AccountId: 011433970860
ContactId: 594d63ea-17d5-4dd3-b3fe-0445ee20dd78
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2082090 ms
Total Talk Time (AGENT): 537273 ms
Total Talk Time (CUSTOMER): 1178632 ms
Interruptions: 7
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/594d63ea-17d5-4dd3-b3fe-0445ee20dd78_20250106T21:22_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm here at Allcare in [PII]. Um, I'm currently seeking to get an annual physical with a specialist that I, through checking my insurance had confirmed was a network, um, but the woman at the counter does not know where she can send my claims to.
[AGENT][POSITIVE] OK, well, I can help you.
[CUSTOMER][NEGATIVE] I've already given her my card. I was on the phone with benefits in the card. They sent me the same thing that she already has. We don't know where to send it.
[AGENT][POSITIVE] OK, I can help you. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] A good contact number is [PII].
[CUSTOMER][NEUTRAL] First and last name is [PII].
[AGENT][NEUTRAL] Thank you. And Mr. [PII], may I have your um policy number?
[CUSTOMER][NEUTRAL] My policy number.
[CUSTOMER][NEUTRAL] And is it D? Is it?
[AGENT][NEUTRAL] On your card
[AGENT][NEUTRAL] On your card, it will say in hospital or out.
[CUSTOMER][NEUTRAL] Does it start with a B?
[AGENT][NEUTRAL] On your card, it will say in hospital or outpatient policy er number. It should start with a 01 or 02.
[CUSTOMER][NEUTRAL] 02563568
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Alright, so I have your policy here and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] 9
[CUSTOMER][NEUTRAL] 989 4
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And so you just need the claim's mailing address?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] What do you mean?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Here she is.
[CUSTOMER][NEUTRAL] Hi, um, I was just calling because I have, I'm doing good. Are you? I've been trying to put in Mr. [PII]'s information in. Um, I have tried American Public Life. I have tried the, um, to make claims just in the back. Then I pop it up and I've tried multi plan, um, so I was trying to see if there's a possibility that you can see if we are in network with you guys.
[AGENT][NEUTRAL] Hi, how are you doing?
[CUSTOMER][NEUTRAL] By our tax ID?
[AGENT][NEUTRAL] So, there's really no outside of the PPO network that he has with multi-plan, there is no network. It's a hospital indemnity policy. Um, now, we don't have access to multiplans list of providers because it's a different company, but I can give you their number if you're wanting to confirm if you're in network or not.
[AGENT][NEUTRAL] But on the back of the ID card, um, the submit claims to attention IMA, that's the claims mailing address I, I'm gonna give you.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, um, and it is just IMA, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and his claim his um.
[AGENT][NEUTRAL] And they have a payer ID.
[CUSTOMER][NEUTRAL] Yeah, his, um, so his member ID number is the 02 number, right?
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] OK, give me one second, let me see.
[AGENT][NEUTRAL] And then there's on the front of the card under the um like the plan name and everything, it says to locate a provider that [PII] number right there. That's the number for multiplan if you want to see if your provider is in network or not. They'll ask you for your MPI number.
[CUSTOMER][NEUTRAL] Got you. OK, every time I call that number it's been an automated system though.
[CUSTOMER][NEGATIVE] And it doesn't give me the option to actually talk to a person.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] OK, so would you like to call together? I mean, there's prompts. I don't know the, I'm not familiar with their system, but when I call, there's prompts and
[AGENT][NEUTRAL] I just picked the prompt for the.
[CUSTOMER][POSITIVE] Yeah, if we could walk through that together to get this start that'd be fantastic thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[CUSTOMER][NEUTRAL] Is it working?
[CUSTOMER][NEUTRAL] It said that [PII] was in that work.
[CUSTOMER][NEGATIVE] That one. You are on hold.
[CUSTOMER][NEUTRAL] For questions about your privacy choices, please view our privacy policy on our website at [PII]enhanced privacy-policy.
[CUSTOMER][NEUTRAL] So I don't understand how I know you are. I appreciate it [PII] privacy Guion policy.
[CUSTOMER][NEUTRAL] Thank you for calling Multiplans. Find a provider service for limited benefit plan members accessing the multi-plan network.
[CUSTOMER][NEUTRAL] Remain on the line to locate or confirm status of a network provider. This information is also available using our website, [PII]. All other inquiries, press [PII].
[CUSTOMER][NEUTRAL] By continuing, you agree that the provider information given out is not a guarantee of benefits coverage. It is your responsibility to contact your health benefit plan to confirm benefits coverage. You must also contact the provider to verify participation in our network at the location you plan to visit and that the provider is accepting new patients. Calls may be recorded for quality assurance.
[CUSTOMER][NEUTRAL] I can help you find a doctor or healthcare facility within your network. To get started, please tell me which of these best describes you a plan member, a healthcare professional, or a plan administrator.
[CUSTOMER][NEUTRAL] Plan member.
[CUSTOMER][NEUTRAL] Tell me what you'd like to do by saying one of these phrases. Find a doctor or find a facility.
[AGENT][NEUTRAL] Find a doctor.
[CUSTOMER][NEUTRAL] Find a, a doctor.
[CUSTOMER][NEUTRAL] You want to find a doctor, is that right? Please say yes or no.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Would you like to find a doctor by name or by specialty?
[AGENT][NEUTRAL] What's the doctor, do you, what's the doctor's name by name?
[CUSTOMER][NEUTRAL] You want to start a new search, is that right? Please say yes or no.
[AGENT][NEUTRAL] Yes, Mr. [PII], what's the name of your doctor?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You want to find a facility, is that right? Please say yes or no.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] My mistake. Tell me what you'd like to do by saying one of these phrases. Find a doctor or.
[AGENT][NEUTRAL] Find a doctor.
[CUSTOMER][NEUTRAL] Tell me what you'd like to
[CUSTOMER][NEUTRAL] Would you like to find a doctor by name or by specialty?
[AGENT][NEUTRAL] By name.
[CUSTOMER][NEUTRAL] All right. Now, please say and spell the doctor's last name. For example, you could say [PII], [PII]
[CUSTOMER][NEUTRAL] Sorry, I didn't hear you. What's the doctor's last name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] That was
[CUSTOMER][NEUTRAL] Can
[CUSTOMER][NEUTRAL] Spelled [PII] Is that right? Please say yes or no.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] My mistake.
[CUSTOMER][NEUTRAL] All right, now please say and spell the doctor's last name. For example, you could say [PII], [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] All right, now please say and spell the doctor's last name. For example, you could say [PII], S.
[AGENT][NEGATIVE] OK, we're not gonna do this. What's the doctor's NPI number?
[CUSTOMER][NEUTRAL] What's the doctor's MPI number?
[AGENT][NEGATIVE] Cause I don't want you to have to keep going through that. That's frustrating.
[CUSTOMER][NEUTRAL] It was the worst thing I've ever had to experience. I'm so glad that you were here on the phone to witness it with me.
[AGENT][NEUTRAL] Yeah, I guess it's because it's a member line. Usually when you put a healthcare provider, they come right on the line, but I can search it on their website with the MPI or um I could do the name too if you like.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] Can you spell that one more time for me? I was trying not to get you. OK.
[CUSTOMER][NEUTRAL] So the MCI number.
[CUSTOMER][NEUTRAL] Uh, the MPI number is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK, so I'm not showing that provider um like on their list of providers.
[CUSTOMER][NEUTRAL] OK, great. I'm glad that we have that resolution. I'm pissed as fuck because she was on the website. She was literally listed on the website and I wanted to confirm, but I wasn't able to confirm. No, you don't need to. It's fine. I just need to figure out how I can find an actual provider to get me in office so that I can get these appointments because I am sick of having to use the phone line.
[AGENT][NEUTRAL] OK, well, let's try her name.
[CUSTOMER][NEGATIVE] I'm like, no, this frustration isn't for you, but you're the first human that I've talked to over the phone in regards to my insurance since I got my insurance in October.
[AGENT][NEUTRAL] OK, so if you, if the MPI is not working, I can try the name, um, or if you want to, that's the only two options that we have the website or the phone number, unfortunately.
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] The only difference that we do is that we use a provider.
[CUSTOMER][NEUTRAL] So is there a way?
[AGENT][NEUTRAL] So I don't know
[CUSTOMER][NEUTRAL] OK. I, I don't, I don't see the utility of using the MPI number because my girl here cannot find a way to verify me in her system, and you cannot verify the provider that I thought I was going to see in your system. We know that I can't be taken here. So I need to figure out who can take me and when.
[AGENT][NEUTRAL] OK, so either you can go to the website and put in your zip code and look for a list of providers or we can call.
[CUSTOMER][NEGATIVE] The same thing that I did last time that got me in this situation, we're not doing that.
[AGENT][NEUTRAL] So I'm not trying to frustrate you more. I'm trying to help you find an option. I only have 2. I can't go outside of what I have. So, I can help you on the website or I can call again on the phone, but I
[CUSTOMER][NEUTRAL] Can you please assist me with finding another way?
[AGENT][NEUTRAL] I can't do any. I'm sorry?
[CUSTOMER][NEUTRAL] Let's call again.
[CUSTOMER][NEUTRAL] Let's call again.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] OK, [PII], he's rude and you're gonna have to get it together.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] To get your foot in, get your mind right and help them.
[CUSTOMER][NEUTRAL] For Questions about your privacy choices, please view our privacy policy on our website at [PII]enhanced privacy-policy.
[CUSTOMER][NEUTRAL] Cit preunta soresus privaciata nuestra politica deprivaciatenestrositio we in [PII] privacy [PII] policy.
[AGENT][NEUTRAL] stay out.
[CUSTOMER][NEUTRAL] Thank you for calling Multiplans. Find a provider service for limited benefit plan members accessing the multi-plan network.
[CUSTOMER][NEUTRAL] On the line to locate or confirm status of a network provider. This information is also available using our website [PII]. All other inquiries, press [PII].
[CUSTOMER][NEUTRAL] By continuing, you agree that the provider information given out. Please note, multi-plan representatives do not have information on benefits, eligibility, pre-certification, prescriptions, or claim payment status. You'll need to contact the insurance company or health plan administrator directly for these topics. Their phone number.
[AGENT][NEUTRAL] Just give it to a person.
[CUSTOMER][NEUTRAL] Please note, multi-plan representatives do not have information on benefits, eligibility, free certification, prescriptions, or claim payment status. You'll need to contact the insurance company or health plan administrator directly for these topics. Their phone number should be located on the member's ID card. Our representatives do not have this number. To hear that messaging.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Please note, multi-plan representatives do not have information on benefits, eligibility, free certification, prescriptions, or claim payment status. You'll need to contact the insurance company or health plan administrator directly for these topics. Their phone number should be located on the member's ID card.
[CUSTOMER][NEUTRAL] Our representatives do not have this number. To hear that message again, say repeat. To look for a doctor or healthcare facility, say start a new search. If you're all finished, you can say goodbye or just hang up.
[CUSTOMER][NEUTRAL] Multi-plan representatives are not able to answer questions regarding benefits, eligibility, claims information, pre-authorization of care, or assist in finding a dentist or pharmacy. You'll need to contact the insurance company or health plan administrator directly. Their phone number should be located on the ID card, or you can contact your human resources representative. Multi-plan representatives do not have this number. The
[CUSTOMER][NEUTRAL] Questions about your privacy choices, please view our privacy policy on our website at [PII].
[CUSTOMER][NEUTRAL] Cit preunta soreses deprivaidada nuestra politica deprivaciat enuestrositio we in [PII] enhanced guilon privacy Guion policy.
[CUSTOMER][NEUTRAL] Thank you for calling Multiplans. Find a provider service for limited benefit plan members accessing the multi-plan network.
[CUSTOMER][NEUTRAL] Remain on the line to locate or confirm status of a network provider. This information is also available using our website, [PII]. All other inquiries, press 4. By continuing, you agree that the provider information given out is not a guarantee of benefits coverage. It is your I can help you find a doctor or healthcare facility within your network to get started, please tell me.
[CUSTOMER][NEUTRAL] We are having difficulty completing your request. Let's try again. Please repeat your information. Let's try again. Tell me which category you are in by saying one of these phrases plan member, healthcare professional, or plan administrator.
[AGENT][NEUTRAL] Healthcare professional.
[CUSTOMER][NEUTRAL] To verify your network participation status or look for a doctor or healthcare facility, say, start a new search. The multi-plan number you originally dialed today is for help in finding a doctor or other type of provider. Multiplan is not a health plan or insurer, and we do not pay claims or provide benefits and eligibility information. You should only call Multiplan for assistance in finding a PHCS or multi-plan network provider for benefits, eligibility, claims information, pre.
[AGENT][NEUTRAL] Oh my God.
[CUSTOMER][NEUTRAL] You want to end the call, is that right? Please say yes or no.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] My mistake. To verify your network participation status or look for a doctor or healthcare facility, say, start a new search. The multi-plan number.
[AGENT][NEUTRAL] Start a new search.
[CUSTOMER][NEUTRAL] You want to start a new search, is that right? Please say yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Tell me what you'd like to do by saying one of these phrases. Would you like to check the participation status of a doctor or for a facility?
[AGENT][NEUTRAL] Doctor
[CUSTOMER][NEUTRAL] Would you like to find a doctor by name, by tax ID number, or by specialty?
[CUSTOMER][NEUTRAL] We are having difficulty completing your request. Let's try again. Please repeat your information. Would you like to find a doctor by name, by tax ID number, or by specialty?
[AGENT][NEUTRAL] Tax ID number.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] What is
[CUSTOMER][NEUTRAL] Did you say you don't know.
[AGENT][NEUTRAL] Thank you for holding. What's the tax ID number?
[CUSTOMER][NEUTRAL] Tell me
[CUSTOMER][NEGATIVE] We are having difficulty.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You'd like to
[CUSTOMER][NEGATIVE] We are having difficulty.
[AGENT][NEUTRAL] OK, um, do you have the number to your doctor's office?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK, I can give them a call.
[CUSTOMER][NEUTRAL] And just, you know, they're not my doctor.
[CUSTOMER][NEUTRAL] Um, they were just, it was just a business that I was trying to get seen at.
[AGENT][NEUTRAL] OK, well, I need their tax ID to uh
[CUSTOMER][NEUTRAL] You know, it was my first time. I would have been a new patient.
[AGENT][POSITIVE] I understand and I understand your frustration. I'm just trying to get a solution for you because I don't want you to have to keep going through this.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Well, I appreciate that and I'm glad that that hold was so long. I have calmed down. I think so I don't know if trying to go to her would be the best solution. I wanted to know if you could assist me with finding someone that was in network that was confirmed in network because the issue that I ran into prior was the automated system that you experienced prior and then also trying to go online to find my own PCP.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You know it was pulling teeth and that's where I found [PII]. That's where I found Doctor [PII]. I found her going online through that through their portal through my insurance, you know, not APL, of course, but the other one through that portal. That's where I found her. So I don't have a lot of confidence in that. I don't have a lot of confidence in the in the over the phone system. I would like to talk to a human with a human.
[CUSTOMER][NEUTRAL] Would you be able to assist me in talking to somebody with.
[CUSTOMER][NEUTRAL] Talking to someone that could help me find a PCP.
[AGENT][NEUTRAL] So
[CUSTOMER][NEGATIVE] Like I don't think [PII]'s gonna work out.
[AGENT][NEUTRAL] OK, so let me do, because it looks like from calling multiplan today and this is since the [PII], it looks like they've changed their options because I've always been able to speak to somebody. So I'm sorry that you're having that trouble, but I'm going, I'm on the website now, I'm putting in your um your social. I put in your zip code and primary care and uh there's quite a few. I can email you the results if you'd like.
[AGENT][NEUTRAL] It's, it's over 1000 for your zip code.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] When I typed in.
[CUSTOMER][NEUTRAL] What's your name?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] I just really appreciate it. [PII], OK, I'm sorry, I just really appreciate.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Are you really trying to help me. I really appreciate it. Oh.
[CUSTOMER][NEUTRAL] Um, [PII], Ms. [PII], I
[CUSTOMER][NEGATIVE] I'm just really concerned about running into the same issue, cause like if it's 1000 results, [PII] was one of those 1000 results. I am deeply frightened of running into that issue again, um, and I know that you can't guarantee it, but, um, just tell me over the phone, confirm real quick whether or not you can help me connect with another human with this met plan that can figure out how to get me.
[CUSTOMER][NEUTRAL] Like a verified in-network PCP can you do that?
[AGENT][NEUTRAL] I mean, I can try. So what the, the only issue with the other provider, so hospital indemnity is a limited medical policy. I don't know what she was putting in her system, but I could have verified the benefits over the phone with her and let her know that you have, that you have coverage. I mean, I don't really
[AGENT][NEGATIVE] I don't really understand what the hold up.
[CUSTOMER][NEUTRAL] Yeah, no, it wasn't, that's not, that's not what the issue was.
[CUSTOMER][NEUTRAL] So the hold up was is that [PII] is an MD. So I guess from what the woman that we were working with was telling me is that because [PII] is an MD, she can work, she can take a myriad of plans, but the offices out of which she works are still gonna be limited. So [PII] was
[AGENT][NEUTRAL] OK, now that makes sense.
[CUSTOMER][NEUTRAL] That's what it was. And so the system, like Metan's system recognizes [PII] as being able to take me, but [PII] cannot take me because of all the places that she works. They cannot take me.
[CUSTOMER][NEUTRAL] So I'm struggling with finding a doctor that has great reviews that could get me in soon, that would be really great for me personally that I can have as a PCP. I don't even know how to type in to get PCP like a PCP list like is that family practice? Is that what that code is?
[AGENT][NEUTRAL] So instead of putting PCP
[CUSTOMER][NEUTRAL] Cause like I tried to type in PCP.
[AGENT][NEUTRAL] So instead of putting PCP because that just means primary care physician, just put primary care.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You see what I'm saying?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, because that's what, and I'm only saying that because that's what I did on this search right here. I just put primary care, your zip code, and that your mail, you know, try to make it specific. I put 20 miles out.
[CUSTOMER][NEUTRAL] OK. Yes, ma'am, and so.
[CUSTOMER][NEUTRAL] I believe that.
[AGENT][NEUTRAL] And then um it just popped up here. Now, anything, anybody that's on this list, if they are seen at multiple locations, you, you still might run into that same issue, but the thing is, it's under, that's what I don't, it's under the doctor's MPI not where the place of services, so why would that, so it sounds like she just wasn't sure what to do.
[AGENT][NEUTRAL] Because the doctor's NPI is the same no matter where they go and that's what's in network, their ID number.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, but, but I think the issue and what we discovered is that her MPI was not showing up in your system, or like vice versa. Like, no, no, her MPI was not showing up in your system, which means that Net plan needs to update their registry because she is no longer a a a registry, I don't know what it is, but she's no longer associated with that plan.
[AGENT][NEUTRAL] The registry.
[AGENT][POSITIVE] Yeah, that's right.
[CUSTOMER][NEGATIVE] Yeah, she's no longer associated so my worry at this point is that I'm going to get my hopes up, make an appointment, wait all this time, you know, hold so many things up and then walk into the office and they're not gonna be able to take me and the issue with this woman today is not only the MPI, but it's also that she could not her system could not register where to send the claim to.
[AGENT][NEUTRAL] Well, that's their
[CUSTOMER][NEUTRAL] So that was like the big thing that kind of started the tub up it's like.
[CUSTOMER][NEUTRAL] Yeah, so it's just like those two things.
[AGENT][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] But OK, um, uh, Miss [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You can send me the list and I will look over it again when I get home and I will go back to the drawing board.
[AGENT][NEUTRAL] But let me tell you this.
[CUSTOMER][NEUTRAL] Um, you haven't, yeah, I'll do that. I'll just do that.
[AGENT][NEUTRAL] OK, and let me tell you, so anytime, any provider, you can give them your policy, you don't even have to make the appointment, you can call them and give them, give them your policy number and give them our phone number for them to call us, so you don't have to do all this. Let them do it. Call, have them call us and verify the benefits.
[AGENT][NEUTRAL] Because to be honest, your hospital indemnity benefits, whether it's multi-plan or not, your benefits are the same. So, multi-plan is just like an additional to it, it doesn't change your benefits. So,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Whoever you choose, and we tell the providers this all the time, have them call us to verify the benefits, we go over the claims, all that stuff, so that we can help them, um.
[AGENT][NEUTRAL] Because it's, it's not like if it was Aetna or Blue Cross Blue Shield or something, they would know what to do. This is a second day or, you know, like a supplemental or secondary insurance. It's not a major insurance, so that's what's making everybody, you know, I don't know what this is, but they just need to call us and be educated on it and we'll tell them how to file the claim. Even if they didn't find it in their system, they still had a way to manually put in our our information to file the claim or even the payer ID.
[CUSTOMER][POSITIVE] For sure.
[CUSTOMER][NEUTRAL] OK, that's good to know. I think it's a little late for me to turn around, but I'll keep that in mind for next time.
[AGENT][POSITIVE] Yes, and I'm the only [PII] here. So if you ever need help, just give us a call. If you get somebody else, they'll be able to help you too, but it's not hard to get to me because I'm the only one.
[CUSTOMER][NEUTRAL] So it's [PII] at american Public Life.
[AGENT][NEUTRAL] Mhm. That's me.
[CUSTOMER][NEUTRAL] OK. All right, Ms. [PII], you'll be hearing from me again.
[AGENT][NEUTRAL] All right, well, I'm going to put some thorough notes on your policy. So if I'm not here, something whoever comes behind me will know what's going on, so you don't have to explain everything and then I'm gonna email you this list and we can just go from there. But keep in mind, it's just for the PPO part of it. You could still be, you don't even have to really mention that if you don't want to and still be seen. And once we get the claim, we'll handle it.
[CUSTOMER][NEUTRAL] But um
[CUSTOMER][POSITIVE] That's good to know. I'm almost tempted to turn around, but no, it's fine. OK, that's good to know. I will do my best to.
[CUSTOMER][POSITIVE] Find another person in this new network that you're gonna send me and go from there. Thank you so much and thank you for your time and your patience and your kindness and your thoroughness.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Well, you're very welcome. I know it's frustrating, especially when you're trying to be seen, so I, I mean, I completely understand. I'm a patient too, so I definitely get it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But this whole list that I'm sending you is just family practice, so you and I put it for mail, so um you should be whatever you choose from here, from what it's saying on their website, these are all in network for you, but if you need us, just let us know.
[CUSTOMER][POSITIVE] No, I feel that for sure. I appreciate you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, and so family practice or primary care, which one do I put again?
[AGENT][NEUTRAL] It's all the same family practice, primary care is just different terms for the same thing. Your primary care physician. Some, some just put family because they take children too.
[CUSTOMER][NEUTRAL] Understood.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Understood OK.
[AGENT][POSITIVE] All right, well, I'm sending this over to you now. You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Well thank you so much that definitely helps.
[CUSTOMER][NEUTRAL] Uh, is there a survey? Do I have to wait for the survey, or do I just hang up?
[AGENT][NEUTRAL] For me, oh, there's no survey, but if you want to talk to my supervisor, you can.
[CUSTOMER][NEUTRAL] Yeah, I'll talk to your supervisor.
[AGENT][NEUTRAL] OK. Well, hold on one moment. I'll get her for you and again.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Huh, I'm sorry?
[AGENT][NEUTRAL] I didn't hear you.
[CUSTOMER][NEUTRAL] I her on over.
[AGENT][POSITIVE] Oh, right. Well, thanks for calling ATF.
[CUSTOMER][NEUTRAL] Oh, I said, I said something stupid and funny.
[AGENT][NEUTRAL] Well, I hope you have a [PII] and don't let this stuff frustrate you. We're gonna get to the bottom of it.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you I appreciate it.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Calling ATL. This is [PII]. How may I help you?
[AGENT][POSITIVE] Hey [PII], should I introduce y'all? I'm gonna introduce y'all.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] Alright, hold on.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you so much for holding. I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Oh, this is [PII]. How may I help you?
[CUSTOMER][POSITIVE] I, uh, I wanted to, um, I just got off the phone with [PII]. She was exceptional, um, and she said that in lieu of a survey which I have come to expect, um, I could speak with her supervisor, so she passed me over to you. Um, [PII] was really great at handling me. Um, I like to think that when I get on the phone with someone, I'm kind, I like to be straight to the point.
[CUSTOMER][NEGATIVE] Today my situation was I'm not a provider, they don't see my insurance, they can't find my insurance. I talked to two other people.
[CUSTOMER][NEGATIVE] Those people patched me over to [PII] at the very end of it, and [PII] was able to determine that this person, that the provider was not able to take me and I got very upset by that. I've been on the phone at that point for 30 minutes, literally playing telephone with the provider agent in the office and over the phone. When I got to [PII], I was very upset. We had already gotten the confirmation I couldn't be seen and she was really good at not only.
[CUSTOMER][NEGATIVE] Aligning with how frustrated I was.
[CUSTOMER][POSITIVE] But also really proactive about getting me to a solution.
[CUSTOMER][MIXED] So like, there were times where I got vertical just cause I didn't feel like I was being heard, but she did very well, um.
[CUSTOMER][POSITIVE] And she was very determined.
[CUSTOMER][NEGATIVE] To get me to a solution where I could have been seen today, um, I don't think that would have been possible.
[CUSTOMER][POSITIVE] Um, but even still like she heard me out, she heard what I wanted to do.
[CUSTOMER][POSITIVE] Um, she listened very well and provided me with, you know, the solutions that she could.
[CUSTOMER][POSITIVE] And she was very patient.
[CUSTOMER][POSITIVE] And I really appreciate that because it is not easy being a woman over the phone.
[CUSTOMER][POSITIVE] Well, thank you so much for taking the time to give [PII] these kudos. You know, we pride ourselves in our customer service here at APL and when we have just exceptional customers like you that take the time out to actually recognize our colleagues, that just, just brightens our whole day. So I thank you so much for for taking this time.
[CUSTOMER][POSITIVE] Yeah for sure yeah thank you for your time I appreciate it. You're welcome. I hope you have a great day and thanks again so much and I'll make sure to pass this along to.