AccountId: 011433970860
ContactId: 39a074ee-21e0-4b5c-8816-6028daf3cf83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396980 ms
Total Talk Time (AGENT): 157388 ms
Total Talk Time (CUSTOMER): 184850 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/39a074ee-21e0-4b5c-8816-6028daf3cf83_20250102T21:27_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. Um, I am calling because um I'm new with this insurance and, um, my employer had given me, um, the information for me to create a, an account, which I did, but I had no idea um if I do I get an ID card or something because I had a test done today and they were asking me for proof of um a card and I didn't have it, so.
[CUSTOMER][NEGATIVE] I had to do the test, so I pay whatever they asked me for. It was $500 and something dollars um that I had to pay out of pocket.
[AGENT][NEUTRAL] May I have your policy number and I'll get your file pulled up.
[CUSTOMER][NEUTRAL] Um, I don't have a policy number. I, I just have, I mean, the information that I was given was to um log in to APL and I gave my social and all that, but I don't have uh.
[CUSTOMER][NEGATIVE] I never received anything through the mail.
[AGENT][NEUTRAL] May I have your social security number?
[CUSTOMER][NEUTRAL] Yes, please. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have your first and last name along with your date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And your good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] Can you verify your mailing address and your email, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My personal email is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. So under this plan, I do have your policy number if you would like to write that down.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] It is 02552666. And were you able to log into your account?
[CUSTOMER][NEUTRAL] Yeah, I did that. I just did that. Mhm.
[AGENT][NEUTRAL] So under there you can actually upload a copy of your ID card.
[AGENT][NEUTRAL] There and I'll also put in a request to have one mailed to you as well.
[CUSTOMER][NEUTRAL] OK, so I couldn't uploaded there. Wow, it was one of those stuff.
[CUSTOMER][NEGATIVE] Cases that I was at the office and nobody was answering me and I didn't know what to do and I was scheduled for, for a test, so I had to pay for it and I got the receipt here.
[AGENT][NEUTRAL] OK, so you can submit that claim. You would need an itemized bill from your provider. You would need your primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And you would need a Metlink claim form, which you can obtain online.
[AGENT][NEUTRAL] At [PII] and then you can submit that for reimbursement.
[CUSTOMER][POSITIVE] OK, I'm so sorry. So, I got, they gave me a
[CUSTOMER][NEUTRAL] And a receipt of what I paid and um payment receipt.
[CUSTOMER][NEUTRAL] The method that I played and everything, so that, that would be the um
[CUSTOMER][NEUTRAL] One of the items. What else was the other item?
[AGENT][NEUTRAL] Your primary insurance explanation of benefits from your primary?
[CUSTOMER][NEUTRAL] So explanation of benefits, how do, that's from my primary insurance.
[AGENT][NEUTRAL] Correct. So once they submit to your primary,
[AGENT][NEUTRAL] Then they'll show what was applied to your co-pays, your co-insurance, and our deductibles, and then normally the provider would send that over to us, but since you've already paid, you can submit it over to us once you receive that EOB.
[CUSTOMER][NEUTRAL] OK, so I have to ask for, so I'm assuming that um.
[CUSTOMER][NEUTRAL] That since I just did that today, it's gonna have to be once they send it to you, OK.
[AGENT][NEUTRAL] Yes, so once your primary processes it, you'll receive an EOB showing what was paid or denied.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And then you will take that and send that over to us cause this plan will pick up your co-pays, your co-insured, and or deductible as long as it's covered under your plan.
[CUSTOMER][NEUTRAL] So for the future, what I have to show is the ID card.
[AGENT][NEUTRAL] Yes, and have the provider file as your secondary. Every time you receive services, just have them submitted to your primary, I mean your secondary.
[CUSTOMER][NEUTRAL] OK, I don't know if I could still do that if um, if this was just done today.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] You can always call them back and give them your policy number along with the telephone number and they can call us and verify as well.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm gonna try to do that. I don't know if they're still open, but I'm gonna try to do that. So I'll give you your phone number and the number I just dialed and my policy number, OK.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, so, um, let's see, I'm gonna try that route and see if they accept it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because otherwise this is gonna be a process, right? Because I have to wait for the DOB and then I have to submit it with this and
[CUSTOMER][NEUTRAL] After the explanation of benefits and copy of my primary insurance card, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] No, not at this time, and if you could send me a card, I appreciate it, OK?
[AGENT][POSITIVE] Yes, ma'am, I'll get that over to you and thank you for calling American Public Life, [PII]. Have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. You too. Thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.