AccountId: 011433970860
ContactId: 94cd18e4-6bdd-4cbf-b159-40b4a43f2d38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 672020 ms
Total Talk Time (AGENT): 276973 ms
Total Talk Time (CUSTOMER): 322360 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/94cd18e4-6bdd-4cbf-b159-40b4a43f2d38_20250513T21:25_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. This is [PII], and I have a question and hopefully you'll be able to help me.
[AGENT][POSITIVE] OK, I'll be more than happy to try.
[CUSTOMER][NEUTRAL] What do you need? What, what do you need from me?
[AGENT][NEUTRAL] Are you the insured or you're calling with the provider's office?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I'm the one insured.
[AGENT][NEUTRAL] OK, and may I have your name and a good contact number in case, I'm sorry, you already gave me your name, a good contact number and your policy number.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, let me, um, I can pull out my policy number. It's uh [PII] 864.
[CUSTOMER][NEUTRAL] Put you on speakerphone.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 313-254-6 and I'll get out my policy number right.
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's my secondary insurance. um, OK, it is ATL, uh, do you want the um the policy cart cert number?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] 02620609
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] the
[AGENT][NEUTRAL] 6
[AGENT][NEUTRAL] And can you verify um your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] And my mailing address is [PII].
[CUSTOMER][NEUTRAL] I believe my email, it's either my work or my home.
[CUSTOMER][NEUTRAL] Do you need that?
[AGENT][POSITIVE] Looks like work. Mhm.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][POSITIVE] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And how may I assist you today?
[CUSTOMER][NEUTRAL] Oh, thank you. So I am, um, I've had a bunch of knee operations starting in December, and I'm starting to get some bills and I was just online and I couldn't find it on the APL um website and it said they're doing some upgrades, so that might be it. But is there an invoice? I don't think my, the hospital has billed.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] APL, I think they've only built Blue Cross for [PII], there's a hospital services, um, invoice of $1,128.91. And if you go down, it's just
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] I don't want you to have to go into too much, just to let you know we haven't processed any claims for you, so no, they have not submitted the claims to us, but there
[CUSTOMER][NEUTRAL] Oh, is that
[CUSTOMER][POSITIVE] Mm, it's good for you.
[AGENT][NEGATIVE] There is no timely filing and your policy um has been active since [PII], so as long as the
[AGENT][NEUTRAL] Policy was active, you can file the claim at any time. Or you can just give them this policy number and our phone number and let them know, hey, I have a secondary policy, bill them and call them if you, oh, and they won't.
[CUSTOMER][NEUTRAL] I have, and
[CUSTOMER][NEUTRAL] Mm, uh, you know, and they say, oh yeah, yeah, we'll do it. And they, they never do it. So good. Well, I'm glad. Yeah, the, um, our insurance broker said, don't pay any bill till you confirm that it's gone through ABL. So it, so it says on here, it says American Public Life bill to insurance and it says $1,128. And
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It says insurance covered 0.
[CUSTOMER][NEGATIVE] But you're saying you haven't received a bill for it.
[AGENT][NEUTRAL] Yeah, like it's just blank. Everything is, the screen is blank, like we don't have one claim yet.
[CUSTOMER][NEUTRAL] Wow. OK. Um, so I wonder, I mean, this document says they build American public life back in December.
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] Let me see if there's another policy, maybe.
[AGENT][NEUTRAL] Maybe that's it. Hold on one second.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] The date of service is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, hold on one moment, December.
[AGENT][NEUTRAL] So it would be your previous policy. Hold on one moment.
[AGENT][NEUTRAL] Let's go there.
[AGENT][NEUTRAL] OK, now this one has more claims. Hold on one second.
[CUSTOMER][NEGATIVE] Oh shucks
[AGENT][NEUTRAL] OK, so let me get this claim number for you. 3.
[AGENT][NEUTRAL] Just for the call, I don't remember if I said it. I just want to make sure all the information provided is a verification of benefits, not a guarantee of payment. And hold on one moment, 863.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And they put an account number on here with that.
[AGENT][NEUTRAL] Yes, is it, does it start with the EBG?
[CUSTOMER][NEUTRAL] Uh, no, this is patient's name, and they, they got my name wrong. Um, it said [PII], primary payer Blue Cross Blue Shield account number, and then it lists a bunch of numbers.
[AGENT][NEUTRAL] Is it 667?
[CUSTOMER][NEUTRAL] This is from the hospital.
[CUSTOMER][NEUTRAL] Um, no, it's [PII].
[AGENT][NEUTRAL] OK, no, that's different. So I was trying to see because we only have one claim on file for [PII]. So I was trying to see if that was this, but it's not and it's um how much is that invoice for, because this is only for $20.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm mm. This one's for 1000, what they sent, they, what they said they sent to American Public Life is 1,128 91 cents. So obviously,
[AGENT][NEUTRAL] Oh no, that's not it.
[AGENT][NEUTRAL] 1100.
[CUSTOMER][NEGATIVE] They've sent it to the wrong place.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Now, that could also be um because we had a claims mailing address in [PII], so maybe that's what's happening. Maybe they're sending it to the old, well, the old mailing address, but at this point, like a lot of providers are calling saying their mail has been returned.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Because, because we're in [PII] now, but um,
[CUSTOMER][NEGATIVE] What should I call them and say um they never received it?
[AGENT][NEGATIVE] Uh, I would, I would just call and say, um, what claims mailing address do you have for my secondary insurance? And if they say anything in [PII], then we know they've been sending it to the wrong place and that's why we didn't answer because we didn't receive it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Gotcha. Hold on, let me uh make sure it's on my right on my card.
[CUSTOMER][NEUTRAL] Um, and here's in public life.
[CUSTOMER][NEUTRAL] This is, uh, this is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that, that's correct?
[AGENT][NEUTRAL] On the new card, the one for the um
[AGENT][NEUTRAL] The [PII]?
[CUSTOMER][NEUTRAL] The, um, the, uh, the American Public Life card that I have it says [PII].
[AGENT][NEUTRAL] Yes, what's the policy sir on there?
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] OK, it's uh 02620609.
[AGENT][NEUTRAL] Yes, so that's a new card, so it'll have the new address, but this other policy.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oops, hold on one second, I hit the wrong button.
[AGENT][NEUTRAL] Do you have any other dates of service?
[AGENT][NEUTRAL] That you want me to look into?
[CUSTOMER][NEUTRAL] Um, I
[CUSTOMER][NEUTRAL] I'm well, I had an operation in January too, so they, you should have some um
[CUSTOMER][NEUTRAL] Invoices from January.
[CUSTOMER][NEGATIVE] But I'm thinking they they're sending it to the, they've sent it to the wrong place.
[AGENT][NEUTRAL] I would see who they're sending it, what what they're sending it to, and if you want, I can give you all the correct information. Um, so if they do have it wrong, we can, you can just let them know, well, here's the mailing address, the fax, and the payer ID, but from what I see, just for that date, yeah, they haven't sent any. Well, we haven't received it, let me say that.
[CUSTOMER][NEUTRAL] I, um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh yeah, I forgot you had a new card, yes, and then uh the fax number is also on there.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what about the payer ID?
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Should be 60801.
[CUSTOMER][NEUTRAL] Oh yeah, I'm sorry, I wait, I was looking straight at it, yes.
[AGENT][NEUTRAL] OK, well then, OK, so the
[CUSTOMER][NEUTRAL] So I should, I should.
[AGENT][NEUTRAL] I'm sorry, go ahead. No, no, you're fine.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] So they're just, so they, they, they, if they've sent it, they've sent it to the wrong address.
[AGENT][NEUTRAL] The possibly, I mean, I'm assuming that's what happened because we don't have it here, but you don't have a timely filing, so they can still file with us, even if it's for previous claims and you, you've had a um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A secondary policy with us since [PII]. So, depending on, I mean, you can go back. So depending on what dates of service would determine which which policy number is filed under, but you still can file from [PII] to.
[CUSTOMER][POSITIVE] Wonderful.
[AGENT][NEUTRAL] Whatever
[CUSTOMER][NEUTRAL] Well, I'll, I'll call, I'll get in touch with um [PII] and tell him that y'all, y'all haven't gotten the, the bill.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Because they're saying I owe them.
[CUSTOMER][POSITIVE] A couple of 1000. Well, good. Well, thank you so much. I appreciate it.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Well, you're very welcome, Ms. [PII]. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] And I'll, uh
[CUSTOMER][NEUTRAL] I will
[CUSTOMER][POSITIVE] That's, that's it. I appreciate your help.
[AGENT][POSITIVE] You're welcome. Well, thank you for calling APL. I hope you have a good evening. You're welcome.
[CUSTOMER][POSITIVE] Thank you so much. You too. Thank you. Bye. Bye, [PII]. Bye.
[AGENT][NEUTRAL] Yes. Bye-bye.
[CUSTOMER][NEUTRAL] And