AccountId: 011433970860
ContactId: 2e1dc92a-3242-4749-85e5-03693f647c8c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 988090 ms
Total Talk Time (AGENT): 323569 ms
Total Talk Time (CUSTOMER): 410681 ms
Interruptions: 5
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/2e1dc92a-3242-4749-85e5-03693f647c8c_20250318T15:59_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I have a question. Um, so I have APL through my work as our secondary, um, med link with benefits, and I have a bill from All Saints Home Medical, um, and I don't think that they ran it against you guys, um, and so I was just checking to see how I do that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK. Um, so you just want to see if there's a claim on file from
[AGENT][NEGATIVE] The provider that you said it slipped my mind. OK.
[CUSTOMER][NEUTRAL] Yeah, because I have an invoice from them, but I don't, I mean, it's the same like nothing was paid, so.
[AGENT][NEUTRAL] OK, I can definitely check for you and see if they've um filed a claim with us. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, I'm at work right now. My number at work is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 02058865
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] Alright, so I have you here and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um, [PII], um, my home mailing address is [PII], and my personal email is my name [PII].
[AGENT][NEUTRAL] OK, and I think this may be your work email that we have on file.
[CUSTOMER][NEUTRAL] OK, so it'll be [PII].
[AGENT][POSITIVE] Yes, and thank you so much for verifying your information. And on that invoice there, what does it have for the data service?
[CUSTOMER][NEUTRAL] Uh 1213 24.
[AGENT][NEUTRAL] 213, 2024.
[CUSTOMER][NEUTRAL] It's uh a a wrist laser and a knee immobilizer.
[AGENT][NEUTRAL] And what's the total bills for on that invoice?
[CUSTOMER][NEUTRAL] 193 59.
[AGENT][NEUTRAL] 9359.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] 911536 OK.
[AGENT][NEUTRAL] I'm trying to get all the information. Hold on one second. 33.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And who, what's the name of the provider?
[CUSTOMER][NEUTRAL] All Saints Home Medical.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] They were, I went to urgent care and that's who the braces came from that they had to brace me with.
[AGENT][NEUTRAL] OK, so I'm gonna say that there is no claim on file because we do have two claims, but it's a different total bills and let me check if both of them say Warren Clinic. Hold on one second.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well, it was Warren clinic where I went, but All Saints is who bills for the braces.
[AGENT][NEUTRAL] Yeah, because these total the total bill on the claims from Warren Clinic, they don't total the 193 59, but
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It like they're like they're uh.
[AGENT][NEUTRAL] They're within the Warren clinic, right? But no, if this is being me.
[CUSTOMER][NEUTRAL] Yeah, that's where I, that's where I went, the urgent care at the Warren clinic, and they said it was the All Saints would, yeah, they, they put the braces on me there and they said that the All Saints would bill separately, but they were supposed to give my insurance to them so I'm not sure what happened.
[AGENT][NEUTRAL] And they gave you the brace?
[AGENT][NEUTRAL] Do separately. OK, yeah, that's a thought.
[AGENT][NEUTRAL] OK, so all you have to do is call Allstate, let them know that you
[AGENT][NEUTRAL] Am I saying that right? They say Allstate or all state.
[CUSTOMER][NEUTRAL] All Saints
[CUSTOMER][NEGATIVE] Yeah, well, because see I did call them and then they're like, well you'll have to call them and I'm like, OK this is getting ridiculous. I don't know what to do.
[AGENT][NEUTRAL] OK, well, let's call them together. Do you have their phone number?
[CUSTOMER][NEUTRAL] Um, it is.
[AGENT][NEUTRAL] Because I don't want you to keep going in circles.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Because I mean you guys should cover that, right?
[AGENT][NEUTRAL] Let me take a look at your coverage. Hold on one second.
[AGENT][NEUTRAL] I mean, you do have the durable medical equipment writer, so it just from what it looks like to on my end, it just looks like they haven't filed a claim.
[CUSTOMER][NEUTRAL] OK, so they just need to file a claim. OK, cool, so then, yeah, let's call them.
[AGENT][NEUTRAL] But I'm going to check with them just to make sure, so, OK. All right, hold on one second, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for choosing All Saints Home Medical. Your call may be recorded for training purposes.
[CUSTOMER][NEUTRAL] Please choose from one of the following menu options. If calling from a physician's office, press 0. For oxygen tank refills and supplies, press 1. To order CPAP supplies or ask about a CPAP.
[CUSTOMER][NEUTRAL] Please hold. All agents are currently assisting other customers. We will answer your call in the order in which we received it.
[AGENT][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, so make sure you're here with me.
[CUSTOMER][NEUTRAL] Saints Home Medical, this is [PII].
[AGENT][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from American Public Life. Um, we have a mutual patient and we're trying to see if um she's trying to see if a claim has been filed from you all for braces that she received. Um, can I go over the tax ID with you because we have claims on file, but it doesn't look like it's from your provider or the total bill.
[CUSTOMER][NEUTRAL] Yeah I'm gonna have to get you to the billing department on that, but I'll, I'll just to make sure you know we supplied with the item and all that. What's the date of birth?
[AGENT][NEUTRAL] Hold on, let me
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Beat it.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And last name?
[CUSTOMER][NEUTRAL] Oh [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] There's some notes in here from today.
[CUSTOMER][NEUTRAL] Got to mobilize your knee single panel back in December along with the laser wrist with thumb.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'll get you over to the billing department on this.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Please hold. All agents are currently assisting other customers. We will answer your call in the order in which we received it.
[CUSTOMER][POSITIVE] Thank you for holding. We'll be with you momentarily.
[CUSTOMER][NEUTRAL] Hello, you have reached All Saints Home Medical billing office. Our office hours are [PII] Monday through Friday. All representatives are busy helping other customers. Please leave a message and we will return your call shortly. Messages left after [PII] may not be returned until the following business day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, hold on one second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you for choosing All Saints Home Medical. Your call may be recorded for training purposes. Please choose from one of the following menu options. If calling from a physician's office, press 0. For oxygen tank refills and supplies, press 1. To order CPAP supplies or ask about a CPAP referral, press 2. To make a payment or for questions on a bill, press 3.
[CUSTOMER][NEUTRAL] For any other questions, press 0. Please make a selection now.
[AGENT][NEUTRAL] Billing.
[CUSTOMER][NEUTRAL] Please hold. All agents are currently assisting other customers. We will answer your call in the order in which we received it.
[CUSTOMER][POSITIVE] Thank you for holding. We'll be with you momentarily.
[CUSTOMER][NEUTRAL] Please continue to hold. Your call is important to us.
[CUSTOMER][NEUTRAL] Thank you for calling All Saints Home Medical. Unfortunately, all of our representatives are busy. Please leave your name and number and a brief message and we'll return your call as soon as possible. Thank you for calling All Saints Home Medical.
[AGENT][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Hold on one moment, [PII].
[AGENT][NEGATIVE] No, I can't get anyone. Hold on one second.
[CUSTOMER][NEUTRAL] Thank you for choosing All Saints Home Medical. Your call may be recorded for training purposes. Please choose from one of the following menu options. If calling from a physician's office, press [PII].
[AGENT][NEGATIVE] I called and I couldn't get anyone so I'm gonna try again.
[CUSTOMER][NEUTRAL] For oxygen tank refills and supplies, press [PII].
[CUSTOMER][NEUTRAL] To order CPAP supplies or ask about a CPAP referral, press [PII]. Make a payment or for questions on a bill, press [PII]. For any other questions.
[CUSTOMER][NEUTRAL] Please hold. All agents are currently assisting other customers. We will answer your call in the order in which we received it. We'll be right with you.
[CUSTOMER][NEUTRAL] Please continue to hold. Your call is important to us.
[CUSTOMER][NEUTRAL] Hello, you've reached All Saints Home Medical billing office. Our office hours are [PII].
[AGENT][NEUTRAL] Yeah, I was gonna say maybe this is their lunch hour. Um, if you want to, if you want to try to call them later and then call us, I'm the only [PII] here, so maybe we can try it the other way around.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And basically all they just need to do is send you guys the bill or however they do it.
[AGENT][NEUTRAL] So here's the thing. So, OK, so since they've already said that all saints, I'll say it again, All Saints is going to bill separately.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Where it says Warren clinic here on these claims, the two claims that we do have here, it should say All Saints, but
[AGENT][NEUTRAL] If it's like in the same facility, it's just you go down the hall or something to go to DME, then it could come up as that, it's not OK, so then there's no claim here.
[CUSTOMER][NEUTRAL] No, they're not the same thing.
[AGENT][NEUTRAL] So they just need to submit it.
[CUSTOMER][NEUTRAL] What do you mean?
[AGENT][NEUTRAL] If it's not
[CUSTOMER][NEUTRAL] OK, so should can I, I have the invoice. Can I send it to you?
[AGENT][NEUTRAL] So it's not just the invoice, so you'll need the
[AGENT][NEUTRAL] So you have your patient bill there, but there's also like a bigger, like a, we call it an itemized bill or a universal bill, that's what your patient bill is generated from. We need that copy, the big bill, because it has all of the coding. Your bill will show some coding, but that's treatment and the charges for the treatment. We need the diagnosis, which shows the medical necessity for that treatment that you received or braces in this case.
[CUSTOMER][NEUTRAL] Uh let me see if I have anything else on this because I feel like they sent me something.
[AGENT][NEUTRAL] And do you have, or do you have the explanation of benefits from your primary insurance for this data service for the braces?
[CUSTOMER][NEUTRAL] Mm, maybe like uh explanation of like my um on my my chart where I visited them is that what you're talking about.
[AGENT][NEUTRAL] Well, no, let me see, hold on, let me see if I see the name on here.
[AGENT][NEUTRAL] OK, so this one would be for community care. It would be the explanation of benefits from community care, because they should have, well, let me back up. If they submitted, if All Saints submitted the claim to your primary insurance, they're supposed to submit it to primary first because we're 2.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, yes, so it shows on here they submitted to community care and commercial UMR which is my husband's.
[AGENT][NEUTRAL] So let's see if they, they did.
[AGENT][NEUTRAL] Oh, that's what's happening. OK, so there's a try, OK, now that makes sense. They have your husband as 2nd and they probably don't have us down. They need to have community care, us, and then your husband, so that's what happened.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so it should have went communica, you and then [PII] OK.
[AGENT][NEUTRAL] OK, now that makes sense to me.
[AGENT][NEUTRAL] Uh, because we're second only to community care.
[CUSTOMER][NEUTRAL] Ouch.
[CUSTOMER][NEUTRAL] Got you, got you, OK, so then that's the whole problem. OK, I'll let them know.
[AGENT][NEUTRAL] OK, and let them know if they have any questions or anything you need to verify insurance or see how we work, anything, just give them our phone number also, and yeah, you can do that, have them call us.
[CUSTOMER][NEUTRAL] And just have them reset it.
[AGENT][POSITIVE] So you don't have to worry about it.
[CUSTOMER][POSITIVE] Because this is crazy, right? I will do that. OK, thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, I think that will do it.
[AGENT][POSITIVE] All right. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.