AccountId: 011433970860
ContactId: 834873c1-ecb0-4391-91b2-8e410b61d341
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1486880 ms
Total Talk Time (AGENT): 380605 ms
Total Talk Time (CUSTOMER): 670023 ms
Interruptions: 6
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/834873c1-ecb0-4391-91b2-8e410b61d341_20250609T15:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hello, good afternoon. Well, good morning, [PII]. How are you doing today?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][NEUTRAL] I'm fine. Well, I'm just trying to see if I could get some information based on the coverage that I have with the company that I work for.
[CUSTOMER][NEUTRAL] I don't know why I can't find my card, so I'm trying to see if I could maybe have it emailed over to me or something.
[AGENT][NEUTRAL] OK, yeah, we can definitely email you a card. Do you have a policy number by chance or?
[CUSTOMER][NEUTRAL] That's what no I do not have my policy number on me.
[AGENT][NEUTRAL] OK, um, we can do a search by your name or social, whichever you prefer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, let me see, let me, uh, I'll, let me, let me see if it pulls up by my name. If not, we'll just try my social.
[AGENT][NEUTRAL] What's the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is your last name spelled [PII]?
[CUSTOMER][NEUTRAL] No, it's spelled [PII]
[AGENT][NEUTRAL] Can you spell your first name, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] May I please have your date of birth and address?
[CUSTOMER][NEUTRAL] [PII] and the address on file should be my old address which is um [PII].
[AGENT][NEUTRAL] It looks like we have a different one.
[CUSTOMER][NEUTRAL] For the address?
[AGENT][NEUTRAL] Yeah, it's a [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So the email on file is [PII].
[CUSTOMER][POSITIVE] [PII] perfect so yes it is.
[AGENT][NEUTRAL] Alright, so I've sent you an email with a card. Did you wanna copy down the policy number? Did you need anything else?
[CUSTOMER][NEUTRAL] Uh, yeah, um, I do need some additional help too, but yes, I'll take all that information if possible.
[AGENT][NEUTRAL] So the policy number is going to be
[AGENT][NEUTRAL] 02.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 450-168.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What other questions or concerns did you have regarding coverage?
[CUSTOMER][NEUTRAL] OK, so regarding my coverage, um, I went to
[CUSTOMER][NEUTRAL] The doctor, the, the hospital the other day. I have another insurance that covers whatever happens and I use APL just in case I need additional help. They try the um.
[CUSTOMER][NEUTRAL] I think they mischarged it. I think they didn't charge APL they only charged my other insurance, and they was trying to have me covered, so I'm trying to see how could we get that ratified.
[AGENT][NEUTRAL] So you can contact them and then ask them to submit the claim on your behalf. If they're not willing to do that, then you can submit the claim yourself. You would need a medlink claim form from our website. You would need the explanation of benefits from your primary insurance showing what was covered for your deductible co-pay and co-insurance.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then an itemized bill from the provider.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] OK, and there was some, there was another thing too, but this was um a while ago where I went to an urgent care and they charged me for the same thing, but I ended up calling, calling in. I'm not sure if you could be able to put it up on file because I would appreciate that. I called it in, explained to what was going on. The lady who was on the phone was perfect. She helped me out. We end up calling the urgent care, but they was not picking up the phone for us to get that bill started out because she was telling me that.
[CUSTOMER][NEUTRAL] I'm covered. Um, I have, um, my, my, I'm good, and I don't really be using my APL insurance like that. And I'd be getting some charges that they're only charging to my other insurance. So I'm trying to figure out why they're only charging that insurance and not going with the both insurance when I give it to them.
[AGENT][NEUTRAL] Yeah, I mean,
[CUSTOMER][NEGATIVE] Father, it's, it's making me feel like I'm being harassed getting all these.
[AGENT][NEUTRAL] Why they
[AGENT][NEUTRAL] I, you know, unfortunately sir, I can't answer the question as to why they're not billing us after your primary if they have the information, you know, that's a question for the provider um it's not a question that I can answer as to why that they're not sending us any sort of claims for anything additional left over.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] Um, the recourse on that is to contact the provider and advise them that you do have a secondary and that that needs to be processed before you'll pay anything, or you can take matters into your own hands and just file the claims yourself.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And where do I file the claim?
[AGENT][NEUTRAL] You can submit claims online through our service center. You can put them in the US postal mail or you can also fax them.
[CUSTOMER][NEUTRAL] Online?
[CUSTOMER][NEUTRAL] OK, but there's nobody who I could speak to over the phone and have it done over the phone.
[AGENT][NEUTRAL] Yeah, we don't generally submit claims.
[CUSTOMER][NEGATIVE] There's no representative for in that department that I could speak to because as I said, I spoke to somebody regarding the urgent care matter and she actually stayed on the phone with me and called the urgent care to see what was going on. She actually went out of her way, so I'm just trying to see if that's, there's nobody who can do that or I have to just put that claim.
[AGENT][NEUTRAL] Have you contacted the provider yourself to see why they haven't filed it?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] I did, but every time I contacted them, they keep sending me back the same bill. So that's why I'm trying to figure out what was going on. So that's why I called APO and then we was trying to see why they're not sending the bill to APO.
[CUSTOMER][NEGATIVE] So that's what that's what genuinely be my concern. I've been through this before. I'm and I'm keep getting the bill, but the person who I was on the phone with, he was not able to get to the office.
[CUSTOMER][NEGATIVE] We called like 10 times. She stayed on the phone with me for almost an hour trying to get through, she left voicemail of everything trying to get through that office.
[CUSTOMER][NEGATIVE] And nobody actually got back to me, to be honest, to let me know what was going on, and I'm sure it should be on file because it had been noted.
[CUSTOMER][NEGATIVE] And I just feel like I'm being harassed by these people paying so much for my insurance and I'm still be asking to pay, makes no sense.
[AGENT][NEUTRAL] So, I mean, I see where you spoke with an agent back in February regarding an urgent care visit and you wanted to make sure that it was covered and that they tried to do a conference call. So,
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Yes, and I, mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And nobody got back to me on that and I'm gonna keep on getting the bill so I did everything that you said. I reached out to my provider and my insurance and I'm still getting like in circles. So now I have to go online and do it again so I'm just genuinely confused as to what to do and I'm paying so much for my insurance. So is there somebody that I can genuinely speak to I'm not having to bother you in your department so we could get this rectified.
[AGENT][NEUTRAL] So we unfortunately like we can't speak to like a provider generally like on your behalf.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Do you have like a what's the specific date of service or doctor that's in question?
[CUSTOMER][NEUTRAL] OK, the first one is the same urgent care and I think I've sent all that information, but let me see if I find it back because they be emailing me every day.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And thank you, I see the ID card in my mail, so the.
[CUSTOMER][NEUTRAL] The invoice
[CUSTOMER][NEUTRAL] So this invoice is from
[CUSTOMER][NEUTRAL] So it's loading up.
[CUSTOMER][NEUTRAL] Is there an email that I could send it to?
[AGENT][NEUTRAL] No, I don't have any sort of email that I can give you to send it to.
[CUSTOMER][NEUTRAL] So what information you want off the invoice I could give you.
[AGENT][NEUTRAL] What was, what was the date that you were seen?
[CUSTOMER][NEUTRAL] The date is [PII].
[CUSTOMER][NEUTRAL] You see the
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] That's all you do.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You want you, you like this too?
[CUSTOMER][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, is there a phone number on there to contact?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] So he'll be trying to
[CUSTOMER][POSITIVE] I'm trying to get this started forever.
[CUSTOMER][NEUTRAL] I'm honestly not seeing a number. I just have the
[CUSTOMER][NEUTRAL] Oh yes, um, number would be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, [PII] and then what was the rest?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And when you've tried to call that number, you're not getting through to anybody?
[CUSTOMER][NEUTRAL] Who, me?
[CUSTOMER][NEUTRAL] Or the person who called it last time.
[AGENT][NEUTRAL] OK. So that was for [PII]. So what's the other date that you're um wondering on?
[CUSTOMER][NEUTRAL] Oh that date, well [PII] or [PII], let me see.
[CUSTOMER][NEUTRAL] Because that's the date on the invoice for.
[CUSTOMER][POSITIVE] The um the copay that they're charging me for the other one was with the hospital, but I spoke with the billing department with them, so I'm not sure if they had that sorted out that I will try to deal with another day, but this one is what I actually wanna take care of because they'd be keeping sending me bills.
[CUSTOMER][POSITIVE] So the hospital actually had my APL on file and everything so that should be worked out with the billing department and I'm going to call them to make sure everything was sorted out too.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is the bill that they're sending you just for the copay?
[CUSTOMER][NEGATIVE] Yes, just for the copay. I went 2 times and I'm just getting it for the copay for 2 times. They're charging my, my other insurance for that.
[AGENT][NEUTRAL] So the policy that you have doesn't cover an office visit fee, it looks like.
[CUSTOMER][NEUTRAL] Mm, I was never told that. I was told that it covered the office.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Under physician covered charges.
[CUSTOMER][NEUTRAL] So my plan that don't that.
[AGENT][NEUTRAL] It states um.
[AGENT][NEUTRAL] That it covers treatment and services and supplies recommended in a physician's office.
[AGENT][NEUTRAL] Does not include charges for physical therapy, durable medical equipment, physician office visit fee.
[CUSTOMER][NEUTRAL] Exactly, so it.
[CUSTOMER][NEUTRAL] I'm sorry, what was that last part?
[AGENT][NEUTRAL] The physician office visit fee.
[CUSTOMER][NEUTRAL] So you guys don't pay for the visit fee basically.
[AGENT][NEUTRAL] I don't know if that would actually be covered on here, but
[CUSTOMER][NEGATIVE] It has to be because I was genuinely told that the last time it has to be on, I was told it is covered. That's why I went out of my way to make sure everything was being done.
[CUSTOMER][NEGATIVE] And this is the only reason I have this second insurance. I don't need this insurance. My other insurance is already paying for my stuff. I have this to pay for if anything else, so I don't need to have this done. I got to speak to my office, but whoever I spoke to the last time told me that it is covered under my insurance. I should not be paying for no.
[CUSTOMER][NEUTRAL] So that's what I'm trying to figure out.
[AGENT][NEUTRAL] I can try
[AGENT][NEUTRAL] I can try and call them [PII], but I can't unfortunately stay on the line with them for a long time. I can just try and reach out and see if if if they answer. If not, I'll be honest, if.
[CUSTOMER][NEUTRAL] No, no, I'm only a file with that that.
[AGENT][NEUTRAL] If you can't get through to somebody, then I would just physically go up to the place and tell them that they need to file the claim with your secondary insurance. At this point, like we can't force them to file it, so like if they're not going to file it, you're going to have to take it upon yourself to do it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, that I'm on your side with.
[CUSTOMER][NEGATIVE] That I would do. I definitely will do. I just wanna make sure that that I'm covered for that visit before I try to do something crazy because I'm being harassed by these people and I'm paying so much for my insurance. So I'm on your side with that too. So I'm not trying to have you stay on the phone or call nobody. I'm just trying to figure out why they are not charging.
[CUSTOMER][NEUTRAL] my size.
[AGENT][NEUTRAL] Well, yeah, I mean, I don't have the answer to that, sir. I don't know.
[CUSTOMER][NEGATIVE] Well, I was being sarcastic. I was not genuinely acting.
[AGENT][NEUTRAL] Like there's no
[AGENT][NEUTRAL] Yeah, I mean like I, I don't know so what would you like me to do going forward because there are no claims on file for that date. Did you want me to try and call them? Do you wanna call them yourself? What would you like to do?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Could you try and call them and see what happens? Leave them a voicemail if possible, and we could go from there so I could know that my, I could have that as my.
[CUSTOMER][NEUTRAL] Evidence that my provider reached out to them.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][POSITIVE] Hi, thank you for calling Dr. G's Urgent Care and for letting our family take care of your family. We are very happy to announce our new Sunrise location is now open. We are open from [PII] daily at the
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Good afternoon. Thank you for calling Doctor G's urgent care.
[AGENT][NEUTRAL] Hi, my name is [PII], and I'm calling from American Public Life Insurance. I have an insured on the line with us. His name is [PII], and he has some concerns regarding, I guess, a bill he's getting from your facility that has not been submitted to our department as a secondary. Is this something that you could help with?
[CUSTOMER][NEUTRAL] Hold on one
[CUSTOMER][NEUTRAL] What's the patient's date of birth?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Uh, date of birth, I'm, yeah. You can give her your date of birth, [PII]. Go ahead.
[CUSTOMER][POSITIVE] Oh, I'm sorry?
[CUSTOMER][NEUTRAL] Oh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. [PII] [PII].
[CUSTOMER][NEUTRAL] And your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And what was your date of service?
[CUSTOMER][NEUTRAL] Hold on, the invoice number that I have for you guys, the date would be.
[CUSTOMER][NEUTRAL] The date that you came to the clinic, what date?
[CUSTOMER][NEUTRAL] It was two dates, [PII] and then [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Spell your last name.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And spell your first name.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] It's a
[CUSTOMER][NEUTRAL] And hold on a second, OK? Hold on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You definitely can.
[CUSTOMER][NEUTRAL] I have a [PII]
[CUSTOMER][NEUTRAL] I know. I don't know if he knows.
[CUSTOMER][NEUTRAL] Do they have the is it here or is it like in the where the big people speak up?
[CUSTOMER][NEUTRAL] Hello hi hello, your name is [PII], right?
[CUSTOMER][NEUTRAL] Yes it is. It's [PII].
[CUSTOMER][NEUTRAL] [PII], yes it is.
[CUSTOMER][NEUTRAL] OK, what is your address? I just wanna make sure I got the right person.
[CUSTOMER][NEUTRAL] Well, my address that was on file should be [PII]. Yeah this is.
[CUSTOMER][NEUTRAL] And who do you have on the phone you said?
[CUSTOMER][NEUTRAL] Um, my insurance provider?
[AGENT][NEUTRAL] So we're, we're.
[AGENT][NEUTRAL] Yeah, we're the secondary insurance and he's stating that
[AGENT][NEUTRAL] The primary has been billed but we have not been billed as a secondary.
[CUSTOMER][NEUTRAL] Alright, hold on, and the secondaries, what are your names, the secondary?
[AGENT][NEUTRAL] We're [PII] that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, hold on.
[CUSTOMER][POSITIVE] Let's go get one thing on this school.
[CUSTOMER][NEUTRAL] We don't have all day.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Mhm. The best one get this cause she only has a nightgown.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] And I.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] The only insurance we have on file is AMed. There never was a secondary.
[AGENT][NEUTRAL] OK, so what does he need to do to add the secondary and it be billed to us before he sent a bill?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright, hold on.
[CUSTOMER][POSITIVE] And I did, I did provide my both insurances, and the others. I appreciate your help so much, but I did provide all that.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] OK, is it APL a public life?
[AGENT][NEUTRAL] American public life.
[CUSTOMER][NEUTRAL] Like, right, I mean, and the ID 60801.
[AGENT][NEUTRAL] That's our payer ID, yeah, 60801, uh huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well we'll build the secondary then I see it.
[AGENT][NEUTRAL] Do you need his policy number or effective date or anything?
[CUSTOMER][NEUTRAL] Um, it's the effective date [PII].
[AGENT][POSITIVE] Mhm, that is correct, yes ma'am.
[CUSTOMER][NEUTRAL] And let me make sure this number is correct.
[CUSTOMER][NEUTRAL] Is the number is.
[CUSTOMER][NEUTRAL] 0245016AMLA.
[AGENT][NEUTRAL] Mhm. Correct, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] And what was your name again?
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Thank you [PII] and then you'll just notate that this needs to be billed before he sent anything else?
[CUSTOMER][POSITIVE] Right, I'm gonna do it right now, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And your name?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][POSITIVE] Thank you [PII] for your help, we appreciate it.
[CUSTOMER][POSITIVE] OK, you're welcome. OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright [PII], so we spoke to [PII] over there, note that down date and time. I'm gonna notate the account and then.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You are the best. You are the best.
[AGENT][NEUTRAL] Go from there, OK?
[CUSTOMER][POSITIVE] Thank you so much, [PII], and you have a wonderful day.
[AGENT][NEUTRAL] You too.