AccountId: 011433970860
ContactId: 887da198-b278-4269-95f5-7659070ca358
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 241880 ms
Total Talk Time (AGENT): 85920 ms
Total Talk Time (CUSTOMER): 133909 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/887da198-b278-4269-95f5-7659070ca358_20250425T15:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Yeah, hi, how are you going today, [PII]?
[AGENT][POSITIVE] I'm great how are you?
[CUSTOMER][NEUTRAL] Not too bad, thanks. Um, I called up a couple of weeks ago and I was talking to somebody. I recently went to Kaiser, got some work done, um, there, and I was trying to find out what do I need to do. Do, uh, cause there's a bill for like $500. Do I, do I need to pay it and get, submit that to you, get reimbursed, but the lady said on the phone.
[CUSTOMER][NEUTRAL] that I just need to give Kaiser the details and Kaiser can bill you guys directly. And then I just got a message. I did that, I gave that to Kaiser and then I just got an email from Kaiser saying we were notified of a request to add American Public Life Insurance to your Pfizer and then account. We were unable to verify full medical coverage due to supplemental coverage. If your coverage is supplemental, you're required to send the claims directly to the carrier.
[CUSTOMER][NEUTRAL] Um, but the ladies, so do I need to like submit the claim to you? Because previously the lady said you guys have a link with [PII] where I don't need to do that. So she's trying to work out what I need to do to get this fixed.
[AGENT][POSITIVE] OK, I'll be happy to help you. May I have your name and the policy number and I'll pull up your account.
[CUSTOMER][NEUTRAL] Cool. Uh, my name is [PII] and my policy number is 02486928.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yeah, you can call me back on [PII].
[AGENT][NEUTRAL] Thank you, can you verify your mailing address, your date of birth, and your email?
[CUSTOMER][NEUTRAL] Yeah, mailing address is [PII]. Um, my date of birth is [PII], sorry, [PII]. And what was the last thing you wanted?
[AGENT][NEUTRAL] Your email address?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. So with this policy, if the provider does not file for you, you would need 3 items to submit the claim. You will need your itemized bill from that provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You would need your primary insurance explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you would need a Medlink claim form, which you can obtain online at [PII] and you would need the Medlink form and then you can submit the form, submit the claim.
[CUSTOMER][NEUTRAL] And I should, I submit that online?
[AGENT][NEUTRAL] You can go to [PII], register your account and upload the claim there.
[CUSTOMER][NEUTRAL] Uh [PII]. So I need the bill from Kaiser and then I need, uh, the, the, the, uh, coverage details from Kaiser. Is that what you said?
[AGENT][NEUTRAL] Your primary insurance, you would need the ELB showing what was applied to your co-pays, co-insurance, and or deductibles.
[CUSTOMER][NEUTRAL] OK. And then so in the bill, the EOB and then
[CUSTOMER][NEUTRAL] I need a, uh, I need to fill out the med link form and then I go to the [PII] website and I submit all that. That's correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh. All right. And do you guys usually just do this directly or is this, if I do stuff, is this usually how I'll have to do it every time, pay in advance, and then get reimbursed?
[AGENT][NEUTRAL] If the provider does not file the claim for you, then yes.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] Oh, awesome. Thank you for this information today and you have a great afternoon.
[AGENT][POSITIVE] [PII], you're so welcome and thank you for calling American Public Life. Have a great evening. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye.