AccountId: 011433970860
ContactId: 9a9340e4-48bd-44d7-aac2-e99129dcbada
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 425769 ms
Total Talk Time (AGENT): 139110 ms
Total Talk Time (CUSTOMER): 254991 ms
Interruptions: 9
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/9a9340e4-48bd-44d7-aac2-e99129dcbada_20250312T17:38_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] they
[CUSTOMER][NEUTRAL] Yes, hi [PII], my name is [PII], um.
[CUSTOMER][NEUTRAL] I have some bills that um.
[CUSTOMER][NEGATIVE] For some labs and I just called Quest to ask them if they were submitting them to APL and they said yes they had submitted them in October and June and didn't get any responses and I've been paying these and I shouldn't have to because I pay my insurance for that reason.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII], let's take a look. Do you have your uh policy number there?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Um, which one do you want? The medical, hospital, outpatient?
[AGENT][NEUTRAL] Uh, you can give me the outpatient. That'll work.
[CUSTOMER][NEUTRAL] OK, 023-29391, M as in Mary, L as in Larry, H.
[AGENT][NEUTRAL] All right. And then for security, I'll need to get [PII] please your date of birth and address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you by chance know the exact date of service or?
[CUSTOMER][NEUTRAL] Um, I don't, I know the amounts. Um, let me hold on, no, I might be able to, yeah, give me one second because I think I have the bills right here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I do.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK, so this data service.
[CUSTOMER][NEUTRAL] For the first one is um uh let me see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know, it just says date but it doesn't say date of service filling date, um.
[CUSTOMER][NEUTRAL] That looks like they filed it twice a different time, um, try [PII].
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] Uh, is it like that um.
[CUSTOMER][NEGATIVE] So I really, I really don't.
[CUSTOMER][NEUTRAL] So you said it's for tomorrow morning?
[AGENT][NEUTRAL] I don't see anything for [PII], um.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, and then I have another date [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And all of these were sent at this they said together they filed them all.
[AGENT][NEUTRAL] They didn't
[CUSTOMER][NEUTRAL] In October and June.
[AGENT][NEUTRAL] OK, they didn't give you any claim numbers or anything by chance? OK.
[CUSTOMER][NEUTRAL] Mm mm. No, I didn't ask.
[AGENT][NEUTRAL] Let's see October or June.
[CUSTOMER][NEUTRAL] This is. How may I help you?
[AGENT][NEUTRAL] OK, [PII], so I'm just going back through some of the last claims that I see in here that have maybe been denied.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] I don't even see any from Quest Diagnostics. Did they tell you how they were submitting them?
[CUSTOMER][NEUTRAL] OK, what kind of appointment is it?
[CUSTOMER][NEGATIVE] No, they didn't. I just asked her why I was being billed because I have two insurances and I shouldn't be and I asked her, I gave her the information. I said, are you guys filing, you know, with the APL? and she said yes, we did it in October and we did it in June for all of these. I said, OK, well I don't understand why.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, I mean,
[CUSTOMER][NEUTRAL] So can I send these bills or do they need to or what? I mean, I have 3 bills right here, although this one doesn't have codes and stuff.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Um, yeah, so that's was my next thing that I was gonna say would be that um if you want to, you can file them yourself, um, you could reach back out.
[CUSTOMER][NEUTRAL] And you know, and what's your first name?
[CUSTOMER][NEUTRAL] But that's.
[CUSTOMER][NEGATIVE] Yeah, that's a pain in the neck because I have to fill out all that paperwork to file them right? because I did this year when we first started there you have to fill out the forms for APL and stuff to send.
[AGENT][NEUTRAL] The paper
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm, yeah, you would, correct, yeah.
[CUSTOMER][NEUTRAL] Yeah, see that's, yeah, I, I mean I shouldn't have to they should, so I can I just have them refile it?
[AGENT][NEUTRAL] They can resubmit it. You may want to verify how they're submitting the claim. I can give you uh the fax, mailing address, and the payer ID so you have it and you can make sure they're submitting it to the right place.
[CUSTOMER][NEUTRAL] OK, hold on, I have to ask to see if I can do that. You said yourself correct, and they, did they tell you how much 50 is gonna be and all that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, hold on just a minute clean. OK, so fax is what?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] 942-3 and the payer ID OK, and what other information?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The claims mailing address is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oops, wait a minute, [PII].
[CUSTOMER][NEUTRAL] [PII] [PII] just for the A1C.
[AGENT][NEUTRAL] And it's in [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, hold on just one to to get before I can do that, OK.
[CUSTOMER][POSITIVE] You're right.
[AGENT][NEUTRAL] And if they're saying that they're they're denied claims, um, the only other thing that would help us, [PII], if you need to call us back would just be if they can give you the claim number.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, she didn't say they were denied she just said we haven't gotten responses.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right, so they may be sending it to the wrong place. I would double check that next.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I will call them right now. Yes, ma'am. Thank you. What was your name, [PII]?
[AGENT][NEUTRAL] My name is [PII]. Uh-huh.
[CUSTOMER][POSITIVE] OK, thank you, [PII].
[AGENT][POSITIVE] You're welcome, [PII]. Have a good one.
[CUSTOMER][POSITIVE] Yes ma'am you too thanks.
[AGENT][NEUTRAL] Bye bye.