AccountId: 011433970860
ContactId: 97f4b496-ccfa-4bc7-93e5-baf52d88881c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1231400 ms
Total Talk Time (AGENT): 215339 ms
Total Talk Time (CUSTOMER): 341194 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/97f4b496-ccfa-4bc7-93e5-baf52d88881c_20250407T20:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I had a couple questions, um, about some claims that I've put in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, of course I can help you with claims today. Do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, one second, let me get it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, you need my payer ID or my group number?
[AGENT][NEUTRAL] Uh, let's do, I believe it's the payer ID. Let's try that one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 608.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 01.
[AGENT][NEUTRAL] Oh, sorry, can I have the group number please?
[CUSTOMER][NEUTRAL] Yes, 80084.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then I just have to verify a couple pieces of information. Uh, what is your first and last name and date of birth?
[CUSTOMER][NEUTRAL] So if you have a large 10492.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] And you said the group number?
[AGENT][NEUTRAL] Was 80084.
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I'm going to pull up your policy by your first and last name actually, that one's not working. Um, OK, can you spell your first and last name for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII]. Last name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] And then [PII], what is a good callback number in case our call gets dropped?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, just one second while I pull up your policy.
[CUSTOMER][NEGATIVE] That one was bad.
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And the chairs so it was more upright.
[AGENT][NEUTRAL] OK. And then, can you repeat your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the mailing address on file and email?
[CUSTOMER][NEUTRAL] [PII] and the email is [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] OK, and you were calling about claims?
[CUSTOMER][NEUTRAL] Um, yeah, so I spoke to Quest, the, the labs, uh, uh, last Friday, um, because my coworker had mentioned to me that Quest was gonna process it through the gap insurance and that she was gonna get refunded by Quest, so I hadn't processed any of my Quest payments and I spoke to Quest and they.
[CUSTOMER][NEGATIVE] But I gave them my gap insurance information and they put the claims in. I think it was um 10 claims that they processed, um, and they told me just to follow up with you guys, um, Monday, which is today, to make sure you guys received it only because my policy, it ends at the end of April, and they told me that it can take 4 to 6 weeks, so I, I want to make sure that we expedite or rush this just because I'm losing coverage, uh, 4:30.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, I understand. Let's see.
[AGENT][NEUTRAL] All right. And
[AGENT][NEUTRAL] What was the date of service?
[CUSTOMER][NEUTRAL] Oh, there's a bunch of different services that there's 10 of them. I, I'm not really sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, that is a lot um let's see.
[AGENT][NEUTRAL] Was it just in, was it in March?
[CUSTOMER][NEUTRAL] Uh, I mean it's been all year there were some in March, but there were some in February, January.
[CUSTOMER][NEUTRAL] November of last year.
[AGENT][NEUTRAL] OK, so we'll need the data services to verify and look up these claims.
[CUSTOMER][NEUTRAL] OK, let me, let me pull it, let me see if I can pull it up one second.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Let me check here.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Alright, I'm trying to log on now to my Quest app.
[AGENT][NEUTRAL] Oh yeah, you're fine.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um, alright.
[CUSTOMER][NEGATIVE] The app wasn't working so I'm trying to log on um another way.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK let's see here 0.
[CUSTOMER][NEUTRAL] 736.
[CUSTOMER][NEUTRAL] Um, OK, I, what exactly did you need? I'm sorry?
[AGENT][NEUTRAL] Uh, just the date of service for all 10 of those claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] The first one that we have is.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hold on a second.
[CUSTOMER][NEUTRAL] I'll just go from, from the top up. OK, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] You want me just to go down, tell you the date of service for all?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK, [PII], then I have [PII].
[CUSTOMER][NEUTRAL] Then I have [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 11 8 2024.
[CUSTOMER][NEUTRAL] 1017 [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 827 2024.
[CUSTOMER][NEUTRAL] And then those are all of the ones under my name, but I also have my son on my gap insurance and there was 3 for him. Should I get you those numbers as well?
[AGENT][NEUTRAL] Uh yes, please.
[CUSTOMER][NEUTRAL] OK, one second.
[CUSTOMER][NEUTRAL] Um, I need to redo this since he has a different date of birth.
[AGENT][NEUTRAL] Do you happen, do you happen to have our OSC website?
[CUSTOMER][NEUTRAL] I'm not sure what that is.
[AGENT][NEUTRAL] So we have a website where you.
[CUSTOMER][NEUTRAL] Like to log on to put in the claim.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Yes, I've, I've put in all the claims, but for Quest specifically I never put in the claims because I did wasn't, I didn't think you guys would refund me.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then Quest, I guess manually did it themselves on Friday. They basically put in my gap insurance number like they process the claim themselves they said so they told me to check in with you guys today to make sure it went through or something like that.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Oh yeah, that's fine. I was just gonna say you could check your claim status on there but I get it you're just trying to.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] OK. Exactly, yep.
[AGENT][POSITIVE] Get this all going, yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, OK, then for my son it's 12-24-2024.
[CUSTOMER][NEUTRAL] And 9 21 2024.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, just 2 for him?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And then for these claims, are you just wanting to know if they are paid or not paid and the reason why if they're not paid?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] I paid Quest um myself um and then my coworker told me that APL um reimbursed her for all those Quest payments that she had made so I'm trying to do the same because I have a bunch of claims and I, I wasn't sure that you guys would cover it but apparently you guys do.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, let's see. I'll check this for you.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] OK, can I just put you on a brief hold while I look into each one of these?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 35
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, so thank you for holding. I am not seeing any claims received from Quest Diagnostics at this time.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, I guess I'll call them or I guess how can I, how can I put them in myself if I
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do I
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Cause I already paid them, so if I, if I log on, it says $0.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] All right. Uh, so you can submit the itemized bill, um, and it needs to include the diag diagnosis code and the primary insurance EOB.
[AGENT][NEUTRAL] Uh, when you
[CUSTOMER][NEUTRAL] OK, let me try to call Quest and see, let me try to call Quest and see if they can look, look into, look into it just because it took forever for them to do it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] I was over I was on the phone with them for like over 2 hours.
[AGENT][NEUTRAL] Oh, no. OK, so for your son, I just need to verify.
[AGENT][NEUTRAL] Um, his first and last name and then his date of birth, and I'll be able to look his up as well.
[CUSTOMER][NEUTRAL] OK, um, his name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, same last name [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah and I'm not seeing any claims on file for him either.
[CUSTOMER][NEUTRAL] For him either, OK, OK, um, let me go ahead and call myself and see if they can help me out.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, and when you submit, usually when you submit the claims, they reimburse the reimbursement of the payment will go to you.
[AGENT][NEUTRAL] Since you already paid, yeah, so it'll go back to you, but.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Alright, perfect. Let me try to call them and see if they can help me out.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with at the moment? No.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] No, no, that's it.
[AGENT][NEUTRAL] OK. All right, thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Mhm. You're welcome. Bye bye.
[CUSTOMER][POSITIVE] Thank you. Have a good one. OK, bye bye.
[AGENT][NEUTRAL] You do.