AccountId: 011433970860
ContactId: 5759e117-7b54-4a29-9e6e-36d157f4b3de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 412070 ms
Total Talk Time (AGENT): 196375 ms
Total Talk Time (CUSTOMER): 132580 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/5759e117-7b54-4a29-9e6e-36d157f4b3de_20250509T21:44_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Yeah, I was just talking to somebody phone must have just disconnected because I couldn't hear anymore. But what do you do if I have the EOB, the insurance processed it and all that stuff, but I'm not having any luck getting the itemized bill.
[AGENT][NEUTRAL] Uh, do you have your policy number?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I don't.
[AGENT][NEUTRAL] OK, uh, let me get this pulled up.
[AGENT][NEUTRAL] Uh, what about your social or last name?
[CUSTOMER][NEUTRAL] Uh, social is [PII].
[AGENT][NEUTRAL] And what was your first and last name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEGATIVE] So I was calling out the DME like they issued me a boot and they issued me crutches, but apparently they billed it and I don't know how they build it because now I don't know where to get the itemized bill from. I called the hospital and they told me, you know, it's through equipped for Life, which is a division of them da da da da. So they gave me a number to call, number I called, they don't have anything on it. So I don't know how my insurance pays something without, I, I don't know.
[AGENT][NEUTRAL] Um, have you, you might try, if you're having trouble trying to get the itemized bill, you could try calling your primary insurance.
[AGENT][NEUTRAL] And asking them how did they process a claim because we have to have that itemized or we have to have your primary insurance showing that it processed first.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So, uh,
[CUSTOMER][NEUTRAL] Yeah, and I did, I sent the EOB. I sent the EOB and that is, you know, it shows where they did process it, but like I said, that's, that's all I have.
[AGENT][NEUTRAL] OK, so if you're having an issue getting it from the provider, you could call Blue Cross Blue Shield.
[AGENT][NEUTRAL] And ask them, do they have some type of so can they share with you how they process the claim, you know, the documentation they received because you're having trouble getting it from the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] See if they can give you like the contact information that they received for enable to process the claim and maybe that can get you a better contact person to con uh call and see if you can get an itemization because Blue Cross has to have.
[AGENT][NEUTRAL] Everything that we would need to to process the claim, so they had to have gotten a provider claim with the tax ID, the bill charges, the codes, all of that they had to have that to process the claim. So see if you can get some help from Blue Cross Blue Shield if you're having, if you're running into a wall trying to get something from the provider, see if they could share any information with you so.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, OK, I'll do that. Um, alright, and I think my other claim I submitted is cut and dry, um, cause I had both of those things, but I just didn't have it for this one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you want me to check on another claim for you?
[CUSTOMER][NEUTRAL] Oh, sure, you can check on them.
[AGENT][NEUTRAL] OK. Uh, let me verify, what's your address, [PII]?
[CUSTOMER][NEUTRAL] It's yeah, it's [PII].
[AGENT][NEUTRAL] And then what's your birthday?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] And then lastly your email address?
[CUSTOMER][NEUTRAL] Uh yes, it's [PII].
[AGENT][NEUTRAL] OK, and are you at [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. OK, let's see what else we have.
[AGENT][NEUTRAL] Uh, looks like we've got a claim in processing, um, right now. Uh, looks like they started processing 57, so that's currently in processing. It should should release sometime next week, but it's currently being processed, uh, for 424-25 date of service.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yeah, yeah, that's the one, and then I just submitted one from uh March. You probably don't see that yet.
[AGENT][NEUTRAL] Uh, looks like we, yeah, it looks like we just got something, um, today, so it's being entered into the system, so.
[CUSTOMER][NEUTRAL] I think it was [PII]
[CUSTOMER][NEGATIVE] Yeah, so the problem that I'm running into is when I show people this, this card, they act like they don't know what it is. Are y'all new?
[AGENT][NEUTRAL] No, um, just I, the easiest thing I would tell them, this is a secondary gap policy.
[AGENT][NEUTRAL] So it's your secondary insurance.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And they keep like they keep asking me who is it through and I'm like, I don't know. I guess it's through people.
[AGENT][NEUTRAL] Yeah, it's through American Public Life, so we're the company. Just like there's Blue Cross Blue Shield. We're American Public Life for this policy. Blue Cross Blue Shield does your major medical.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] And it's a supplemental for, for, for just me, right? It's not for my family, right?
[AGENT][POSITIVE] That's correct. Yeah, I just show you on the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And basically, I can, I can file it anytime I go to the doctor as a secondary.
[AGENT][NEUTRAL] Correct, yes, yeah, we just have to have that EOB from Blue Cross Blue Shield and then, you know, something that shows a breakdown of those charges like.
[AGENT][NEUTRAL] You know, the bill amount, what was done, your diagnosis, where the services were rendered, and how much it cost.
[CUSTOMER][NEUTRAL] So, so they will do all of that if
[CUSTOMER][NEUTRAL] Instead of me having to do it.
[AGENT][POSITIVE] Yeah, they will, yes, they will do it um for you, uh, usually cause we will pay them.
[AGENT][NEUTRAL] We either pay you or we pay the provider if they file everything and there's an assignment for you that you said you're saying that they can release payment or we can release payment to them.
[AGENT][POSITIVE] They can file everything and we'll send a check to them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sounds good. Alright, thank you though.
[AGENT][NEUTRAL] OK. Anything else I can help with, [PII]?
[CUSTOMER][POSITIVE] That's it, thank you so much.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a good weekend.
[CUSTOMER][NEUTRAL] You as well bye bye.