AccountId: 011433970860
ContactId: 9aa21714-339c-4c63-8916-07410f644660
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1203359 ms
Total Talk Time (AGENT): 408612 ms
Total Talk Time (CUSTOMER): 502861 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/9aa21714-339c-4c63-8916-07410f644660_20250421T13:56_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yeah, so this is [PII] calling.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I have your insurance through the temp service I work for.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I had 1000 points today at [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] The place is called Bloomington Bloomington Internal Medicine.
[CUSTOMER][NEUTRAL] It's here in [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEGATIVE] They didn't take me to the appointment because they don't think this is gonna pay for my doctor's appointment, this insurance.
[CUSTOMER][NEUTRAL] Because they say that
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] They're not in the network and I tried to tell the woman that she needs to call the number.
[CUSTOMER][NEGATIVE] To verify the, the, get paid for that, they don't think they're gonna get paid from the doctor visit today.
[CUSTOMER][POSITIVE] Good.
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's 02.
[CUSTOMER][NEUTRAL] 58
[CUSTOMER][NEUTRAL] 6238.
[AGENT][NEUTRAL] OK, and what was your date of birth?
[CUSTOMER][NEUTRAL] No [PII].
[AGENT][NEUTRAL] OK, and uh, Mr. [PII], do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, just need two other pieces of information. What is your address?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your email address.
[CUSTOMER][NEUTRAL] No, I don't have no.
[AGENT][NEUTRAL] Uh, looks like you gave us a Gmail.
[CUSTOMER][NEUTRAL] No, I think that's the one my friend made up for me, I think, but I, well, I'm in the car here at daughter's always outside of.
[CUSTOMER][NEUTRAL] In my car here, so that's at home.
[AGENT][NEUTRAL] OK. Um, I see.
[AGENT][NEUTRAL] So you're going in for an office visit, is that right?
[CUSTOMER][NEUTRAL] Well I'm saying I was supposed to have my daughter's appointment today at [PII], and they've been trying to
[CUSTOMER][NEUTRAL] Figure out.
[CUSTOMER][NEUTRAL] I don't know what they were doing I.
[CUSTOMER][NEGATIVE] I told that woman at the front desk, she's supposed to call that number on the back of the insurance card to verify that I'm covered, but she didn't do that. She's trying to get a hold of her boss.
[CUSTOMER][NEUTRAL] The mile from her
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] So now they're gonna make recancel because they don't think you're gonna pay them for the visit.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] I'm, I'm covered for the visit though, right?
[AGENT][NEUTRAL] Do you have
[AGENT][NEUTRAL] Um, let me look at your
[CUSTOMER][NEUTRAL] Well, I'm gonna get.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] What's that?
[AGENT][NEUTRAL] Um, let me look at your policy. Hold on one moment, OK?
[AGENT][NEUTRAL] Um, looks like this is not a guarantee of payment. It's a basic outline of your policy. So for physician's office visits, the max we'll pay is $50.
[AGENT][POSITIVE] Um, I'm happy to
[CUSTOMER][NEUTRAL] What do you mean?
[AGENT][NEUTRAL] The the maximum that we'll pay under this policy is $50 for the office visit.
[CUSTOMER][NEUTRAL] Oh, I don't know how much it is.
[CUSTOMER][NEUTRAL] For is it for an office visit.
[CUSTOMER][NEUTRAL] Well, I got a, I got their phone number here. Do you wanna take it down and call them and tell them or find out.
[AGENT][NEUTRAL] Sure, what's their number?
[CUSTOMER][NEUTRAL] Well, if you can find anything from them or not.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Did you talk to somebody in particular or just anyone?
[CUSTOMER][NEUTRAL] That was the one at the front desk.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I say I'm, I'm still here at the doctor's office. I'm just here in my car, using my cell phone.
[AGENT][NEUTRAL] OK, let me uh let me put you on hold and I'll call her real quick, OK?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Alright, I don't know the woman's name, but.
[AGENT][NEUTRAL] That's OK. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Bloomington Internal Medicine. If this is a medical emergency, please hang up and dial [PII] or proceed to the nearest emergency department.
[CUSTOMER][NEUTRAL] If you are calling for a prescription refill, please utilize our online portal for your refill requests.
[CUSTOMER][NEUTRAL] Listen carefully to the following options.
[CUSTOMER][NEUTRAL] If you are a physician or calling from a physician's office, please press one.
[CUSTOMER][NEUTRAL] If you are calling to schedule an appointment, please press 2.
[CUSTOMER][NEUTRAL] If you are calling for a prescription refill, please press 3.
[CUSTOMER][NEUTRAL] If you're calling with a medical question, please press 4.
[CUSTOMER][NEUTRAL] If you have a billing question, please press 5.
[CUSTOMER][NEUTRAL] Wait while I transfer your call.
[CUSTOMER][NEUTRAL] Bloomington Internal Medicine, this is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII]. Uh, my name is [PII]. I'm with American Public Life, and we have a, uh, patient that I'm trying to help. He has a doctor's appointment scheduled at [PII] and said that, um.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, do you know who I'm talking about?
[AGENT][NEUTRAL] Let me get his name.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So he does have a hospital indemnity plan, um, that this, that we cover for him.
[AGENT][NEUTRAL] Um, in which the benefit, so they do use multiplan or PHCS, not sure if you're in network with them.
[AGENT][NEUTRAL] Um, but he does have a benefit for office visits that pays $50 for an office visit.
[CUSTOMER][NEUTRAL] Um, yeah, so like our whole thing was if we're not credentialed with them like we can't, we're we're not promised payment.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And I don't like if I go into our program that we use to collect copays and stuff like that I can't even find that is there like a.
[CUSTOMER][NEUTRAL] Carrier for that for the is it ADL or APL?
[AGENT][NEUTRAL] Yeah, we're APL.
[AGENT][NEUTRAL] We're APL and then multiplan is the PPO network he can utilize.
[AGENT][NEUTRAL] Um, so that provides a discount, a PPO discount, and then.
[AGENT][NEUTRAL] This plan will pay $50 for an office visit.
[AGENT][NEUTRAL] And then we do do assignment of benefits. So if you submitted the claim, you would collect payment on it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] I don't even know where to go like I don't even know how to pull that up though.
[CUSTOMER][NEUTRAL] Like I don't know.
[AGENT][NEUTRAL] Well, we typically we, we get a lot of calls from providers' offices and then they present their card.
[AGENT][NEUTRAL] And then you look at the card and there's claims mailing address on it. We have a payer ID fax number.
[CUSTOMER][NEUTRAL] Right, I understand that, but I have um I have to put some sort of insurance in his chart.
[CUSTOMER][NEGATIVE] Um, along with his card, like I have to scan in his card and put his numbers in and all of that and if I can't even if I can't pull it up in my system, then I don't have anything to put in his chart.
[AGENT][NEUTRAL] OK. I guess I'm a little confused.
[CUSTOMER][NEUTRAL] So like, so there's certain like some people like have they bring in something and it's like you almost never hear of it and they're we're like oh that's Aetna it's part of Aetna so we can look under Aetna or oh that's under that's part of United Healthcare and we can look under that um I don't have like an APL here or.
[CUSTOMER][NEGATIVE] Like I have no idea. I'm at a complete loss. I have no idea where to look.
[AGENT][NEUTRAL] Well, it's not major medical, so it's a supplemental policy.
[AGENT][NEUTRAL] So I guess, I guess my question is, is there not a capability for data entry to set up a group or?
[AGENT][NEUTRAL] In your system.
[CUSTOMER][NEUTRAL] And so I think our billing does that uh that's not something that we do, um.
[AGENT][NEUTRAL] Yes I, I, I.
[AGENT][NEGATIVE] I've just never heard of a provider not accepting someone because they don't have something in their system.
[CUSTOMER][NEUTRAL] So if we're not cre credentialed with that with the insurance if if our providers aren't credentialed with an insurance then we don't take it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I guess I'll tell him that to find a different provider if you're not able to do data entry into your system of APL.
[CUSTOMER][NEUTRAL] Yeah, like there's nowhere for me to like let's see.
[CUSTOMER][NEUTRAL] Give me a second here.
[AGENT][NEUTRAL] I guess my confusion is too when he called to make the appointment, nobody talked to him about this. I
[CUSTOMER][NEUTRAL] He was in his self pay.
[CUSTOMER][NEUTRAL] So he came in on an acute basis back in October and he had a different insurance and then when he called in for this one at that point he was self-pay and that's what was put into his chart.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So then he came in with a different insurance.
[CUSTOMER][NEUTRAL] So I don't, is there any way I could have, is there a good contact number that I could get you directly and have my boss call you?
[AGENT][NEUTRAL] Um, yeah, I mean, you can call.
[CUSTOMER][NEUTRAL] Because she might be able.
[CUSTOMER][POSITIVE] Yeah she might be able to do yeah what's a good number for you that she can call you?
[AGENT][NEUTRAL] Um, so it's, it's our [PII] number, so [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, sorry, let me get the last part. I started just a while back.
[AGENT][NEUTRAL] When she calls, she'll she'll just ask for me. My name is [PII], last initial or [PII] initial to last name is [PII]. Let me get the number though. Hold on one moment, so sorry about that.
[CUSTOMER][NEUTRAL] OK, no, that's OK.
[AGENT][NEUTRAL] It's Monday. I'm my brain, my brain's drawn a blank.
[CUSTOMER][NEUTRAL] Same, same.
[AGENT][NEUTRAL] I haven't had my coffee. I need some coffee.
[CUSTOMER][NEGATIVE] I have and it didn't help.
[AGENT][POSITIVE] Great.
[AGENT][POSITIVE] OK, so sorry about that. OK, so let me get that. Oh my goodness, I can't believe I'm OK, [PII], and then I'm happy to also, um, did so do y'all have a copy of his card?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I that's the thing when we go to scan it in I have nothing to attach it to like I can't that doesn't come up in my system.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's my whole issue, so yeah, can I, if I, so my boss's name is [PII], if I could have her reach out to you um she I think she would be able to understand this a little bit better than I am.
[AGENT][NEUTRAL] OK, yeah, that's, that's no problem. Yeah, just, just trying to help him and he's trying to be seen, so.
[CUSTOMER][POSITIVE] Yeah, yeah, no, I understand, and I mean he was very patient in here, um, I, yeah, uh, let me call my boss and I'm gonna have her call you.
[AGENT][POSITIVE] OK, that sounds good. Thank you so much.
[CUSTOMER][POSITIVE] You're welcome thank you.
[AGENT][NEUTRAL] All right, bye.
[CUSTOMER][NEUTRAL] Mm bye.
[AGENT][POSITIVE] OK, so sorry about that. I'm trying to get this all squared away, so I guess.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] From my understanding, you were seen back in October, but you had different insurance that they did have in the system, and now you have, this is a different insurance, so they don't have it in their system. So she's gonna have her boss call me.
[AGENT][NEUTRAL] To verify the coverage that you have.
[AGENT][NEUTRAL] Um, I don't know. Yeah, I don't.
[CUSTOMER][NEUTRAL] Well, the
[CUSTOMER][NEUTRAL] There's
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Well, no, the insurance I had in, well I didn't have none in October.
[CUSTOMER][NEUTRAL] When I went to see [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But the insurance I had when I was working before I quit in September.
[CUSTOMER][NEUTRAL] Well uh
[CUSTOMER][NEUTRAL] A different insurance. So I work through a temp service which is
[CUSTOMER][NEUTRAL] That Hamilton Riker.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And this is the insurance that they got me.
[CUSTOMER][NEUTRAL] Oh now do a temp service.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] APL.
[AGENT][NEUTRAL] Right, yeah, so I explained to her what type of insurance this is, what we would pay, etc. but she has to get things verified through her cost.
[CUSTOMER][NEUTRAL] What did she say?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] You say you only pay $50 for the office visit. How, how much did you say the office visit is?
[AGENT][NEUTRAL] Oh, I don't, I don't know how much. No, I didn't ask her. uh uh. I'm not sure how much they charge for an office visit.
[CUSTOMER][NEUTRAL] Did you ask her?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, I know she don't want to take blood work is her daughter cause they gotta check my sugar and cholesterol and everything. So does this insurance cover blood work do they take?
[AGENT][NEUTRAL] Um, let me see what else it covers.
[AGENT][NEUTRAL] So for, let's see.
[AGENT][NEGATIVE] Uh, it doesn't, there's not a benefit for labs.
[AGENT][NEUTRAL] So if they're doing labs, there wouldn't be a benefit for that because this is a really limited policy.
[AGENT][NEUTRAL] It does
[CUSTOMER][NEUTRAL] Oh what you mean?
[AGENT][NEGATIVE] So it doesn't cover lab lab work. So if they're taking your blood, it's not gonna cover that.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Why is that?
[AGENT][NEUTRAL] this is the type of policy it is, it's.
[CUSTOMER][NEUTRAL] I mean this your attempt.
[CUSTOMER][POSITIVE] So this your temp services got this insurance for everybody.
[CUSTOMER][NEUTRAL] And the company we work for is over here in [PII].
[CUSTOMER][NEGATIVE] I can't figure out
[CUSTOMER][NEGATIVE] Why this insurance don't pay up or why would they have an insurance company that don't pay nothing?
[AGENT][NEUTRAL] Well, it's just a very limited policy.
[CUSTOMER][NEUTRAL] The stamps are
[AGENT][NEUTRAL] So it, I don't, I don't know their reasoning for that. That's, I mean, that's the
[AGENT][NEUTRAL] That's their business decision. I'm not sure on that. I can't really answer that question.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, I'll have to call them and find out, I guess.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] This temp service and file.
[AGENT][NEUTRAL] But I
[AGENT][NEUTRAL] I, I did have, tell her to give me a call and I'll explain to her what policy you have, um, but it looks like right now you'll probably have to reschedule, so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Cause I'm not sure when she's calling me.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's what she said, because it was at [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] When I was supposed to see him.
[AGENT][NEUTRAL] I'm so sorry about that, yeah, but she, she is gonna give me a call and I'll explain to her just like we talked about what, what you have under this policy.
[CUSTOMER][NEUTRAL] Well, so what else do I have then?
[CUSTOMER][NEUTRAL] Can you see it in the computer there? Well, all this covers, if it don't cover doctors appointment. I like I say, they need to do blood work cause I need my sugar checked, and that's the only way they can do that, [PII].
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] If you
[AGENT][NEUTRAL] Um, yeah, I'm not, I'm not, I assume so. I'm not sure what how else they could check sugar without a laboratory.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I mean you can't check your.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So what's this insurance cover? Does it cover the hospital if I have to go to the ER sometime? Does it cover the emergency room with even?
[AGENT][NEUTRAL] Yeah, it's a, it's a very limited policy. So for emergency room, it only pays $50.
[AGENT][NEUTRAL] Urgent care will pay $50.
[CUSTOMER][NEUTRAL] Oh what do you mean that.
[AGENT][NEUTRAL] That's what it pays.
[CUSTOMER][NEGATIVE] It should pay the whole bill.
[AGENT][NEUTRAL] Yeah, it's, this isn't, it's not a major medical policy, so it's not like Aetna or United Healthcare. This is just like a limited hospital plan.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEGATIVE] So it has very limited benefits.
[AGENT][NEUTRAL] If you're admitted to the hospital, pay $500. If you're confined to the hospital, it pays $50 per day.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Surgery, it'll pay $250 so it's, it just pays a real limited amount if you need to be in the hospital or need services.
[AGENT][NEUTRAL] Again, it's not, it's not like a major medical plan.
[CUSTOMER][NEUTRAL] Yeah, I don't know, I have a.
[CUSTOMER][NEUTRAL] When I go home I'm gonna have to call that temp service and.
[CUSTOMER][NEGATIVE] Ask them why they have insurance that, that don't pay nothing for it.
[AGENT][NEUTRAL] But like I said, when they call, I'll explain to them what benefits you do have, and then I'm sure they'll give you a call back and see if you'd like to reschedule.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Well, leave me here at the doctor's office. Well, I'll probably reschedule it.
[CUSTOMER][NEUTRAL] I, I have to go back and reschedule today, I'm saying, so.
[AGENT][NEUTRAL] Yeah, I mean, I know they, they won't be able to see you right now, so I mean I'll I'll I'll tell them when I talk to them to call you and then y'all can figure out if you want to come in or when you can come in next.
[CUSTOMER][NEUTRAL] All right. Yeah, well, I'll go here and see if she wants me to wait till you talk to them first before they reschedule, we're gonna reschedule today.
[CUSTOMER][NEUTRAL] I'm not so alright yeah I'll go back in here.
[AGENT][NEUTRAL] Yeah, I, I doubt they'll be able to, OK, alright, but, but when I, I'll tell them what you have when they call, OK?
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] OK, well thank, thank you for calling [PII]. I hope you have a good day.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah, you too.
[AGENT][NEUTRAL] OK, bye.
[CUSTOMER][NEUTRAL] But uh.