benefit amount which was applied to your deductible. We don't need that package. We just need that page with.
[AGENT][NEUTRAL] That data service and that EOB.
[AGENT][NEUTRAL] Issuing the copay, co-insurance or deductible.
[CUSTOMER][NEGATIVE] OK, I still think regardless of that one, I think when I try to just do the DLO one, it also wouldn't go through, which is only 2 pages.
[AGENT][POSITIVE] OK, we haven't had any issues on receiving anything through the secured portal as well.
[CUSTOMER][NEUTRAL] Yeah, I, I, it might be because like I don't have a scanner, so I was using a scanning app on my phone that turns things into PDF files and then for whatever reason, it says the file size is too big.
[CUSTOMER][NEUTRAL] So I'll just try to find another way to
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Up to scan those documents, I guess, but um I thought, well, since they resubmitted it hypothetically recently, I was hoping you guys just got it.
[AGENT][NEUTRAL] OK. Now I can tell you uh a lot of times people do take pictures with their phone.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And they can save that file and then they can upload it into the system.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Yeah, so that's what I tried to do, but it says that the size is too big.
[AGENT][NEUTRAL] OK, cause yeah, cause I mean we receive different images in.
[AGENT][NEUTRAL] Through the secured portal.
[CUSTOMER][NEUTRAL] Well, and then I also did it, um, I had didn't try it again since then, but I did it on one of those days where we're having all the weather stuff, so I don't know if that would have had some kind of effect. So I will try again today and see if it will cooperate.
[AGENT][NEUTRAL] OK. Now, when you submit them in, just make sure that you do have something that's indicating with the doctor's name listed on it that shows the diagnosis code for that date of service.
[CUSTOMER][NEUTRAL] So I have the diagnostic codes and procedure codes, but I don't know if the doctor's names on here. Um, I have the referring physician's name. Does that count?
[AGENT][NEUTRAL] Does it indicate that date of service?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] On that, well, that could be used as long as it does show that exact date of service as well that the procedures were done to indicate the diagnosis code.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there because I know this was obviously done last year, is there some kind of time expiration that I need to get this to you guys before a certain point for it to be covered?
[AGENT][NEUTRAL] No, we have no timely filing as long as your policy was active, you can submit that claim in.
[CUSTOMER][POSITIVE] Sweet. OK. All right. Well, I will see if technology wants to be here today.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] Well, I do want to thank you so much for calling American Public Life. You have a great rest of your day and enjoy your weekend.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you, bye.