AccountId: 011433970860
ContactId: 490929a2-8f30-4df4-8c71-42c7099a7dae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1049800 ms
Total Talk Time (AGENT): 149986 ms
Total Talk Time (CUSTOMER): 697972 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/490929a2-8f30-4df4-8c71-42c7099a7dae_20250113T17:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. I had called a few minutes ago. I'm not sure who I had talked with, um, about my coverage. Um.
[CUSTOMER][NEUTRAL] I've been trying to deal with ATI physical therapy on some bills. And when I talked with them a minute ago, after I talked to you guys originally, they're trying to say that y'all are telling them that I didn't have um
[CUSTOMER][NEGATIVE] My gap insurance prior to [PII]. I've had it like 4 years. I think somehow they've got a miscommunication because y'all have been paying some of my bills all through October and other dates.
[CUSTOMER][NEGATIVE] But they claimed that that's why these claims have not been processed for October was because y'all are showing that I didn't have insurance at that time.
[AGENT][NEUTRAL] May I have your policy number and I'll pull up your policy?
[CUSTOMER][NEUTRAL] Yes, ma'am. Um, it's 002137700 and it's [PII].
[AGENT][NEUTRAL] And may I
[CUSTOMER][NEUTRAL] My date of birth
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can you verify your mailing address and your email, please?
[CUSTOMER][NEUTRAL] Yeah, the mailing address is [PII] and the email is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Looks like this plan is effective [PII] and it is active.
[AGENT][NEUTRAL] Let's see, not showing any coverage prior to [PII]. And what are the dates?
[CUSTOMER][NEUTRAL] I actually did have coverage, I think prior to that, but I don't know what happened there, but right now I'm just mainly concerned about this year, so.
[AGENT][NEUTRAL] So it looks like we've processed 11-182024. We've processed [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, there's like 4 of them from November that y'all have processed and he claims that they had submitted the other ones from October, but y'all.
[CUSTOMER][NEUTRAL] Supposedly didn't respond back and then they said that when you did that I didn't have coverage prior to [PII], and
[CUSTOMER][NEUTRAL] He said they're resubmitting it again, but if somebody from American Public Life would call them, um, they would go ahead and, and refile with you or something. I don't know if y'all can call them or
[AGENT][NEGATIVE] I don't even see where we received any bills from them in October to deny them.
[CUSTOMER][NEGATIVE] Right. That's what I told him. I looked on the website and I talked to y'all multiple times, and I don't see where they've been submitted either, but they're trying to tell me that they have been trying since December, but they didn't even submit the ones for November until like the end of December, and that was after I called them and kept complaining about them not submitting.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't think they're telling me the truth, honestly, but
[AGENT][NEUTRAL] OK, let me see if I can get this claim image pulled up.
[CUSTOMER][NEUTRAL] They claimed the first time they submitted it, that it was a pharmacy program, and I said, no, it is not a pharmacy program.
[AGENT][NEUTRAL] No, ma'am. It is not.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, let me see I'm gonna place you on a brief hold and see if I can get someone on the line one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling ATI Physical Therapy. Your call may be recorded for quality purposes. If you know your party's extension, you can enter it at any time. For new patients and scheduling, press 1. For payments, billing questions, and medical records, press 2. For a list of departments, press 4. For the company dial. It was billing. I'm not sure.
[AGENT][NEUTRAL] Which one do you choose?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Thank you for calling ATI Physical Therapy. Your call is very important to us. Please note, your call may be monitored for training and quality purposes.
[CUSTOMER][POSITIVE] Thank you for calling ATI Physical Therapy. Your call is very important to us.
[CUSTOMER][NEUTRAL] For Spanish, please press one.
[CUSTOMER][NEUTRAL] For payment, please press 2.
[CUSTOMER][NEUTRAL] For billing please press 3.
[CUSTOMER][NEUTRAL] For attorney please press.
[CUSTOMER][POSITIVE] Thank you for calling HTI Physical Therapy. We are currently experiencing high call volumes. We recommend you call back later in the week when our volumes are lower. Thank you for continuing to hold. Someone will be with you shortly.
[AGENT][POSITIVE] Wow.
[AGENT][NEUTRAL] OK, let's hold for a couple of minutes and see if we get a live person.
[CUSTOMER][POSITIVE] OK, yeah, because it didn't do that. Thank you for continuing to hold. Someone will be with you shortly.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Hi, thank you for choosing ATI Physical Therapy. My name is [PII]. To whom do I have the pleasure of speaking with?
[AGENT][NEUTRAL] Good morning, [PII]. My name is [PII] and I'm with American Public Life. How are you today?
[CUSTOMER][POSITIVE] I'm good, Miss [PII]. Yes, thank you and how are you doing as well, ma'am?
[AGENT][POSITIVE] I am wonderful, thanks for asking. I do have my insured on the line and I am trying to assist her with getting some of her claims filed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me, let me, let me pull up the account first, uh, Ms. [PII], can I ask the patient's name and date of birth?
[AGENT][NEUTRAL] Yes, she's on the line.
[CUSTOMER][NEUTRAL] Ma'am, my name is [PII], [PII]. The date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, let me check this there, Ms. [PII].
[CUSTOMER][NEUTRAL] Give me a second, ma'am.
[CUSTOMER][NEUTRAL] OK, miss, OK, uh, Ms. [PII], uh, let me, ma'am, can I get this your callback number in case this call will be disconnected, uh, we can reach you back.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] [PII]. OK, thank you so much.
[CUSTOMER][POSITIVE] That's so funny.
[CUSTOMER][NEUTRAL] OK, OK, uh, Ms. [PII], uh, because I need to verify your account, ma'am, can you please provide your complete address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] You so much for the verification. Yes, as I've opened here your, your account, so your primary insurance, it's regarding your bill, right?
[CUSTOMER][NEUTRAL] Your primary insurance is mhm.
[CUSTOMER][NEUTRAL] Yes, it's already been filed through Cigna and now it should be going through a um American public life. Um, the problem that I had, I just talked to [PII] that works with [PII] a few minutes ago and billing, and he said when you guys tried to submit more of my bill through American Public Life, it showed that my
[CUSTOMER][NEUTRAL] Insurance through American Public Life was not effective until [PII]. That is not accurate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure, let's let's look here.
[CUSTOMER][NEUTRAL] It's an American.
[CUSTOMER][NEUTRAL] Effective [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] It was 11, effective start.
[CUSTOMER][NEUTRAL] Yes, ma'am. So what is the, what is the correct effective effective date of your uh insurance?
[CUSTOMER][NEUTRAL] [PII], do you have that?
[CUSTOMER][NEUTRAL] Hello. My name.
[CUSTOMER][NEUTRAL] Hello Ms. [PII].
[CUSTOMER][NEUTRAL] Because I.
[CUSTOMER][NEGATIVE] Just nothing.
[CUSTOMER][NEUTRAL] I guess she's not on the line.
[CUSTOMER][NEUTRAL] Ma'am, do you have your card with you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] This is already forwarded actually.
[CUSTOMER][NEUTRAL] And she said that it was effective since [PII], um.
[CUSTOMER][NEUTRAL] And that's why she was calling you guys to verify it. I don't know how we lost her on the line though. Mhm.
[CUSTOMER][NEUTRAL] Mhm, mm, yeah, she I guess she's
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] [PII]. Hello. OK. OK. Hello, [PII].
[AGENT][NEUTRAL] I'm here. Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, OK. Yes, [PII], uh, because what we have here for the effective date of, of Ms. [PII]'s American Public Health insurance is, uh, effective starting date is [PII].
[AGENT][NEUTRAL] No, ma'am. We have her in our system as [PII] and it is active.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, ma'am, uh can I ask please the the member ID so we can have this clarify with our insurance verification team.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, it's 02137700.
[CUSTOMER][NEUTRAL] 7700.
[CUSTOMER][NEUTRAL] Again, the member ID is 2,137,700.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so effective date is here.
[CUSTOMER][NEUTRAL] OK, so what I will be doing this one, ma'am, actually this was already uh forwarded yesterday to our central insurance verification team. Uh, Ms. [PII], uh, did you give the information of the sec of your secondary secondary insurance yesterday?
[CUSTOMER][NEUTRAL] Did I receive something about the insurance yesterday?
[CUSTOMER][NEGATIVE] No, I have not received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what I will be doing this one now, ma'am, uh, I will be sending this back, uh, the this member ID and the effective date. I will be sending this, uh, to our central insurance verification team, and they will gonna investigate this one and they will be up and they will update the information here in your account so it will be processed accordingly as per the date of service.
[CUSTOMER][NEUTRAL] The key of your claims.
[CUSTOMER][NEUTRAL] I just need, uh, can I, can I just get the insurance, uh, phone number, please?
[AGENT][NEUTRAL] Yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, this is what I needed now. OK, um, Ms. [PII], um, Ms. [PII], thank you so much. I guess, uh, I got already the, the information of your secondary insurance American Public Life, right?
[AGENT][NEUTRAL] Yes, that is correct, and we do have claims on file from your office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. So,
[CUSTOMER][NEUTRAL] So it's still uh I just want to confirm um the claims that we have that we had uh.
[CUSTOMER][NEUTRAL] Submitted is starting with uh 10-182024.
[AGENT][NEUTRAL] I'm not showing any 1018.
[CUSTOMER][NEUTRAL] That the date of service?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] ATI you don't have any claims that were submitted for October. The only ones that you guys had submitted was for November and none for October.
[CUSTOMER][NEUTRAL] complete. None for October.
[CUSTOMER][NEUTRAL] There's incomplete secondary build here which I will be.
[CUSTOMER][NEUTRAL] Yes, because it's supposed to be November because that's what we have here with the effective date. So if we will just check. OK, sure, ma'am. What I will be doing this one, on my end, I will be sending this back to our claims department.
[CUSTOMER][NEUTRAL] Uh, how, first thing I will be sending to our insurance verification team to verify and update the effective date here in our system and from that time I will be sending it back to our team's processing. It will take a little bit, um, Ms. [PII], uh, will you allow us more time for this one because this will take a little bit, um, a little bit, uh.
[CUSTOMER][NEGATIVE] A more times needed for the process.
[CUSTOMER][NEUTRAL] Actually for that I just didn't walk for the 48 hours yeah.
[CUSTOMER][NEUTRAL] Yeah, that, that's fine. I just didn't want my bill sent to collections or anything.
[CUSTOMER][NEUTRAL] OK, sure, ma'am. OK, sure ma'am. uh I will uh do the process for this one. OK, for now I will be sending this to our insurance verification team that will take 24 to 48 hours, um, verification time and then they will be sending it to our claims department and depending on the carrier for the secondary insurance, American Public uh life insurance typically the the processing it will take 30 to 45 days so they will, um.
[CUSTOMER][NEUTRAL] They will reprocess the claims for this one. sorry for that actually we will resubmit the claims and the first thing we will resubmit the claims with the correct effective date of your insurance card, OK?
[CUSTOMER][NEUTRAL] Which date of service is within the effective date of your insurance card?
[CUSTOMER][POSITIVE] Correct. OK, OK, ma'am, so allow us more time for for this process.
[CUSTOMER][NEUTRAL] Uh, will you update us after, uh, for 30 to 45 days?
[CUSTOMER][NEUTRAL] Will you call us back after that time? Yes.
[CUSTOMER][POSITIVE] Yes. If it's OK for you. OK, ma'am. OK, ma'am, that's what I will be doing this one now.
[AGENT][NEUTRAL] And can you spell your first name for me, please?
[CUSTOMER][NEUTRAL] Yeah, sure. My name is [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK. And we thank you.
[CUSTOMER][NEUTRAL] Do you want the call reference number?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, sure. OK, the call reference number is 107.
[CUSTOMER][NEUTRAL] 84752.
[AGENT][POSITIVE] [PII], thank you so much. We really appreciate it.
[CUSTOMER][POSITIVE] You're welcome, Ms. [PII], and Ms. [PII], thank you so much also and uh sorry for that inconvenience and yes, ma'am, and
[CUSTOMER][NEUTRAL] Is there anything else I can assist regarding your bill and your insurance uh verification?
[CUSTOMER][POSITIVE] No, ma'am, that took care of it.
[CUSTOMER][POSITIVE] OK, sure then, ma'am. And for future reference, you may visit us on our website. It's [PII]. And thank you for choosing AT therapy and have a great day, um, Ms. [PII] and Ms. [PII].
[AGENT][POSITIVE] [PII], thank you so much. Have a great day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Have a great day ahead. Bye for now.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, ma'am. I think you got it covered. Thank you so much for your help.
[AGENT][POSITIVE] You are so welcome and thank you for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] OK, fine. Thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.