AccountId: 011433970860
ContactId: 7dbc3778-9715-4482-a5b1-4af707ad3c55
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1849660 ms
Total Talk Time (AGENT): 376746 ms
Total Talk Time (CUSTOMER): 489974 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/7dbc3778-9715-4482-a5b1-4af707ad3c55_20250317T18:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I received some uh uh.
[CUSTOMER][NEUTRAL] Uh, a letter from you guys. I'm trying to process a claim and it says in order to process my claim you need itemized statements of services provided listing the diagnosis codes and then uh benefits payable under the certified certificate uh are limited blah blah blah blah well anyways I uh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I got the form
[CUSTOMER][NEUTRAL] And I filled that all out and I sent it to a line of health.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And then the line of health says we apologize, but we cannot process your request for medical records for the following reasons um request indicates it expired [PII] records from that section need clarification which a line of facility our our records are.
[CUSTOMER][NEGATIVE] are being requested from, why are there, why are there two facility names, American Public Life and such and such. My, I don't know, American Public Life, but they have my electric company on there, which they shouldn't. So that's something that have anything to do with you. And it says, please submit a new request form.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh I help, so I, I filled out the, the form and let's see here.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] And they sent me another one to fill out and obviously I'm doing something wrong. What I'm trying to figure out is why can't I have one of your agents just talk to their agent and you guys instead of me being the middle man and trying to get the right stuff because I'm just trying to get them paid.
[CUSTOMER][NEUTRAL] You know, and uh.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's, it's, it's getting to be, it's, it's been set, set, uh, since.
[CUSTOMER][NEUTRAL] I don't know. It has to be since last November that I've been going back and forth with the both of you guys. It's like I'm the um tennis ball just going back and forth between you two that once this paperwork what I is there any way that you can talk directly to them um and their billing or how you know.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Yeah, let me pull your policy up. Do you have your policy number or the claim number there so I can just look at your.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, let's see here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII], I miss it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I I got the order. Hold on a second.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] That's the paperwork from me. It doesn't have the claim number on here. We received your claim and policy, reviewed the the claim that started in some cases, the claims department.
[CUSTOMER][NEUTRAL] Um, can you look up my name or something? I can't find my claim number.
[AGENT][NEUTRAL] Yeah, let me look it up by name. What's your last name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then first name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], here I found it now, claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 355.
[CUSTOMER][NEUTRAL] 645 9
[AGENT][NEUTRAL] And that's the claim number, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] All right, I've got the policy pulled up here. Can you just verify your date of birth for me and address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, address is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let me see.
[AGENT][NEUTRAL] If the examiner themselves can reach out to the facility, um.
[CUSTOMER][NEUTRAL] And I have a and I have the the lady's name and number.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] What is her name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] OK, and then what's her number?
[CUSTOMER][NEUTRAL] Her number is 612.
[CUSTOMER][NEUTRAL] 262.
[CUSTOMER][NEUTRAL] 2300.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or or faxes in case you guys need this is 612.
[CUSTOMER][NEUTRAL] 262.
[CUSTOMER][NEUTRAL] 2323.
[CUSTOMER][NEGATIVE] What's so frustrating is I'm dealing with a line of health and
[CUSTOMER][NEGATIVE] I'm dealing with [PII], but then they don't talk to.
[CUSTOMER][NEGATIVE] Their their claim department and I've, I've been trying to tell their claim department that I'm trying to get the claim processed but a line of health is holding me up, you know, and so in the meantime I'm getting bills from bills from them because their left hand is not talking to the right hand, you know what I mean.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Mhm, yeah, that's frustrating. Yeah, because most of the time, um, in these situations, like, you know, I'll advise like uh an insured, you know, hey, just contact the provider. They should know exactly what you're talking about as far as like an itemized statement with the diagnosis codes, and they should be able to email it to you, no problem, you know.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, and I don't, I don't know what uh diagnosis codes are and you know, none of that stuff, and I'm, I'm just the I'm just been the messenger, you know.
[AGENT][NEUTRAL] Yeah, no, I mean, the provider shouldn't give you any sort of slack on that. It should be something they're pretty familiar with as far as like dealing with insurance, you know. Um, so, OK, let me see what we can get done on this. Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] So I just
[CUSTOMER][NEUTRAL] Right, yeah.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, thank you so much. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for calling Elia Health release of information department. In order to direct your call appropriately, please choose one of the following options. If you need information on where to find a request to release records or where to fax requests, please press 1. If you have other questions, please press 0 and a representative will be with you.
[AGENT][NEUTRAL] Thank you for your patience. Um, I'm gonna call [PII]. I may need to, uh, three way you in just for verification, uh, since it is your policy. So let's call over there and just see what we can get figured out how we can get this uh resolved, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Yeah, you're welcome. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Thank you for calling Eina Health release of information department. In order to direct your call appropriately, please choose one of the following options. If you need information on where to find a request to release records or where to fax requests, please press [PII]. If you have other questions, please press 0 and a representative will be with you as soon as possible.
[CUSTOMER][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] With the line and release of information, how can I help you?
[AGENT][NEUTRAL] Hi, my name is [PII] and I'm calling from American Public Life Insurance. I'm trying to reach [PII] if she is available.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] She is currently away from at the moment.
[AGENT][NEUTRAL] All right. Do you know if there's a better time to reach her maybe during the day?
[CUSTOMER][NEUTRAL] Uh not too sure.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Would she like leave you a voicemail?
[AGENT][NEUTRAL] So we have like a mutual client. Um, I have the insured on the other line. They've been trying to get um an itemized bill for some um procedures that they had done. So we had denied the claim and um they were saying they were having a hard time getting it and this was their point of contact with [PII], so I was just trying to three-way call and see if I could help them out.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] What is the patient's last name?
[AGENT][NEUTRAL] Uh, their last name is [PII]. So it's [PII]
[CUSTOMER][NEUTRAL] First name?
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] What's the date?
[AGENT][NEUTRAL] Uh, date of birth is [PII].
[CUSTOMER][NEUTRAL] So it looks like he's request to send records and she sent back.
[CUSTOMER][NEGATIVE] So it was expired.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So she state she let him know that we needed a new request.
[CUSTOMER][NEUTRAL] That lets us know what a line of location and what.
[CUSTOMER][POSITIVE] And exactly what we are needing.
[CUSTOMER][NEUTRAL] Exactly where we are sending the records to.
[AGENT][NEUTRAL] So you guys need a new request sent?
[CUSTOMER][POSITIVE] Correct, yup.
[AGENT][NEUTRAL] With where to send it.
[AGENT][NEUTRAL] And what is being requested?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. So the request you had expired. When did the request expire? Do you have that?
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, that is helpful. I will, and what is the, um,
[AGENT][NEUTRAL] Fax so we can send it. Do you guys accept the request via fax or?
[CUSTOMER][NEUTRAL] Mhm. Yup. The fax number is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thank you so much. I appreciate it.
[CUSTOMER][POSITIVE] You're very welcome, yeah you have a great day.
[AGENT][NEUTRAL] All right, bye bye. Uh huh bye bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Yeah, you need to wait for me to finish this call.
[AGENT][NEUTRAL] No, from claims it seems like.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you for patiently waiting, [PII]. I spoke to Elana Medical.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so I figured out exactly kind of what they're needing and so I'm reaching out to my claims department to see how we can get that sent over to them.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEGATIVE] They basically are just saying that they need a new request from us that the request expired.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, well, do you guys need me to do that, or, or can you guys work it out between you two?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, I
[AGENT][NEUTRAL] I'm yeah I'm looking to see if there's a way that we can send a new request, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So hang with me just a moment because I'm not sure.
[CUSTOMER][POSITIVE] Mm, OK. Hey, you're doing me a favor. I'll hang with you as long as I have to.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I'm gonna place you on just another brief hold. I'll be right back.
[CUSTOMER][POSITIVE] Not a problem.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Alright, [PII], thank you so much for your patience. So I'm gonna need to call them back and speak to them again because the the release of information should be good for a year and I don't know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, I don't know what they're, you know, I know you sent over the release of information, but even that that states right on there authorization will expire 224 months from the date this is signed. Will you sign this on one you signed this on [PII], you know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, I don't know what.
[CUSTOMER][NEGATIVE] Yeah, so they must have made a mistake on an error on their part then.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So that doesn't make any sense to me. So let me call back over there and see what we can do. um, [PII] wasn't there, she was out of the office so I don't even know if we're gonna, if I'm gonna be able to get [PII] on the line, but.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me try, go ahead.
[CUSTOMER][POSITIVE] Well, at least, at least we got the ball rolling. That's, you know.
[AGENT][NEUTRAL] Yeah, let me try them back and see what we can find out here one second.
[CUSTOMER][NEUTRAL] Oh all right.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Elina Health release of information department. In order to direct your call appropriately, please choose one of the following options. If you need information on where to find a request to release records or where to fax requests, please press 1. If you have other questions, please press 0 and a representative will be with you as soon as possible.
[CUSTOMER][NEUTRAL] Thank you for calling Elina Health release of information department. In order to direct your call appropriately, please choose one of the following options. If you need information on where to find a request to release records or where to fax requests, please press 1. If you have other questions, please press 0 and a representative will be with you as soon as possible.
[CUSTOMER][NEUTRAL] Thank you for calling Eina Health release of information department in order to direct your call appropriately, please choose one of the following options if you need information on we are experiencing a high call volume during this time and we'll answer your call as soon as possible.
[CUSTOMER][POSITIVE] Thank you for your patience. Please continue to hold. Your call will be answered in the order it was received. If you prefer to leave a voicemail message, press one now.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Alright, [PII], so what, what may be the best thing to do here is they're having high call volumes now so let me try and get through to them and then I can give you a call back if you want instead of just placing you on hold. Um, is this [PII] a good call back number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, that's my only call back number and you can text me or leave a message that's fine.
[AGENT][NEUTRAL] OK, so I'm just gonna try and get through to them again. I don't wanna leave you on hold and see if they're confused by what we're asking for because I mean as a patient, you should be able to get a receipt for like services rendered. I don't understand why that's an issue, so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Yeah, yeah, the whole thing has been a nightmare, the whole thing. I can't even get my prescriptions filled, you know, so.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] It's uh it's all right. It's not your fault.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, well, let me, let me reach out to them and as soon as I get some more information, I will call you, OK?
[CUSTOMER][POSITIVE] So, thank you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] My pleasure.
[CUSTOMER][POSITIVE] Have a good day. Bye.
[AGENT][NEUTRAL] You too.