AccountId: 011433970860
ContactId: a120e7d5-4bae-427a-9d03-03315da3c340
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 509109 ms
Total Talk Time (AGENT): 150655 ms
Total Talk Time (CUSTOMER): 169552 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/a120e7d5-4bae-427a-9d03-03315da3c340_20250610T21:34_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. Um, I received a letter from you guys saying you are.
[CUSTOMER][NEUTRAL] Um, you received a claim for my policy, and I'm kinda curious cause I haven't been to the doctor, so I don't know why I would be getting a letter.
[AGENT][NEUTRAL] OK. Does it have a policy number on it or certificate number?
[CUSTOMER][NEUTRAL] No, it's just one of those blank letters that has the date is [PII].
[CUSTOMER][NEUTRAL] And it's your policy holder.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] I, I get them all the time and
[AGENT][NEUTRAL] OK, uh, I can look it up by your last name or social.
[CUSTOMER][NEUTRAL] Uh, last name, please. uh [PII]
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it didn't indicate a policy number on there?
[CUSTOMER][NEGATIVE] No, I get these letters all the time and there's nothing. And it's like, what is the point of that?
[AGENT][NEUTRAL] And you said your first name was [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, yep, [PII]
[CUSTOMER][NEUTRAL] In [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And then can you verify your date of birth for me, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your address and email address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh shoot, and I think my email I have with you guys is [PII].
[AGENT][NEUTRAL] OK, yeah, that's what I've got. And then do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yup.
[CUSTOMER][NEUTRAL] Yep, [PII].
[AGENT][NEUTRAL] OK, let me see if I can locate.
[AGENT][NEUTRAL] Possibly where.
[AGENT][NEUTRAL] Oh, OK. It looks like we received a claim, must have been submitted by the provider for Mankato Clinic for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Looks like maybe some DME supplies. Let me see.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me pull that up real quick.
[CUSTOMER][NEUTRAL] Does it show who the doctor is?
[AGENT][NEUTRAL] Yeah let me get that pulled up.
[AGENT][NEUTRAL] Uh looks like Doctor [PII].
[CUSTOMER][NEUTRAL] Oh, I haven't seen [PII].
[AGENT][NEUTRAL] Um, let me see what this
[CUSTOMER][NEUTRAL] What kind of charge is it?
[AGENT][NEUTRAL] It's just a charge for $11.28. Let me see what they're charging for.
[AGENT][NEUTRAL] Uh, it looks like it's just a medical home program, comprehensive care coordination and planning maintenance of plan. It's used to bill for ongoing care coordination and planning services with the medical home program.
[AGENT][NEUTRAL] Do you do any like in-home durable medical equipment or?
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Are you part of any kind of
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Care planning like um
[AGENT][NEUTRAL] Where like a nurse follows you for any kind of
[AGENT][NEUTRAL] Um, specific disease. Sometimes it's for diabetes or
[AGENT][NEUTRAL] Um, let me see what.
[CUSTOMER][NEUTRAL] Um, I am diabetic, but I don't, uh, I don't treat with her for that.
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] And I can't even remember the last time I seen her, so.
[CUSTOMER][NEUTRAL] And that's weird that it's June that you would just now be.
[CUSTOMER][NEGATIVE] They now be charging my account?
[AGENT][NEGATIVE] Um, I, they, they just sent it in, yeah, just for, like I said, for $11.28 of course we denied it because it's just, it's like uh because of the type of service that it is.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] That's really weird.
[AGENT][NEUTRAL] So there's any kind of like care care plan that that clinic offers you, um, the
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I don't think they even offer anything like that, so that's why I'm kind of like.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Yeah. I don't know. There's a lot of weird stuff and you guys denied another claim too from Doctor [PII]. And, and I have to, do I have to um submit a, a letter in writing?
[CUSTOMER][NEUTRAL] Like it's through the mail in order to attest it.
[CUSTOMER][NEUTRAL] That you guys didn't cover it?
[AGENT][NEUTRAL] Uh, yeah. What date was that for?
[CUSTOMER][NEUTRAL] Um, I don't recall the date, but it's with Doctor [PII]. I don't know if you're able to look at.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, was it for a recent date or sometime back or?
[CUSTOMER][NEUTRAL] Um, it would be the past few months.
[AGENT][NEUTRAL] OK. Um, let me see.
[CUSTOMER][NEGATIVE] Gosh, I'm, I'm terrible at remembering dates.
[AGENT][NEUTRAL] Oh no, you're fine. Um, I was gonna say I have the clinic number if you need that, if you'd like to call them and inquire what what exactly this was for.
[AGENT][NEUTRAL] Um, it's on the claim.
[CUSTOMER][NEUTRAL] Oh no, I, no, I have it in my phone, so.
[AGENT][NEUTRAL] OK, let me, um, let me pull up this other one, see what we've got going.
[AGENT][NEUTRAL] OK, it looks like we denied one for March. Let me see what that is.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] If it's like 500 and some that's probably the one.
[CUSTOMER][NEUTRAL] I'm asking about.
[AGENT][NEUTRAL] OK, yes, it, it was for an office visit and then.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Other procedure, it looks like.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, and I'm, and I'm stumped on that one because when I called about it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The lady I talked to said because I didn't have it done in a doctor's office or whatever.
[CUSTOMER][NEUTRAL] And I'm like, well, where did I have it done in the parking lot?
[CUSTOMER][NEGATIVE] You know, I'm, I'm, I'm really stumped.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?