AccountId: 011433970860
ContactId: 5b62b6ba-a425-4e19-902e-6bdfc65835b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 338929 ms
Total Talk Time (AGENT): 111729 ms
Total Talk Time (CUSTOMER): 172038 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/5b62b6ba-a425-4e19-902e-6bdfc65835b8_20250313T19:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Well, Ms. [PII]. This is [PII] in APL, an APL help and customer service. How are you, dear?
[AGENT][POSITIVE] I'm doing good. How about you?
[CUSTOMER][NEUTRAL] I'm fine, thank you, ma'am. [PII], I have policy number 251.
[CUSTOMER][NEUTRAL] I'm a horse, so 8233.
[CUSTOMER][NEUTRAL] I did try to go through to the uh care team first, but everybody's on a call or at lunch.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And is this the provider or the insured?
[CUSTOMER][NEUTRAL] It is the insured [PII].
[CUSTOMER][NEUTRAL] And Ms. [PII] just has a question about a claim um that she had done a biopsy on an outpatient uh basis. I told her about the online service center. She is going to uh get that set up tonight.
[AGENT][NEUTRAL] OK, and did you verify any other information?
[CUSTOMER][NEUTRAL] Yes ma'am, I did, and the number she is sorry about that number she is calling from is uh the same one we have on file but I can still give that to you.
[AGENT][NEUTRAL] OK, it's not showing one in the system.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And C U D A T, you don't see it?
[AGENT][NEUTRAL] No, see, we pull it up on the [PII] screen.
[CUSTOMER][NEUTRAL] Oh, well, let me give that to you, darling, cause I did not know that.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it is 317.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 507.
[CUSTOMER][NEUTRAL] 0918.
[AGENT][POSITIVE] OK, and thank you so much, Ms. [PII] you can go ahead and transfer.
[CUSTOMER][POSITIVE] Thank you, dear. Have a good day.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And same to you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Thank you for calling American Public Life, Ms. [PII]. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I have a question. I had to have a biopsy, a breast biopsy done, and insurance covered, um, a portion of it, but they sent me a bill for 85-19 or something like that. So I'm wanting to find out if my APL coverage will cover any of that.
[AGENT][NEUTRAL] OK. And so the claim hasn't been submitted in over to us as of yet?
[CUSTOMER][NEUTRAL] I, you know, I, I don't know if they submitted it. I, I don't know they, I didn't know anything about it until yesterday when they um sent me a text telling me that I had a balance and so when I called them they said that was the remaining of that biopsy so I want to clarify, you know, if I needed to pay it or if any of it's covered or how it works because I've not used this coverage before so I'm not sure.
[CUSTOMER][NEUTRAL] You know what I need to do.
[AGENT][NEUTRAL] OK. So was this done within an outpatient facility or diagnostic facility?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] It was at Nice Countryside Hospital.
[AGENT][NEUTRAL] And do you know if it was for sickness or injury?
[CUSTOMER][NEUTRAL] No, it wasn't. It was just a, like a, they found this when I had a mammogram, they found a spot and so they did a biopsy of it.
[AGENT][NEUTRAL] OK, so what you can do, you can go ahead and contact that provider and you would give them this information which is your policy number, and if they would like, they can contact us and then they will be able to give us more of a detail of what type of procedure that was rendered and how, you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] How they will submit that bill and then we will be able, once we receive it, we will be able to process that claim if it's payable or not.
[CUSTOMER][POSITIVE] Oh OK, alright, great, I will get in contact with them. I appreciate the information.
[AGENT][NEUTRAL] You're welcome. Just let them know the policy number that you have on that you have on the ID card and it like I said, you can give them the number to contact us and all they will have to submit over is that claim and the primary EOB.
[CUSTOMER][POSITIVE] OK, alright, girl it'll be a wonder.
[CUSTOMER][NEUTRAL] I'm looking to see where that.
[CUSTOMER][NEUTRAL] Will that EOB number, will that be somewhere or will they have that?
[AGENT][NEUTRAL] They should have it, not only when your primary insurance processes the claim and they do submit a payment, then they also submit the EOB that is, is considered an explanation of payment or explanation of benefit, and it'll let them know if any of it was applied towards your deductible co-insurance or co-pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I see OK alright well I appreciate all the information. I will get in contact with them and get them this information then.
[AGENT][NEUTRAL] OK, and is there anything else that I can assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] No, you guys have been wonderful.
[AGENT][POSITIVE] Thank you and I do wanna thank you for calling American Public Life. You have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.