AccountId: 011433970860
ContactId: 90c69817-e770-4bd7-a32d-6796a982c6e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1362300 ms
Total Talk Time (AGENT): 381946 ms
Total Talk Time (CUSTOMER): 604555 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/90c69817-e770-4bd7-a32d-6796a982c6e5_20250331T16:26_UTC.wav
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[AGENT][POSITIVE] Good Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, who am I speaking with please?
[AGENT][NEUTRAL] This is [PII] with APL.
[CUSTOMER][NEUTRAL] Yeah, hi, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] I have you as a uh supplemental insurance for medical.
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] I had a couple of hospital stays last year and this year.
[CUSTOMER][NEGATIVE] And they keep saying that they're sending the claims but they're getting denied.
[CUSTOMER][NEGATIVE] And they keep saying I need a member ID.
[AGENT][NEUTRAL] Um, OK, um, we can check and see.
[CUSTOMER][NEGATIVE] And I'm looking at my card and there my card, there is no member ID on my card.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, OK. Uh, what is the numbers on your card? What numbers do you see?
[CUSTOMER][NEUTRAL] I have my name. Coverage is individual group number is 16257.
[AGENT][NEUTRAL] OK. Any other numbers besides that?
[CUSTOMER][NEUTRAL] And it's got the plan and.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] What a plan is med med link select group med SUP. It's got an in-hospital cert and an outpatient benefit cert.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, that will be the policy number, it's the cert number. I'll go ahead with the outpatient cert number.
[CUSTOMER][NEUTRAL] The outpatient is 01660278 ML 8.
[AGENT][POSITIVE] Thank you. And let me have a callback number just in case we get disconnected, Mr.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Yeah right, yeah, thank you.
[CUSTOMER][NEUTRAL] And I tried to convince them to call you guys with the [PII] number on the card, but they say no we don't call they can call us and we can clarify your coverage but.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hm, that's strange.
[AGENT][NEUTRAL] All right, let's see.
[CUSTOMER][NEUTRAL] Yeah, I know.
[CUSTOMER][NEGATIVE] They make it so difficult.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And if that's something you guys could do is call the hospital at the customer service that would be appreciated but I don't know.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But I've been kicking this around since like April of last year.
[AGENT][NEUTRAL] Yeah, the only way we can call them is if you initiate the call like uh you do a three-way call and you get authorization over the phone because they're gonna need the authorization to release anything or to get anything. Um, they don't really talk to the insurance company, so I'm not really sure why they say that um we need to call. But um let me go ahead and verify your information.
[AGENT][NEUTRAL] Um, may I have your date of birth, mailing address, and email address on file?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And what else did you need?
[AGENT][NEUTRAL] The email and the mailing address on file.
[CUSTOMER][NEUTRAL] The mailing address is [PII]. Email is [PII].
[AGENT][POSITIVE] Thank you, Mr. [PII]. All right. And let's see.
[AGENT][NEGATIVE] Did so they did say that they submitted the claim to us or they are trying to submit it and it's returning to them.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEGATIVE] Yeah, they said they've tried to submit it and it got sent back denied or something like that.
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] Well, the current bill I'm looking at.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I've had so many cause I
[CUSTOMER][NEUTRAL] I was in the hospital for quite a while.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, the date of service I'm looking at right now, there's two on this bill. It's 4-10-2024.
[CUSTOMER][NEUTRAL] And [PII] [PII].
[AGENT][NEUTRAL] OK. What is the first one again? Can you repeat that first one?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] 85
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] An inpatient service?
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] And they say the patient amount due is $2,737.65.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So this is for the facility for the hospital?
[CUSTOMER][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] This is a bill from the hospital itself.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Correct, OK, yes, um, yeah, we have not received that one. Let me see the one in [PII] 1 moment.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, we don't have one for [PII]. That means that they have not submitted the claims or maybe they did try to submit it, but they have the probably the wrong information for some reason. Um, yeah, is there any way you can initiate a call to like do a three way call so we can verify this information with them?
[CUSTOMER][POSITIVE] Yeah, I can try to do that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm gonna try and get this other party on the phone now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You still you still on the line?
[AGENT][NEUTRAL] Yeah, I'm still on the line. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, are you, are you still on the line [PII]?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm, I'm still here. Yes. Mhm.
[CUSTOMER][NEUTRAL] Please enter your account number followed by the pound key for help locating your account number on your statement press star. If you don't know your account number, just press pound.
[CUSTOMER][NEUTRAL] It looks like you need further assis[PII]. Please hold while we transfer your call.
[CUSTOMER][NEUTRAL] I don't usually do a three-way call you on the line, ATM.
[AGENT][POSITIVE] Yes, I'm still here. Yes, it's OK.
[CUSTOMER][NEUTRAL] OK, OK, so once we add.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] All of our agents are currently assisting patients. If you would like us to call you back, press one now. Otherwise, please continue holding for the next available representative.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, hi, thank you for calling Henry Ford formerly Essentially customer service. My name is [PII]. How can I assist you today? Hi, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes sir, my name's [PII]. Yeah, hi [PII]. I have you on a, uh, 3 way call with my secondary insurance provider, American Public Life and representative, and I'm trying to get a billing straightened out and I. Um. Mhm.
[CUSTOMER][NEUTRAL] I spoke to somebody from uh [PII] a few minutes ago and she said my claim was denied and we're gonna try and clear up why.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I see, I see. That's good to know that we are in a three-way call here from the insurance so that we can, you know, figure it out everything right away. But let me verify your account first, OK? So, sir, do you have an account number with you? Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Thank you, hold on.
[CUSTOMER][NEUTRAL] Um, are you the patient, sir? I am the patient, yes.
[CUSTOMER][NEUTRAL] What is your first and last name? First name is [PII]. Last name is [PII]
[CUSTOMER][NEUTRAL] Thank you. And what date of service are we looking for here, sir? [PII].
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] Of [PII]. OK. And your date of birth?
[CUSTOMER][NEUTRAL] And pardon, what was that?
[CUSTOMER][NEUTRAL] Your date of birth. [PII]. OK.
[CUSTOMER][NEUTRAL] So what is the the second lead of service?
[CUSTOMER][NEUTRAL] What was that?
[CUSTOMER][NEUTRAL] The second date of service that you would like me to check, sir. [PII].
[CUSTOMER][NEUTRAL] It's all on the it's all on the same bill.
[CUSTOMER][NEUTRAL] I see, I see. Let, let's check [PII] because that's what I have currently, OK? So hold on, so you're calling garden from some denials of it.
[CUSTOMER][NEUTRAL] So yeah, let me check here.
[CUSTOMER][NEUTRAL] May I place you on hold for 1 to 2 minutes? I'll, I'll give you this account real quick. OK.
[AGENT][NEUTRAL] OK. I'm still here, OK?
[CUSTOMER][NEUTRAL] What was your name with [PII]? Yeah, what was your name with [PII]?
[AGENT][NEUTRAL] So, [PII].
[CUSTOMER][POSITIVE] So, yeah, sorry about that.
[AGENT][NEUTRAL] Yes, uh-huh.
[AGENT][POSITIVE] No problem. It's OK.
[CUSTOMER][POSITIVE] I've been going through this so much it's supposed to be healing from surgery.
[CUSTOMER][NEUTRAL] I'm trying to get these guys.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I imagine.
[AGENT][POSITIVE] Yeah, we're gonna get this straight up.
[CUSTOMER][NEGATIVE] Terrible.
[CUSTOMER][NEUTRAL] I can't imagine how a season it is.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm yeah.
[CUSTOMER][NEUTRAL] I mean, I've been I've accepted collection.
[CUSTOMER][NEGATIVE] It's like, come on
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] No just to
[CUSTOMER][NEUTRAL] No, that should be
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, it's like we try, but yeah, sometimes it's like if they don't have the correct information, we don't get the information sent to us, which it sounds like it's the same.
[CUSTOMER][NEGATIVE] Well, the, the biggest problem they seem to have real number ID number.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I give them all the information, the address.
[CUSTOMER][NEUTRAL] and back
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Yeah, sometimes they, um they have it like automatic set up and if they have an old address, that will happen, um, not saying that that's what happened because I'm not sure what happened, but yeah, so there's some instance that it just happened here, but we'll figure it out today and see what we can do to get this receipt processed for you.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] Yeah, I, I would appreciate.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So the card I have stated.
[CUSTOMER][NEUTRAL] On [PII], is that still
[CUSTOMER][POSITIVE] Not a problem
[AGENT][POSITIVE] Oh no, there's no timely filing limits. So just whenever we get them, we'll go ahead and process no matter um when they send it. As long as it's processed by the major medical already and we get that information, it will be fine with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I just wondered if the date on the effective date on the card would be a problem when I submit it for secondary insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh, no, uh, and your effective date is [PII]. So yeah, that's not gonna change. It's gonna be the same even if we send a new card, it's gonna be like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Didn't take this long last time for her to get.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I have all your
[AGENT][NEUTRAL] Mm, yes, OK.
[CUSTOMER][NEUTRAL] I mean I got to get this resolved. I don't, they're going to send us an election.
[CUSTOMER][NEUTRAL] Phone calls
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] It's like, you know, I'm supposed to be healing. I should be.
[AGENT][POSITIVE] Hopefully we'll come back and we can verify that address, make sure they're sending it to the correct address.
[CUSTOMER][NEUTRAL] Um, sir, yes.
[CUSTOMER][NEUTRAL] Um, yes, sorry for a long wait. There's something that they noticed here. Um, actually, um, just recently, you give us a call to send another claim to your secondary insurance, right? Correct.
[CUSTOMER][NEUTRAL] And now, um, this is both from date of service of [PII] and um.
[CUSTOMER][NEUTRAL] [PII] last year they're both currently on they're both these two account or this two date of service currently on hold, OK, because we're now we send or shows here from the records that you request to send another claim.
[CUSTOMER][NEUTRAL] To, to this insurance. OK. So currently, this account is on hold.
[CUSTOMER][NEUTRAL] Right, OK, because we're go, yeah, we will send a claim within 3 to 30 to 45 business days. So that's why I need to. That's why I have the person from American Public Life also on the line so she could verify that sending it, sending it all correct.
[CUSTOMER][NEUTRAL] Oh sure sure yeah um.
[AGENT][NEUTRAL] Mhm. Mr. [PII], this is [PII] with APL and this is the secondary insurance. Um, I just need to uh verify the mailing address that you have or the fax number where you're sending that claim just to make sure that it's sent to the correct place.
[CUSTOMER][NEUTRAL] Mhm, so what should be the right address?
[AGENT][NEUTRAL] The address is the [PII].
[CUSTOMER][NEUTRAL] Sorry, um, can you start over a few but.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The bill
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so that's totally different than what's on my card.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And the zip code, yes, it's [PII].
[CUSTOMER][NEUTRAL] The ZIP code?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Phone number.
[AGENT][NEUTRAL] The phone number is [PII].
[CUSTOMER][NEUTRAL] You the
[CUSTOMER][NEUTRAL] Mhm. OK, let me address that and let me, let me update the address here, OK?
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Yeah, um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] a new.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Where
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, it's a good.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So, uh, there's.
[CUSTOMER][NEUTRAL] Hold on, OK, um, this is for, you know, from the 2.
[AGENT][NEUTRAL] OK, sure. Mhm.
[CUSTOMER][NEUTRAL] Um, to insurance from, I mean, to, um, deed of service, right?
[AGENT][NEUTRAL] Yes, it's from the provider to the insurance company um where they need to send the uh the claims is that address the [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And it's for the two date of service, [PII] and [PII] of last year.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And that's all we need to have the the information.
[AGENT][NEUTRAL] Yes, just update the information so we can receive those claims and you'll be able to send it to the correct place. Do you need the fax number or do you need me to repeat that address one more time?
[CUSTOMER][NEUTRAL] What else?
[CUSTOMER][NEUTRAL] Now I have it right here, uh, [PII] [PII] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, that is correct. OK, thank you.
[CUSTOMER][POSITIVE] That's good enough for me.
[AGENT][NEUTRAL] You're welcome. All right. So, um, yes, so that's all you're gonna need, um, again, you can either mail it or fax it. Um, do you need the fax number?
[CUSTOMER][NEUTRAL] With
[CUSTOMER][POSITIVE] Um, no, that's good enough for me.
[AGENT][NEUTRAL] Oh you don't fax it. OK, it's fine. All right, no problem. OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And um Mr. [PII].
[CUSTOMER][NEUTRAL] Alright, so.
[CUSTOMER][NEUTRAL] Sir [PII]
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, I already uh updated um everything here just to make sure everything will find, you know, to your insurance or anything else.
[CUSTOMER][NEUTRAL] Uh, no, I was just wondering, I mean question for soul, that address is completely different than what's on my card. Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, and I, I went ahead and um, yeah, because that's an old card, um, and that's why I was thinking that you probably have the wrong address there. I'll go ahead and order a new card, so you should be receiving one with the correct address, OK?
[CUSTOMER][POSITIVE] OK, that might help a lot.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, cause mine was [PII].
[AGENT][NEUTRAL] Yeah, that's an old address. Mhm.
[CUSTOMER][NEUTRAL] Alright, and sir, I just wanna add one thing. This, you know, sending a claim to your insurance may take around 30 to 45 business days, and the account will be hold for these two accounts, OK?
[CUSTOMER][NEUTRAL] So do you have any other thing that would you like me to do aside from this?
[CUSTOMER][NEUTRAL] Uh, I don't know.
[CUSTOMER][NEUTRAL] I see. OK, well, um, from your insurance, anything else?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, that that's all we needed to update, OK?
[CUSTOMER][NEUTRAL] No sir I don't think you know.
[CUSTOMER][POSITIVE] I see. OK, have a great day both of you and there will be a quick survey after the call. OK, bye. Thank you.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] OK. Have a good day. Bye-bye. Thank you. And Mr. [PII], um, is there anything else I may help you with today with APL?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, that might explain a lot of the difficulties I've been having though.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah. Yeah, it seems like it, yeah, when, whenever you mentioned that they said they send it and it's just coming back that I thought that was happening. um, but yeah.
[CUSTOMER][NEUTRAL] Please rate your satisfaction with your call. For satisfied, you guys do not have a press 2. For dissatisfied, press 3.
[AGENT][NEUTRAL] The member ID is that policy number. It's the outpatient cert number. That is the member ID.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you'll be receiving the card within 5 to 7 business days, OK?
[CUSTOMER][NEUTRAL] If you would like to leave a recorded message concerning the service you received after the tone, please record your message. I appreciate it. Once you have finished your recording, you may press the pound or hash key to continue.
[AGENT][NEUTRAL] No
[AGENT][POSITIVE] You're welcome, no problem. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, I think we're good.
[AGENT][POSITIVE] Yeah, have a good day bye bye.
[CUSTOMER][POSITIVE] You too thanks.
[AGENT][POSITIVE] You're welcome. Bye-bye.