AccountId: 011433970860
ContactId: 29b85124-dd2f-4de7-8c91-6b581ec0bbb8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284269 ms
Total Talk Time (AGENT): 136736 ms
Total Talk Time (CUSTOMER): 115598 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/29b85124-dd2f-4de7-8c91-6b581ec0bbb8_20250228T14:44_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, [PII]. Um, I received a bill for a hospital, uh, emergency room from last year.
[CUSTOMER][NEUTRAL] Wanted to check to see if it was if there was a claim or anything uh submitted for it.
[AGENT][NEUTRAL] OK, well, I can verify claim status for you. And may I ask who's calling?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Alright, give me one second, um, the in the inhospital one or the outpatient?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh, either one is fine.
[CUSTOMER][NEUTRAL] OK, I'll do the outpatient is 02255705 M as in Mary, L as in Larry 8.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII], and verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] Sure. My date of birth is [PII].
[CUSTOMER][NEUTRAL] My address is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my email is [PII].
[AGENT][NEUTRAL] I do show a different email address. It looks like maybe work email.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, probably [PII].
[AGENT][NEUTRAL] Yes, sir. Is it fine to keep it with that one or you'd rather use your Gmail?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You use my Gmail instead.
[AGENT][NEUTRAL] And what was that one you said, [PII]?
[CUSTOMER][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mail, OK, give me one moment.
[AGENT][NEUTRAL] [PII], correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you had, um, you was in ER and it was in last year. Do you know the date of service?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see, and this is for you, correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, no, sir. I don't show we received the claim from [PII]. I see [PII]. It looks like it was an urgent care visit, but I don't show on [PII].
[CUSTOMER][NEUTRAL] Yeah, I remember, yeah, going to the emergency room on [PII].
[AGENT][NEUTRAL] Yeah, I would say to contact that provider, um, and just verify that they submitted the claim to us as secondary since we have not received it. And if you like, I can give you a fax number and they can fax the claim to our office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what's the fax number?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK alright I'll call them up now.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] All right. Well, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, um.
[CUSTOMER][NEUTRAL] Does my policy also cover lab work?
[AGENT][NEUTRAL] Uh, let me see. Give me one moment.
[CUSTOMER][NEUTRAL] Say how long.
[AGENT][NEUTRAL] And I apologize, my computer is moving a little slow this morning.
[AGENT][NEUTRAL] Um, lab charges are covered, but your policy mainly pays if it's in an outpatient or in hospitals, so an outpatient facility like ER, urgent care, ambulatory surgery center, MRI or imaging center, that is a covered place of service if labs are done, but if it's like an independent lab facility like Quest or LabCorp, it's not covered.
[AGENT][NEUTRAL] So technically it is covered but it has to be an outpatient facility or inpatient.
[CUSTOMER][NEUTRAL] OK, so because
[CUSTOMER][NEUTRAL] So the work has to be done at the facility, but if I went to Quest, it doesn't count.
[AGENT][POSITIVE] Exactly, yes, sir.
[CUSTOMER][NEUTRAL] OK, alright, then I guess I got to pay this bill.
[CUSTOMER][POSITIVE] OK. Um, no, great. Thank you so much for your help.
[AGENT][POSITIVE] Alright, you're welcome and thank you for calling APL. You have a great day and weekend.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. You too. All right, bye-bye.
[AGENT][NEUTRAL] Bye bye.