AccountId: 011433970860
ContactId: 4c3a5f06-83c3-49da-8826-45cee6312106
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 714020 ms
Total Talk Time (AGENT): 195401 ms
Total Talk Time (CUSTOMER): 285573 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/4c3a5f06-83c3-49da-8826-45cee6312106_20250620T17:12_UTC.wav
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[AGENT][POSITIVE] Thank you for calling. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, my name is [PII]. I'm a member of APL.
[CUSTOMER][NEGATIVE] And I need your help. I am totally stressed. You have no idea.
[CUSTOMER][NEUTRAL] And I hope you can help me. Um, I have a um.
[AGENT][NEUTRAL] OK. How can I help you?
[CUSTOMER][NEUTRAL] I guess you need my member number right? to pull up my account.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] For your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, uh.
[CUSTOMER][NEUTRAL] Is that the payer ID number, is that it?
[AGENT][NEUTRAL] No, it might say uh benefit number or policy certificate number, inpatient or outpatient certificate number.
[CUSTOMER][NEUTRAL] Hold on a second
[CUSTOMER][NEUTRAL] Yeah, I have that. Patient or outpatient.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, yeah. Uh 186.
[CUSTOMER][NEUTRAL] 7004 NL 7. Could you just hold one second for me, please?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] I'm still here.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Can I get you to verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] And the address that we have on file for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and how can I help you?
[CUSTOMER][NEUTRAL] OK. I, I'm on a
[CUSTOMER][NEUTRAL] Uh, special equipment. I have, um, sleep apnea.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] I, there have been some confusion with A Healthcare and my insurance and whatever, so I, I, I need some help. So I wanted to find out is that the insurance that I have with you guys, do you guys have any coverage when the, when the first time I pay for it, does my secondary hear that you guys will cover that portion?
[AGENT][NEUTRAL] OK, and let me pull up your policy, but I can say um while I'm looking for that, uh, your primary has to uh provide.
[AGENT][NEUTRAL] At least partial payments first. If your primary insurance denies the claim, then this insurance won't pick up. It only picks up after the primary insurance is paid um on the initial claim, but let me see.
[CUSTOMER][NEUTRAL] So, well, what they're saying that I guess I don't meet my deductible, which I was not aware of that because if I knew that was the point when my doctor write a prescription for the CPAP the machine, I would have told them that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] That uh I did not meet my deductible. I can't afford it. Now, they send me the equipment, and now they're billing me and then when I talked to the insurance, know, first they were telling me I was 100% covered.
[CUSTOMER][NEUTRAL] But you know, when you talk to people on the phone, you talk to several different representatives, and everybody has something totally different to say.
[CUSTOMER][NEGATIVE] So now they're saying now that I owe them 800 and something dollars after Healthcare because the insurance is saying that I don't need the deductible. If I knew that I would not.
[CUSTOMER][NEGATIVE] Have them send me the machine because now I need supplies. I can't get supplies. I need to get supplies every 3 months.
[CUSTOMER][NEGATIVE] So I'm just, I'm just tired just.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So this insurance, so.
[CUSTOMER][NEGATIVE] I am stressed. My blood pressure.
[AGENT][NEUTRAL] If you're um.
[AGENT][NEUTRAL] If your primary insurance helps cover partial, um, this insurance will help pick up that deductible, um, so this insurance does help with co-pay, co-insurance, and co-deductible, um, and this is just a verification of benefits and not a guarantee of payment. You do have.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] I don't understand I.
[AGENT][NEUTRAL] That
[CUSTOMER][NEUTRAL] Did they bill you guys just out of curiosity after healthcare? Did they send you guys a bill because they, they should have have you guys on my, they should have had this insurance too. I when I use my insurance, I usually give them two. I usually give them UMR, United Healthcare, and APL. Did you see that they submit any bill to you guys?
[AGENT][NEUTRAL] Uh, do you know when the date of service was?
[CUSTOMER][NEUTRAL] They said uh it was November, December, January and Feb. I think they were just submitting the same bill over and over.
[AGENT][NEUTRAL] OK. When
[CUSTOMER][NEUTRAL] The name of the company is A Healthcare, A P R I A.
[AGENT][NEUTRAL] A PRIA. Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Do you know when the initial date of service was for you when you went into your provider?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, I didn't go in. The doctor wrote a prescription, I say November of last year, October, November last year.
[AGENT][NEUTRAL] OK. Give me just a moment.
[CUSTOMER][NEUTRAL] And then I get
[CUSTOMER][NEUTRAL] Yeah, according to this one, I'm so I'm just tired. I've been on the phone from [PII] this morning trying to sort this thing out.
[AGENT][NEUTRAL] Yeah, I'm not showing anything from them. Um, it's, it's gonna be hard to find the exact one without the date of service. Um, so you can either have your doctor call, give us a call back or if you can get the date, um, the date of service for when he saw you and wrote that prescription, um.
[CUSTOMER][NEUTRAL] Or how
[AGENT][NEUTRAL] But I'm not seeing any, any claim for that, but again I'm I'm, I'm limited in what I can look for.
[CUSTOMER][NEUTRAL] So you don't think
[CUSTOMER][NEUTRAL] You, you don't send a thing for AA Healthcare.
[AGENT][NEUTRAL] I, I don't, but since I don't have the, the data service, all I can really do is go in one by one and all of your claims and try and find it, um, and I looked around, um, October, November and December and I couldn't see it, um, so I would have your doctor call us because they will have that date of service.
[CUSTOMER][NEUTRAL] Doctor call you or or have A Healthcare.
[CUSTOMER][NEUTRAL] Do I need to make up healthcare send the send the bill to you guys then?
[AGENT][NEUTRAL] Is that your primary insurance or is that who you went through?
[CUSTOMER][NEUTRAL] No, hold on, my primary is United Healthcare. AA Healthcare is the one who supply me with the equipment.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, yeah, I would have them uh give us a call.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because they they might have the details that we need to look for that claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I need to call AA Healthcare and tell them to call American Public Life.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Or have them send the information to you guys.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Do you want me to give you their number?
[AGENT][NEUTRAL] Um, I would have them call us back.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, and then we can, we can see what we can do from there.
[CUSTOMER][NEUTRAL] OK, so let me call them and tell them to um.
[CUSTOMER][NEUTRAL] Call you guys.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] That way we can see if there's a claim on file right.
[CUSTOMER][NEUTRAL] Whatever, send the information.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, and is there anything else I can help you with until then?
[CUSTOMER][NEGATIVE] No, I just have to call and I can't, so I'm tired.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well I will, I will put in your notes that we should be expecting a call from them.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So if there's nothing else, we will be waiting for.
[CUSTOMER][NEUTRAL] The name is A A P R A P R I A Apria Healthcare, so sleep apnea machine.
[AGENT][NEUTRAL] OK, I will have them, or I will put that in your notes and we'll be waiting for their call, OK?
[CUSTOMER][NEUTRAL] OK, and what's your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], you said?
[AGENT][NEUTRAL] Yes, sir, but they should be able to speak to any one of us, um, if I'm not available.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][POSITIVE] All right. Thank you.