AccountId: 011433970860
ContactId: 482e5891-bfaf-49ac-985a-a8cc25676a1b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 966590 ms
Total Talk Time (AGENT): 183021 ms
Total Talk Time (CUSTOMER): 446275 ms
Interruptions: 5
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/482e5891-bfaf-49ac-985a-a8cc25676a1b_20250522T13:36_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Yes, hi, good morning, um.
[CUSTOMER][NEUTRAL] Uh, hang on one second here.
[CUSTOMER][NEUTRAL] Hi, I'm calling in regards. I'm one of the members of APL and I'm calling because I'm having a little bit of difficulty with um one of the um diagnosis center that needs to refund um money to my account and they're saying that they're pending payment from APL and I'm calling to see if you guys have received the claim and if you guys issued the payment for them already.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I can help you with that. Um, what's your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] My callback number is [PII].
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] Uh, let's see here.
[CUSTOMER][NEUTRAL] Would that be the
[CUSTOMER][NEUTRAL] Group number or?
[AGENT][NEUTRAL] Um, it should say policy certification or in hospitals benefit number.
[CUSTOMER][NEUTRAL] It says in-house benefit certificate number and outpatient benefit.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So but this was an outpatient.
[AGENT][NEGATIVE] Neither one should work.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that's 02.
[CUSTOMER][NEUTRAL] 25
[CUSTOMER][NEUTRAL] 8741
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, let me look that up for you.
[AGENT][NEUTRAL] And can I get you to verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And your mailing address and phone number that we have on file?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And do you have a date of service for the claim?
[CUSTOMER][NEUTRAL] I think it was [PII].
[AGENT][NEUTRAL] OK, we can look.
[CUSTOMER][NEUTRAL] It's coming from a Palmetto Baptist Palmetto Diagnostic Center.
[AGENT][NEUTRAL] OK, let me look on that for you.
[AGENT][NEUTRAL] Do you know what the total amount was that you were charged?
[CUSTOMER][NEUTRAL] $1,502.
[CUSTOMER][NEUTRAL] I put $2 in cash and the other ones were in credit cards.
[AGENT][NEUTRAL] So 1,502. OK. Um.
[CUSTOMER][NEUTRAL] I was only supposed to pay a copay.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] Gave the APL card for the.
[CUSTOMER][NEUTRAL] To see if they would cover for me and
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And they say that they're pending payment from you guys and that is the reason why they haven't credited my card.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, because I'm not showing anything.
[AGENT][NEUTRAL] For the [PII].
[AGENT][NEUTRAL] Of April.
[CUSTOMER][NEUTRAL] I mean I have an account number with them uh I don't know if that works but.
[AGENT][NEUTRAL] Um, no, I look it up by the day that day, the day of your service.
[CUSTOMER][NEUTRAL] Yeah, it was done.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] So they're telling, I just got off the phone with them.
[CUSTOMER][NEUTRAL] And they told me that they're waiting on APL for payment.
[CUSTOMER][NEGATIVE] They have not received payment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment. I'm gonna try and find that claim because I'm not showing one for that data service. Let me check and see um and you said it was in the amount of 1,502, correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You wanna call?
[CUSTOMER][NEUTRAL] Well, no, that's what I was charged, right.
[AGENT][NEUTRAL] Right, OK.
[CUSTOMER][NEGATIVE] That's what I was charged, but I don't think, I don't think they're charging you guys that. I think what they're charging you is the deductible, which is $500.
[CUSTOMER][NEUTRAL] But I cannot.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And you said it was for Baptist hospitals, that's right.
[CUSTOMER][NEUTRAL] It's for a diagnostic center.
[AGENT][NEUTRAL] Amount
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For it's affiliated with the Baptist Health system.
[CUSTOMER][NEUTRAL] But it's one of their diagnostic centers that they have in the city, in different areas of the city, and I had my appointment was at that one.
[CUSTOMER][NEUTRAL] Do you need like the address or something maybe?
[AGENT][NEUTRAL] Um, it would help with the data of service because right now I'm just going through them.
[AGENT][NEUTRAL] Through the claims that you've provided to us.
[CUSTOMER][NEUTRAL] Mhm. Morning.
[CUSTOMER][NEUTRAL] It's the [PII].
[CUSTOMER][NEUTRAL] [PII], that's the address of the, of the place.
[CUSTOMER][NEUTRAL] But you don't show no claim under that place?
[AGENT][NEUTRAL] I don't show a claim for that date of service under that place. I did see one for Baptist Hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh, but that's
[AGENT][NEUTRAL] But that was the only one that I see.
[CUSTOMER][NEUTRAL] Do you want me to call him?
[CUSTOMER][NEUTRAL] Do you want me to, can I?
[AGENT][NEUTRAL] Have
[CUSTOMER][NEGATIVE] Call them and let them know that you guys don't sign uh or they because this is gonna this is gonna run going, it's gonna go off. I mean they don't wanna, I mean they charge you whatever they need to charge, but when they need to give you credit, they don't wanna give you credit.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I would call them and see.
[CUSTOMER][NEGATIVE] And, you know, it's not fair because
[AGENT][POSITIVE] I, I completely understand.
[CUSTOMER][NEUTRAL] Can I call them in with you?
[CUSTOMER][NEUTRAL] I need my credit cards to be credited. They are.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Maxed out.
[AGENT][NEUTRAL] Yeah, go ahead and
[AGENT][NEUTRAL] Give them a call.
[AGENT][NEUTRAL] And see if you can get the exact date of service in the bill and I see the bill amount here um but since I'm not seeing one, I would double check and make sure that they actually sent in the claim and if not, if you need to send in the claim or you can have them call us.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Would I be able to call them with you on the phone?
[CUSTOMER][NEUTRAL] Can I call them with you on the phone?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you. Give me 1 2nd.
[AGENT][POSITIVE] You're welcome. OK.
[CUSTOMER][NEUTRAL] One more thing, it's Friday.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Hi, good morning. Hi, hi, how are you? Good, and you? Good. So I'm calling. I'm patient, um, account number 19689931-1.
[CUSTOMER][NEUTRAL] OK, let me go into the account, OK? Hold on a second please.
[CUSTOMER][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Hello, can you hear me?
[CUSTOMER][POSITIVE] Are you there? OK, thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I can. This is for [PII]? Yes, it is. OK. And what is your date of birth? [PII] and your address please? [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, how can I help you? Yes, I'm, I have APL, um, American Life, um, with me on the line. I just spoke, I'm not sure if I spoke to you or someone else, um, not too long ago. It's about a claim that was sent from Baptist Health Diagnostic Imaging Palmetto Bay, and they stated that you guys were waiting for APL.
[CUSTOMER][NEUTRAL] You send the claim to APL for payment and you have not received the payment as of yet, so I have the rep from [PII] on the phone and she's stating that she doesn't see any claim coming from there.
[CUSTOMER][NEUTRAL] Well, the claim was sent on the [PII].
[CUSTOMER][NEUTRAL] Maybe too soon?
[CUSTOMER][NEUTRAL] Hello? Yeah.
[AGENT][NEUTRAL] One give me one moment, let me see if I see anything for that day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We haven't, OK, hold on one moment. Do you have the date?
[CUSTOMER][NEUTRAL] Cause the, the, it was done on [PII].
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] Can you verify that it was [PII]?
[CUSTOMER][NEUTRAL] I have here uh that it was sent on [PII]. The date of survey was [PII].
[AGENT][NEUTRAL] [PII]. OK, hold on one moment.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] I'm not showing any claims for that date of service.
[CUSTOMER][NEUTRAL] OK, the line.
[CUSTOMER][NEUTRAL] is it you think it might be too soon if we send it uh.
[CUSTOMER][NEUTRAL] A few days ago or used to or you will have it already.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] But she's saying that it hasn't been received.
[AGENT][NEUTRAL] How did you send it?
[AGENT][NEUTRAL] Yeah, we haven't gotten it yet. How did you send it?
[CUSTOMER][NEUTRAL] Electron.
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEGATIVE] It was sent electronically um but actually it says here they started working on the [PII] and it was on [PII], 2 days ago.
[CUSTOMER][NEGATIVE] Ridiculous
[AGENT][NEUTRAL] OK, and did you send it through fax?
[CUSTOMER][NEUTRAL] [PII] here.
[CUSTOMER][NEUTRAL] E-premise I think you think it was electronically. Do you receive a claims electronically on the on the.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] We do, um, and they sent it a few days ago.
[CUSTOMER][NEUTRAL] No, no, let, let me see, hold on a second, hold on, let me see. American Public claims submitted submitted to American Power Life source.
[CUSTOMER][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] Mhm, yeah, electronic.
[AGENT][NEUTRAL] Um, we're not showing anything for that date of service. Would you like our fax number?
[AGENT][NEUTRAL] And you can fax over the claim it's [PII].
[CUSTOMER][NEUTRAL] Sure, go ahead.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and attention claims?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Are you able to fax that now so she can receive it, please? I'm not, I'm not the one that fax it. I'll have to give it to that department to the billing department, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Anything else that I can help you how does, how does that work? So now what do you do? You send an email to the billing department? How, how does it work? Yeah, I'll send them an email and they'll fax it to them.
[CUSTOMER][NEUTRAL] Lord [PII]
[CUSTOMER][NEGATIVE] OK, alright, OK, so I guess I don't have a choice and to continue to wait, right? Like, ma'am, we're not billing you, we're billing the uh insurance and you're that you guys are not billing me but you're charging my credit card and don't wanna give me credit.
[CUSTOMER][POSITIVE] That's what I'm, I'm trying to say I'm trying to get the, the message across here because it's, you know, it's not coming through, you understand what I'm saying? Yes, alright, thank you so much thank you thank you bye bye.
[CUSTOMER][NEUTRAL] I guess we don't have a choice, we would have to wait until you get the claim.
[AGENT][NEUTRAL] OK, and hopefully by fax it should get here um.
[AGENT][NEUTRAL] Sooner it could have been that they inputted it wrong electronically. It, it would have showed up though if they did it two days ago so hopefully through fax.
[CUSTOMER][NEGATIVE] It's always a problem. It's always something.
[CUSTOMER][POSITIVE] Alrighty, OK, thank you. I'll I'll, I'll give it a couple of more days.
[AGENT][NEUTRAL] Well I'll put it in our notes that we reached out and.
[AGENT][POSITIVE] OK. I'm so sorry to hear about all this.
[CUSTOMER][POSITIVE] Yes, OK, thank you so much. You have a nice day, OK?
[AGENT][NEUTRAL] Right
[AGENT][POSITIVE] You're welcome have a great day. Thank you for calling ATL.
[CUSTOMER][NEUTRAL] Bye bye. Mhm. You too.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] To hold