AccountId: 011433970860
ContactId: 268c37f0-e117-493c-b1a8-aaa2220a8ff9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 3261449 ms
Total Talk Time (AGENT): 1290133 ms
Total Talk Time (CUSTOMER): 1510989 ms
Interruptions: 10
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/268c37f0-e117-493c-b1a8-aaa2220a8ff9_20250114T20:14_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, yes, this is [PII], um, and my husband, [PII], who's the, Yeah, [PII], uh, I'm the one who has the policy.
[AGENT][NEUTRAL] OK. I'm sorry, did you, [PII], did you say your last name is [PII]? Is that correct?
[CUSTOMER][POSITIVE] Yes, yep.
[AGENT][NEGATIVE] OK, we do not have a very good connection. I'm not sure. Um, it almost sounds like you're underwater.
[CUSTOMER][NEUTRAL] Oh, that might be our dehumidifier sorry, let me turn that off really quick.
[AGENT][NEUTRAL] So what
[AGENT][NEUTRAL] I'm not, I mean, I don't know that that's what it is. You could try that.
[CUSTOMER][NEUTRAL] Is, is it better now?
[AGENT][NEUTRAL] No, it's not. Give me just a second. I mean, I'm able to somewhat tell basic conversation, but again, it sounds like we're underwater. Give me just a second to see if there's any, I can try to make an adjustment to see if it's on my end, if you all don't mind.
[CUSTOMER][NEUTRAL] Yeah, that's that's OK.
[AGENT][NEUTRAL] OK, one moment, please.
[CUSTOMER][NEUTRAL] They say take it off speaker? Maybe.
[AGENT][NEUTRAL] OK, can you all hear me?
[CUSTOMER][NEUTRAL] Yeah, I can hear you OK. Can you hear us?
[AGENT][NEUTRAL] Uh, yes, I can hear you. OK. And so, I'm sorry, I wasn't able to understand your name though. I was able to understand Mr. [PII], but I did not understand your name.
[CUSTOMER][NEUTRAL] Um, my name is [PII].
[AGENT][NEUTRAL] And [PII], how do you spell your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And then what is a good callback number please for you all?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And how can I help you all today, first off?
[CUSTOMER][NEUTRAL] Um, so yeah, we are just trying to check in on uh two separate claims, um.
[CUSTOMER][NEUTRAL] Uh, that we, we did, um, file them on the online portal, um, and we just called, uh, Dartmouth Hitchcock Medical Center, which is where I was getting, um, appointments. I was having appointments. Um, they did receive contact about 3 of the claims, but there's 2 that they're waiting on. One is a little bit more recent, but the other is, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Earlier than the 3 that they did receive a contact uh from so we just wanted to see if there's any way that we can expedite that or you know kind of um uh figure out why they hadn't heard anything um from you guys about um.
[CUSTOMER][NEUTRAL] That one claim that was in August.
[AGENT][NEUTRAL] OK, so there's one claim that they filed with us that you're wanting to check status on?
[AGENT][NEUTRAL] That they had submitted to us for you.
[CUSTOMER][NEUTRAL] Um, there
[CUSTOMER][NEUTRAL] Yes, there, there's actually, there's 7 in total.
[CUSTOMER][NEUTRAL] Um, and they heard back about 1 in September and 2 in October, um, the one in September has two separate claims attached to it. Um, they did hear back from APL regarding those ones in September, October, and October, but there's one in August and 2 in November that they haven't heard back um from APM.
[AGENT][NEUTRAL] OK, so I can help and check the, the claim status. Um, what I will need to do first is to pull up the policy information and then verify several things for security, and then we can go from there. So, what is your policy number, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Here, I'm gonna give my phone to the my husband really quick because it is his policy. Um, I'm just the patient. Here, here he is. Thank you. She's the policy. Um, hello. Uh, this is [PII]. So,
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Hi, Ms. [PII]. Yes.
[CUSTOMER][NEUTRAL] The policy number is 0254.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 72
[CUSTOMER][NEUTRAL] 09.
[AGENT][NEUTRAL] OK, thank you. So one moment, please, to get the information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And so as I was explaining, I don't know if you heard me explain the [PII], but I will need to verify several things first for security, and then any information that is provided will be a verification of benefits and not a guarantee of payment. So, um, first off, Mr. [PII], if you could please verify your date of birth and then your wife's date of birth.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yep, [PII] is my date of birth.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And [PII] is my wife's.
[AGENT][POSITIVE] Thank you. Also your home mailing address, please.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] Thank you. The phone number that we would have on file for you?
[CUSTOMER][NEUTRAL] would be [PII].
[AGENT][NEUTRAL] Thank you. And then your email address, please?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying your information. OK, so what is the first date of service for A Rose that we're
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Checking on.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And what is the billed amount on the claim that I'm looking for?
[CUSTOMER][NEUTRAL] Um, the bill amount is, hold on, we're checking the.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Our portal.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, $1,815.75.
[AGENT][NEUTRAL] OK, so one moment please.
[AGENT][NEUTRAL] And it's still
[AGENT][NEUTRAL] loading a few pieces of information for me, Mr. [PII].
[CUSTOMER][NEUTRAL] Uh, I'm sorry, what's that?
[AGENT][NEUTRAL] I wanna make sure I see, I said my system is still loading some of the information. So just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do see this claim on file. This is claim number 355-0644.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, we did pay this appears that you all filed a claim with us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we did pay a $50 benefit on this claim.
[AGENT][NEUTRAL] Again, that claim number is 3.
[CUSTOMER][NEUTRAL] Um, that has not been received by Dartmouth.
[AGENT][NEUTRAL] No, it was sent to you all. It wasn't sent to the facility.
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] It was sent to us. How was it sent to us?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, let's see, uh, give me just a moment.
[AGENT][NEUTRAL] This was mailed on a, in a it was a check.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] This check was issued on [PII].
[CUSTOMER][NEUTRAL] OK, so it probably hasn't reached us yet?
[AGENT][NEUTRAL] So it was just issued a few days, right, because today is the [PII]. Let's see, the [PII] was.
[AGENT][POSITIVE] My goodness.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Um, I have to look at a calendar, just one moment. So the [PII] was on Friday, so it would not.
[CUSTOMER][NEUTRAL] Yeah, it's
[AGENT][NEUTRAL] It went through processing on Friday, so that means it would not have even mailed out to you, Mr. [PII], until yesterday.
[CUSTOMER][NEUTRAL] OK, um, so you guys sent us a $50 check for that.
[AGENT][NEUTRAL] So that
[AGENT][POSITIVE] That is correct. That is correct, yes.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And just out of curiosity, uh.
[CUSTOMER][NEUTRAL] Why, why wasn't the hospital contacted at all about that?
[AGENT][NEUTRAL] Um, what do you mean? I don't.
[AGENT][NEGATIVE] I don't understand us contacting, we haven't received anything from the hospital for this data service.
[AGENT][NEUTRAL] This claim appears to have been filed by you all, so the benefit would have been issued to you all.
[CUSTOMER][NEUTRAL] Well, um, we were told that we had to file.
[AGENT][NEGATIVE] They haven't filed anything.
[CUSTOMER][NEGATIVE] So we were told that we had to file all the claims, um, but Dartmouth has reached out and they have not heard back from you.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, which is why we were confused, and it, it's um.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, I mean, we, so we filed, uh, all the claims that we have, we, we filed, um, because, uh, Dartmouth was not hearing from you guys and once we, once we filed the claims in Dartmouth did hear back about, um.
[AGENT][NEUTRAL] They would not receive anything. Yes, sir. They're not gonna receive when you are the one submitting the claim.
[CUSTOMER][NEUTRAL] A majority of them.
[AGENT][NEUTRAL] If they're not filing for you, then we don't send them.
[AGENT][NEUTRAL] If they're requiring you to file your claims, then the correspondence that we provide goes to, goes to you.
[CUSTOMER][NEUTRAL] OK, um,
[AGENT][NEUTRAL] Not to them.
[CUSTOMER][NEUTRAL] They're not requiring us to file the claims. Dartmouth has reached out to you guys, um, and you have not responded to them, so we went in.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Correct. We will.
[AGENT][POSITIVE] Oh, I'm so sorry.
[CUSTOMER][NEUTRAL] So we went ahead and filed the claims because you guys were not contacting Dartmouth because they have they have reached out.
[AGENT][NEUTRAL] We haven't
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] The only person that we have spoken to was on [PII], and that was when you and your wife called in.
[CUSTOMER][NEUTRAL] Um, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um, well, could we get Dartmouth on the phone with a 3 way call?
[AGENT][POSITIVE] Sure, you're welcome to conference them in.
[CUSTOMER][NEUTRAL] OK, um, well, let me try to get them on the other line.
[AGENT][NEUTRAL] I, but I can't, yes, sir, because even if we, if they, if just hypothetically, if they had contacted APL.
[AGENT][NEUTRAL] Regarding a claim that you filed, we would not give them any information, but there would be a note in our system where someone had called and we do not have any record of anyone from that facility calling.
[CUSTOMER][NEUTRAL] OK, well, hold on 2 seconds. I'm gonna conference them in.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Is it 884-4808 08077300.
[AGENT][NEUTRAL] Are you all still there? I just wanna make sure we haven't lost our connection.
[CUSTOMER][NEUTRAL] Um, so we, I, we're on hold. They should be answering soon.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Good afternoon thank you for calling Conifer Health on behalf of Dartmouth. This is [PII]. Please be advised this call may be monitored or recorded. How can I help you? Uh, hello, [PII]. My name is [PII]. Um, I'm calling, I'm here with my wife [PII]. Um, you're also on the phone with APL, our insurance. We've been trying to get to the bottom of some questions, so we, um, figured we would do a three way call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get the guarantor number to the account you're referring to? Yes, it's 267-461-0.
[CUSTOMER][NEUTRAL] And if I could just get.
[CUSTOMER][NEUTRAL] The name of the people
[CUSTOMER][NEUTRAL] That are speaking. Yes, so there's [PII]. And I'm [PII]nti. OK, but.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] What's the name of the person on the guarantor number?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Alright, and [PII], what is your date of birth? [PII]
[CUSTOMER][NEUTRAL] And your mailing address and phone number? It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[CUSTOMER][POSITIVE] All right thank you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Alright, and what is your question?
[CUSTOMER][NEUTRAL] Um, so we are trying to figure out, um, we are on the phone with APL right now, our insurance company, and when we speak with you guys over at Conifer, they were telling us that they have, um.
[CUSTOMER][NEUTRAL] Try to be in correspondence with APL about our um bills over at Dartmouth starting back from August um and they're saying that they haven't heard anything from you guys so we're just trying to figure out.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Why? or or who has and who hasn't been reaching out?
[CUSTOMER][NEUTRAL] Yeah. OK, so what is the name of the insurance? spell that for me. It's called American Public Life.
[CUSTOMER][NEUTRAL] And what is Iovacare?
[CUSTOMER][NEUTRAL] In NovaCare is the um what you, I'm not. Um, that might be the uh. What is it called? The um um.
[CUSTOMER][NEUTRAL] Hospital group um that works with them um.
[CUSTOMER][NEUTRAL] It's just the, the card that we got through the mail that I presented when I went in for appointments that I got from American Public Life.
[CUSTOMER][NEUTRAL] P H C S
[CUSTOMER][NEUTRAL] Public health something.
[CUSTOMER][NEUTRAL] And what is the claims address?
[CUSTOMER][NEUTRAL] Um, there's, uh, well, there's, uh, 7 different claims that are from August to November, um.
[CUSTOMER][NEUTRAL] Would you like all 7. Claims address for the insurance? No, I can see the account uh I'm looking, I'm looking up the claim information for this insurance because I didn't see American public.
[CUSTOMER][NEUTRAL] What was the name of it? American Public. Life.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Life, yeah, so you're asking billing to I know but care what is the claims address? Maybe the insurance could speak on that. What what is the claims address?
[AGENT][NEUTRAL] Our claims address this, my name is [PII] and I'm with APL and our claims mailing address is APL [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] OK, and we were provided I Novaca [PII].
[AGENT][NEUTRAL] I don't know what that is.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I have no idea what that is. Again, this is uh this is still [PII] with APL. I don't know. I've never heard of that company or that address.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So should we have the claim sent to the one at [PII]?
[CUSTOMER][NEUTRAL] Cause that's, that's the, when we send up.
[AGENT][NEUTRAL] The claims now. Mhm.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Yes, the claims mailing address for APO is in [PII].
[CUSTOMER][NEUTRAL] OK, um, did you get that over there at Conifer? I'm sorry, what's your name? [PII]? No, so, so the insurance information that you provided is incorrect that I NovaCare.
[CUSTOMER][NEGATIVE] Well, that's the, is that, well, that's the card that I got when I signed up for American Public Life. This is all very confusing to me too. We signed up through um someone on the phone and then they sent us over.
[CUSTOMER][NEUTRAL] An insurance card and that's what I've been presenting when I go to the hospital for visits.
[AGENT][NEUTRAL] And I don't know.
[CUSTOMER][NEUTRAL] So insurance does she have in incorrect information?
[AGENT][NEUTRAL] Well, I don't know. Give me just a moment to look at something because I don't even see ID cards for your policy in our system. Um, give me just a second, but I've never heard.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] OK, so all of your enrollment, this is through the, so you enrolled Mr. [PII] through Business Workers of America. Is that correct?
[CUSTOMER][POSITIVE] I believe so, yes.
[AGENT][NEUTRAL] The association. OK, so.
[AGENT][NEUTRAL] We do not send out any form of ID cards for this association.
[AGENT][NEUTRAL] Now
[AGENT][NEUTRAL] I have a a phone number that I can give you for their customer support or member services to find out where you are, you know.
[AGENT][NEUTRAL] Where those ID cards actually came from that you have in your possession, they were not sent by us.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] But I have a phone number for member services. I also do have an email address that I can provide to you all for them.
[CUSTOMER][NEUTRAL] Um, yeah, um.
[AGENT][NEUTRAL] Uh, and I'm confused because I've never heard of, of that company or that address that she, you said you have on an ID card that has our company name.
[CUSTOMER][NEUTRAL] OK, but, uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, it
[AGENT][NEUTRAL] Name on it. I don't, I.
[CUSTOMER][NEUTRAL] It doesn't, so we have a PHCS limited benefits plan um through FEAmericare 200.
[CUSTOMER][NEUTRAL] And when we've been making calls and trying to figure out why our uh why Dartmouth was having a hard time getting in touch with anybody we were eventually put on to you guys APL um and then you guys seem to have our information so I uh I. Yeah, we, we thought that that you were in our insurance that was what we that's what we had. Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the the claims are processed by APL on this policy issued to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Again, we receive any enrollment information from the Business Workers of America Association through.
[AGENT][NEUTRAL] This member services.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] That is member services is who you would contact for any questions like related to your premium, policy changes.
[AGENT][NEUTRAL] Anything like that is handled by, because that's who provided us your enrollment information.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] But there's not
[CUSTOMER][NEUTRAL] [PII], can I ask a question? This is [PII] at Conifer. Can I, can I interrupt for a minute because I, I really wanna help the patients here at this point.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes. Uh-huh.
[AGENT][NEUTRAL] Yes ma'am, I
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Me too.
[CUSTOMER][NEUTRAL] Can we submit claims on behalf of the patients to APL?
[AGENT][NEUTRAL] You can. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so that's the information. Would that be correct in saying [PII] and [PII] that.
[CUSTOMER][NEUTRAL] To get this squared away because there's a lot of billing issues on this account. Yeah, yeah. Move forward and get this submitted to the correct insurance.
[CUSTOMER][NEUTRAL] I, yeah, I guess if this is the correct insurance, then yeah, uh, I didn't, I didn't think that we were insured through anybody else.
[CUSTOMER][NEUTRAL] Yeah, I can look at who's been charged billing, you know, we, we've been paying every month since September for insurance, so.
[AGENT][NEUTRAL] Yes, and see, I would not be able to see, this is [PII] at APL. I will not be able to see anything related to your premium because that is all handled through member services.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so
[AGENT][NEUTRAL] I can only see that we have an active policy for the two of you that went into effect [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Under that policy number that you provided for me, Mr. [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm. Yeah.
[AGENT][NEUTRAL] And this is a hospital indemnity limited benefit plan that you all have with us.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And this is the only policy that you have with our company.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So yeah, so I guess because we've got, go ahead.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] No, I didn't mean no and go ahead I I I'll just sit back and listen for a minute and then you guys can give me the correct insurance information so we can submit these claims correctly. OK, um, yeah, I guess I, yeah, I have no idea to be, to be honest I've never, we never have had private insurance so when we, when I went to the hospital since August um when I went to Dartmouth for my appointments and stuff, I've just been giving.
[CUSTOMER][NEUTRAL] I gave Dartmouth the information that you know the card because that's kind of all I guess I knew what to do was give the card um but then when we found out that we had all these outstanding bills, that's when we kind of started to look into it and every time that we call um the like the number on the insurance card, they always send us over to APL and they're the ones that have given us.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, like stuff through the mail and stuff like that. So it's just a bit confusing of, of who is our insurance company and what, what the name of it is and stuff like that.
[AGENT][NEUTRAL] So again, this is [PII], um, and [PII]. So let me, let me just give you all this phone number that we have for member services.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That maybe you can, you may already have this number, Mr. [PII], you may already have this number, but their phone number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I think I do have that.
[AGENT][NEUTRAL] And their email, OK, and their email address, if you would like that is customer [PII].
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The number [PII].
[AGENT][NEUTRAL] Member
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So again, that's customer [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if need be, I can provide the claim's mailing address again for APL.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. [PII], can you hear me?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I can, so let's go over, so I'm gonna submit several claims [PII].
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] And these are gonna go to American Public Life.
[CUSTOMER][NEUTRAL] And what is the member ID number that we should associate with the patient?
[CUSTOMER][NEUTRAL] Um, is that the policy number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It would be, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] 47.
[CUSTOMER][NEUTRAL] 209
[CUSTOMER][NEUTRAL] Member ID number slash.
[CUSTOMER][NEUTRAL] Policy number is 02547209. Yes.
[CUSTOMER][NEUTRAL] And the effective date.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Was [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, and because it says the, the um the card that I'm looking at right now does say on it effective date [PII].
[CUSTOMER][NEGATIVE] So I guess I just don't understand how this card is not related to American public life, how it would have all of our information that's right.
[AGENT][NEUTRAL] Yes, ma'am, and I don't
[AGENT][NEUTRAL] Yeah, that's gonna be a complete, that'll that'll have to be a question unfortunately for um
[AGENT][NEUTRAL] For member services because we don't again we don't issue ID cards.
[AGENT][NEUTRAL] On this particular.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Association.
[CUSTOMER][POSITIVE] Cause yeah, there's a little emblem on the top right that says um that's like a heart with a little.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Doctor's thing and that's the same emblem that shows up when we've gotten emails about what does it say explanation of like of allowance and stuff so we're getting information from both American public life and whatever this other thing is, and we only signed up for one thing so and we're only paying one.
[CUSTOMER][NEGATIVE] You know, we're paying for the insurance that's coming out of my bank account every month and we just have no idea who's actually insuring us.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Yes, definitely member services.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That would be a question for them.
[CUSTOMER][NEUTRAL] OK. And they, they are not related to, to American public life at all?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEGATIVE] That's really confusing.
[CUSTOMER][NEUTRAL] Um, hmm, OK.
[CUSTOMER][NEUTRAL] OK, well I guess if you um.
[CUSTOMER][NEGATIVE] I don't understand.
[CUSTOMER][NEUTRAL] Uh, I guess.
[CUSTOMER][NEUTRAL] As long as the claims are now being sent to, so are we insured with American Public Life?
[AGENT][NEUTRAL] The policy number that you gave me and that effective date are associated with this limited benefit plan. This is not major medical insurance, it's a limited hospital indemnity limited benefit plan.
[AGENT][NEUTRAL] So that PO box that I gave, that policy number that you have and that effective date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is for this coverage, and this is the only policy you have with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so we have we been paying you or have we been, go ahead please. I have no idea what I'm saying. Go ahead. That's it. No, you're doing fine, [PII]. You're, you're fine. I just need the claims address for um APO.
[AGENT][NEUTRAL] Yeah, it is, it's.
[AGENT][NEUTRAL] Again, that would be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Can you repeat that zip code for me?
[AGENT][NEUTRAL] And our payer
[AGENT][NEUTRAL] Do you need the payer ID, [PII]?
[CUSTOMER][NEUTRAL] I need the zip code again.
[AGENT][NEUTRAL] 3, the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the payer ID.
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] 60801
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] And so these visits that the, your clients have, there's um an outpatient surgery, there's some ultrasound visits, there's um of course her uh visits uh at internal medicine. These are covered under that policy.
[AGENT][NEUTRAL] Now, under this policy and any information related to benefits would be a verification of benefits and not a guarantee of payment, but diagnostic testing is not covered under this policy.
[CUSTOMER][NEUTRAL] What about diagnostic?
[AGENT][NEUTRAL] This again is
[AGENT][NEUTRAL] I'm sorry, Mr. [PII]. What was your question?
[CUSTOMER][NEUTRAL] Um, well, it was a diagnostic surgery, um, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So do you, OK, the information you did, you all, I can see, did submit a claim for one of these dates of service that she [PII] mentioned.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And I can see that that claim was denied.
[AGENT][NEUTRAL] Because the policy doesn't provide benefits for diagnostic testing.
[CUSTOMER][NEUTRAL] Does it provide for any of the other services that I had?
[AGENT][NEUTRAL] Now there should, there's a copy of your policy information. I can't say that because we can't pay claims over the phone. We will just have to receive the claims to review.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] For benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so once Dartmouth, um, once [PII] sends over all of the claims, you'll let us know if we're covered for any of it.
[AGENT][NEUTRAL] And the claims, well, yes, you will be able to see what we, anything in the portal.
[AGENT][NEUTRAL] You have access to those explanation of benefits for all of those claims that you all submitted.
[AGENT][NEUTRAL] You have access to the explanation of benefits and on.
[CUSTOMER][NEUTRAL] Well, I haven't
[AGENT][NEUTRAL] Um, I was speaking to [PII]. I'm sorry. That's OK.
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[AGENT][NEUTRAL] So on
[AGENT][NEUTRAL] On the portal where you all have your profile set up Mr. [PII], on any of those claim numbers you can click on that and have access to the explanation of benefits and any of the remark codes are listed on page 2.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And I just checked to make sure that there is a copy of your policy with its benefit information in your portal.
[CUSTOMER][NEUTRAL] How how do we check that?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Because we just got access to this like a week ago and that's why I sent all of the claims.
[AGENT][NEUTRAL] Mhm. When you're logged in, you would just go to the my coverage tab.
[CUSTOMER][NEUTRAL] Through there, yeah.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And you'll see your policy number?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Um, I did not.
[AGENT][NEUTRAL] If you click on your policy number?
[AGENT][NEUTRAL] You'll see a PDF icon.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, it's loading I think.
[AGENT][NEUTRAL] That you can download it will download the policy certificate.
[AGENT][NEUTRAL] So an overview of your benefit information is listed, there's a schedule of benefits.
[AGENT][NEUTRAL] In your policy.
[AGENT][NEUTRAL] But this
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That tells you what services are covered.
[AGENT][NEUTRAL] The amounts
[AGENT][NEUTRAL] Per day that are covered and how many days per calendar year that type of service is covered.
[CUSTOMER][NEUTRAL] OK, should we send this over to [PII]?
[AGENT][NEUTRAL] Oh, we don't, yeah, you, yeah, she.
[CUSTOMER][NEGATIVE] I don't need your benefits, huh.
[CUSTOMER][NEUTRAL] Oh, go ahead.
[AGENT][NEUTRAL] I was gonna say we can't send that.
[AGENT][NEUTRAL] Information
[AGENT][NEUTRAL] We we can't.
[CUSTOMER][NEUTRAL] Yeah, we don't, we don't need that.
[CUSTOMER][NEUTRAL] You don't need that? OK.
[CUSTOMER][NEUTRAL] OK, um I don't need a copy of your benefits package. OK, OK, um.
[CUSTOMER][NEUTRAL] Oh. So,
[CUSTOMER][NEUTRAL] So once they send over the claims again to the right address you'll.
[CUSTOMER][NEUTRAL] Tell us if we're gonna be covered, covered for any of it or not, and you're not gonna send the money to them you're gonna send the money to us.
[AGENT][NEUTRAL] It depends if you, if you file the claim and there are benefits payable, then the benefits would be sent to you.
[CUSTOMER][NEUTRAL] Through the mail.
[AGENT][NEUTRAL] If the facility files claims and there are benefits that are payable, then yes, the payment will be issued to the provider.
[CUSTOMER][NEGATIVE] So it won't
[CUSTOMER][NEUTRAL] OK, that would definitely be pre a preference because I'm just gonna have to give that money to them anyway.
[AGENT][NEUTRAL] But on
[AGENT][NEUTRAL] Because on this, you, so I would recommend that you all just go through your portal and look at the dates that you all submitted your claims for.
[AGENT][NEUTRAL] Obviously, [PII] is going to submit several claims. It's possible that some of them may be duplicates of things that we've already received, but again, that information will all be reviewed once it's received.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK. And I, I hear that you are calling it something other than insurance. Is it technically not insurance?
[AGENT][NEUTRAL] This is a
[CUSTOMER][NEUTRAL] Or is it insurance?
[AGENT][NEUTRAL] Yes, ma'am. What you have is an insurance, yes, it's a hospital indemnity limited benefit insurance plan. It is not major medical coverage.
[CUSTOMER][NEUTRAL] OK, I just wanna make sure that that's on our file over at DHMC because I'm probably gonna have to file some sort of financial aid if you're if I'm not gonna get any help from it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We because it seems like we have financial aid available in a row. OK, thank thank you. Can I ask a question [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] You said that you've already received.
[CUSTOMER][NEUTRAL] Claims from us for this patient.
[AGENT][NEUTRAL] Yes, well, no, no, the, no, ma'am. [PII] the insured.
[AGENT][NEUTRAL] Mr. [PII] and [PII], they have filed claims with us.
[AGENT][NEUTRAL] But I can't provide, I was explaining to them and you know this, correct, I can't provide their claims information.
[CUSTOMER][MIXED] OK, but not to Dartmouth, OK.
[AGENT][NEUTRAL] To you.
[AGENT][NEGATIVE] But they have submitted several claims.
[CUSTOMER][NEUTRAL] No, I, I thought you I thought you were I thought you were referring to the claims that we've been trying to submit to this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am. We've not received any claims. Yes, ma'am. No, we haven't received any claims from a provider. Yes, ma'am.
[CUSTOMER][NEUTRAL] Nova.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From Dartmouth, got you.
[CUSTOMER][POSITIVE] OK, OK, perfect. I just wanted to clear that up because I heard you say that and I'm like.
[AGENT][NEUTRAL] Everything that has been received to date has been from, correct. Now, today, everything that we have received has been from the insured.
[CUSTOMER][NEUTRAL] Something else.
[CUSTOMER][NEUTRAL] OK, so off the 7 records go, I have everything documented. I have who we spoke to as the corrected claim insurance information going to [PII] City. I have the payer ID.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I had the effective date. I have the claims address.
[CUSTOMER][NEUTRAL] And I'm sending these all over to our billing team to get these submitted to this and corrected insurance.
[AGENT][NEUTRAL] And [PII], what department do you work in actually?
[CUSTOMER][NEUTRAL] This is the customer service for billing.
[AGENT][NEUTRAL] OK. OK, billing for billing, OK.
[CUSTOMER][NEUTRAL] So conifer Health yep yep.
[AGENT][NEUTRAL] Uh, is it [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is that the correct spelling?
[AGENT][NEUTRAL] Just for my notes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK, and [PII], I always advise to allow 30 to 40 days. It may not take that long, but I would allow at least 30 to 40 days for these to get submitted.
[CUSTOMER][NEUTRAL] OK for us to get start getting some EOBs back from the corrected insurance, OK? These accounts will go on a temporary hold giving us time to get that get that done. OK, I appreciate that and then I'll I guess I'll see in the portal um if my bill has when that bill has changed and I'll probably have to call back and set up some sort of payment plan.
[CUSTOMER][NEUTRAL] Let's hope not much, but yes, you'll probably start seeing things in your MDH portal even before, uh, so don't hesitate to call if it goes over 30-40 days.
[CUSTOMER][POSITIVE] You know, don't, don't be afraid to follow up and, and. Yeah, no, I'm, I'm not every time I've talked to you guys you've been very helpful and very nice. It's just been a big, um, I guess a misunderstanding. I don't know. I'm the, the two different insurances I've no idea what that what that is, so, um. Yeah, but that's what we're all here for insurance and billing to work together to to get it resolved so I feel like we've got this resolved.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, so if there's anything else you guys need from me or.
[CUSTOMER][NEUTRAL] Are you guys all set? I think, I think, I think we're all set for now. I'll make it I'll, I'll make a point to put in my planner to check in in 30 to 40 days and then I will call back if I don't see anything on my portal but again I'll probably have to call back anyway just for help for sending setting up.
[CUSTOMER][NEUTRAL] I know that someone told me that I could set up a self pay um on my own but I'll probably need help with that and probably have to file for financial aid help as well um so we we will wait, OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Sounds, sounds good.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, Mr. Ms. [PII] is, this is [PII]. Is there anything else that I can help you all with today?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have any other questions for me?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] If we cancel this insurance uh now then it won't mess with the the claims we've already submitted, right? or.
[AGENT][NEUTRAL] If
[CUSTOMER][NEUTRAL] You guys should disconnect me from the call if you're done with the billing. Yeah, thank you [PII].
[CUSTOMER][NEUTRAL] I think that you I think that you'll have to hang up, OK.
[CUSTOMER][POSITIVE] Thank you [PII]. All right, you hold on. OK.
[CUSTOMER][NEUTRAL] OK, I think we're just with [PII], right?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm still here, yes.
[CUSTOMER][NEUTRAL] OK, great, um.
[CUSTOMER][NEUTRAL] Yeah, um, yeah, so [PII] asked if, if we, um, cancel the insurance, um.
[CUSTOMER][NEUTRAL] Now, uh, the, I, I, I, I don't know if I explained it correct and it sounds like you're not confused. You sound like you know what you're talking about, but with this, what you know, why, why, and, uh, Dartmouth was sending stuff over to address in [PII], right that you've like never heard of, it's kind of concerning.
[AGENT][NEUTRAL] Yes, ma'am. I
[AGENT][NEUTRAL] I and that.
[CUSTOMER][NEUTRAL] Um, it's kind of like where, where has all of this information gone, so if it's not a kind of straightforward insurance, um, and if we have to do this every time I get, I have a visit for anything or my husband does, then we probably wouldn't want to continue with it, if that makes sense.
[AGENT][NEUTRAL] Yes, ma'am. I do understand because of it being a limited benefit plan, I, I do understand your concerns. Now, any questions, so as far as the question related to claims payment, from the time the policy goes into effect until its termination date, any claims would still be processed, but if it's outside of obviously of those windows, either prior to the policy being active or
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] You know, a time period where we haven't received premium to cover those service dates and obviously claims would not be able to be processed. So any questions related to like, you know, what has been paid in to what date, um anything like that or the decision to cancel, that is all.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Topics, all of those things rather are topics for member services. For that phone number that I gave Mr. [PII], he said he thought he already had. Are you still on the line, Mr. [PII]?
[CUSTOMER][NEUTRAL] Which is
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes I am.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah, so that's the [PII] that's who we need to call to kind of um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Either cancel and to make sure that we that the claims were only submitted in that time that we were paying, which I think that they were um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I can double check with, with them.
[AGENT][NEUTRAL] Right, because I can't see the exact like premium date received to at this point. I can just see that your policy is showing as active with that effective date.
[CUSTOMER][NEUTRAL] Right, yeah, yeah, well, I definitely have been charged for the month of January and I think I started getting charged for in August, um, and I haven't had any uh appointments since that [PII] date, so I think it should be good, but I can call them to double check and then um likely to um.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] To cancel but we would still be able to continue to be in conversation with you guys as we get this figured out with [PII] is that is that right?
[AGENT][POSITIVE] Oh, absolutely. Oh, absolutely, yes, ma'am. And you, you will still have access to the portal as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But again, you know, um, and, you know, I know this is redundant, somewhat repeating, but all of the claims that you all have filed.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] You can now see the explanation of benefits in the portal. You can click on those claims and see this explanation of benefits, and then that policy certificate, it gives you the schedule of benefits. Um, if you search the full document, if the documents are total looks like the 38 total pages.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So in looking at page 21.
[AGENT][NEUTRAL] Of the total document, not what's on the actual page number on the bottom right, OK? But the total document, no, no. Search the, mhm if you search the total document, that is where your schedule of benefits are and that's gonna tell you what the benefit is and the benefit amount and how much.
[CUSTOMER][NEUTRAL] Oh, not on the, not on the, oh right, OK, OK, yep, OK, I'm on page.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Excuse me, it's covered per person, per day, per calendar year on this limited benefit plan.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK, so, so, um, so [PII] kind of sending, sending all of that stuff over to you isn't really gonna make much of a difference of what we see now on our portal which is that we're not really getting bursed for much of any of it.
[AGENT][NEUTRAL] Again, I can't, I can't say that [PII] because that would be as, you know, like paying claims over the phone which we can't do so we'll just have to and if it's the same thing, you know that you have already submitted, obviously it's still gonna be reviewed um but we'll just have to have that claims information in house.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure. OK. Well, well, hopefully, at least it will be um helpful for Dartmouth to have and so that when I'm starting to pay these bills, they have, um, will that $50 then only come to us it's like, you know, that I know that it said like you said that we got reimbursed for $50 and it's gonna come through the mail. Um, that's something.
[CUSTOMER][NEUTRAL] Separate from obviously what Dartmouth will get but now that they're submitting all these claims through them that going forward they will receive payments from you guys.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Or will it, will it still come to us?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, if, for example, if we receive a claim from the facility.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That you all have not filed for, OK? And there are benefits payable, we would pay them to the facility.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If we are to, if we happen to receive a claim from them that
[AGENT][NEUTRAL] It's a duplicate.
[AGENT][NEUTRAL] Of a claim that you have already submitted for that data service.
[AGENT][NEUTRAL] And even if we paid you all benefits on that claim, I mean, we would obviously deny their claim as a duplicate, right? because you had already filed one.
[AGENT][NEUTRAL] But we can't tell them that we paid you that benefit amount ever how much it is.
[AGENT][NEUTRAL] Whether it, you know what I mean? So like if [PII] had just called me right now and ask about
[AGENT][NEUTRAL] The data service that we went over and I explained we did issue that $50 payment for you for the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I couldn't tell her that if she didn't file the claim. She would have had to contact you, OK? Yes, we do not provide.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Information on claims that you file with APL to anyone other than you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] OK, well I guess uh.
[CUSTOMER][NEUTRAL] Yeah, it makes sense. I just we probably wouldn't have put them in the in the portal if we had figured this out sooner, but that's obviously in a retrospect kind of kind of way because now whatever money we get from because I don't think that they're gonna file any claims that we haven't put online so we're probably gonna have to get the money and then give it to them anyway which is just, you know.
[AGENT][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, uh, like another step, but we can at least explain that to them, yeah.
[AGENT][NEUTRAL] It, yes, it's always, it's all, it, it really, you know, honestly, it is easier if the facilities will file. Um, most will, but I mean, some facilities, even though, even if she had had the right information in her, they still may not have filed. Some won't. And so it, but it is extra work when you have to do it.
[AGENT][NEUTRAL] So, you know, I know that that was a lot to get all those cause I can see what all you have submitted.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] In the system.
[AGENT][NEUTRAL] But we will review anything that we receive.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you all will be able to see the status of anything that we received in your portal.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Whether it's, you know, so you'll be able to have access to all of that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I can connect you all.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 2 member services if you would like, or do you all want to call them directly?
[CUSTOMER][NEUTRAL] Um, I, I, I have an appointment in 10 minutes. Can you call [PII]? Yeah if he's. Yeah, no, no worries, I have, um, an appointment in, in 10 minutes, so I'll have to get off the phone, but my husband is the, you know, he's the policy holder, so he should be able to do that if you were OK to transfer him, that would be great.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, and he, yes.
[AGENT][NEUTRAL] So, OK, and then one last thing, I can see that in the portal, Mr. [PII], you do not have direct deposit information in your profile.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, so if you, and again you don't, it's not required that you add it, but if we are able to pay claims to you, we can direct deposit the funds versus the paper check having to be mailed because obviously that takes about 1010 business days or so to receive mailed, but if you don't wanna add it, that is perfectly fine as well.
[CUSTOMER][NEUTRAL] OK, that that's, that's a good, that's a good thing. That's good to know. Well, that, but we'll still because you already sent out the $50.01 that won't be, but maybe for that other one that I see of $425.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] If you all, if you all were to decide to continue the coverage and, you know, additional claims were filed, you know, that's something you can always add in. You can always add that in.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh, OK, OK, OK, OK, I understand. Sounds good. OK.
[AGENT][NEUTRAL] All right. Well, Mr. [PII], are you gonna want me to connect you to member services?
[CUSTOMER][POSITIVE] Uh, no, that's all right. I'll call them with my phone. We're on my wife's phone right now. Thank you.
[AGENT][POSITIVE] Oh, OK. Well, you're welcome. So can I help either one of you with anything else today?
[CUSTOMER][NEUTRAL] No, that, that, I think that is, that is all.
[AGENT][POSITIVE] OK. Well then, thank you both. I mean, are you good, Mr. [PII]? Any other questions?
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][POSITIVE] Yes, I'm all set thank you no.
[AGENT][POSITIVE] OK. Well then, thank you both for calling APL and I hope that you have a nice rest of your day today.
[CUSTOMER][POSITIVE] Yeah, you too. Thank you for um speaking with [PII] and and clearing up a few things that um we were unsure about it's very helpful. Thank you.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Absolutely. Well, you're very welcome. It was my pleasure.
[CUSTOMER][POSITIVE] OK have a good day.
[AGENT][POSITIVE] OK. Yes, thank you very much. You all too.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.