AccountId: 011433970860
ContactId: a7c3f620-0321-4e4d-b37b-0bdc16aaf233
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455760 ms
Total Talk Time (AGENT): 187433 ms
Total Talk Time (CUSTOMER): 227058 ms
Interruptions: 4
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/a7c3f620-0321-4e4d-b37b-0bdc16aaf233_20250121T13:55_UTC.wav
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[AGENT][POSITIVE] Morning thank you for calling
[CUSTOMER][NEUTRAL] I want the component.
[AGENT][NEUTRAL] Let me help you.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Yes, good morning. Thank you for calling APL. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, [PII], I have a question. Let me give you my name, my policy number, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. My name is [PII].
[AGENT][NEUTRAL] Mhm. And that policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] And the policy number will be or where is it? Where is here? OK you check number policy number 02291422.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. Can you verify your date of birth and current mailing address, please, ma'am?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you and also do you mind verifying your email and phone number?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] And phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right. Thank you, Mr. [PII]. I appreciate that verification. And how can I help you today?
[CUSTOMER][NEUTRAL] OK, it's reference, uh, OK, I see, uh, every time that I go to take blood, my insurance pay part of the, of the, um, I mean.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of the bill and then I say I have a 2nd uh supplemented uh.
[CUSTOMER][NEGATIVE] Insurance and they send you the insurance, but I see that you didn't pay, and I don't know why.
[AGENT][NEUTRAL] Do you know what the data services or claim number?
[CUSTOMER][NEUTRAL] Let me give you
[CUSTOMER][NEUTRAL] OK, uh, here says check number, policy number, reference number. No reference number is the same total bill charge insurance claim number 353-5887.
[AGENT][NEUTRAL] Claim, claim number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, let me take a look, look at that now we did pay.
[AGENT][NEUTRAL] Quest Diagnostics $42.16 for that data service of 10 to 2024.
[CUSTOMER][NEUTRAL] I think
[CUSTOMER][NEUTRAL] Yeah, but I see, I had a bill from
[CUSTOMER][NEUTRAL] From request that I have to pay 18,240.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, because, OK, the code was 36415. And here I see, oh, I have another one that is a claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 353-7495
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it is there.
[AGENT][NEUTRAL] Now that one we did pay $8.56. Now you know on the secondary policy we pay toward the deductible or co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Let
[AGENT][NEUTRAL] So depending on how your primary insurance processes the claim.
[AGENT][NEUTRAL] That is what's determined to process the claim and pay, so we pay toward the deductible, co-payer, co-insurance.
[CUSTOMER][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And that is
[CUSTOMER][NEGATIVE] But why my insurance didn't pay anything? Because here it says charged one, it was $35 the other one was, so I had to call my insurance to see why they didn't pay it.
[AGENT][POSITIVE] Yes, ma'am. Now we paid you, uh, I'm gonna pull that claim up, bear with me just one second and let me just check something for you.
[AGENT][NEUTRAL] I'm gonna pull the one up for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When I see one date is [PII] and [PII].
[AGENT][NEUTRAL] Or you wanna look at those dates of service? Because I have two claims pulled up one for [PII] and one for [PII]. Did you want to look at another date of service?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, this [PII], which one it is?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get that pulled up real quick.
[AGENT][NEUTRAL] Now the one for [PII], that's the one that we paid the $8.56 to.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] I don't you shut.
[AGENT][NEUTRAL] And we pay according to how your primary insurance processes the claim.
[AGENT][NEUTRAL] But let me take a look and
[CUSTOMER][NEUTRAL] no
[CUSTOMER][NEUTRAL] That was so creamy and not watery.
[AGENT][NEUTRAL] So on this claim for [PII].
[AGENT][NEUTRAL] That um
[AGENT][NEUTRAL] $8.56 was applied to your deductible, and that's what we paid.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, but, but I, I, but why I have a deductible when it's a, I, I go to the primary and the, you know, the, um, I mean, uh the, the doctor and the doctor sender.
[CUSTOMER][NEGATIVE] Blood test, why I have to pay, I don't understand. So I had to call my insurance then.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes ma'am, that would be your best bet because we pay according to how they process the claim.
[CUSTOMER][NEUTRAL] OK. Let me, let me call my insurance then.
[AGENT][NEUTRAL] Well, it's
[CUSTOMER][NEUTRAL] Because it shouldn't be any, any, any.
[AGENT][NEUTRAL] Any payment for you?
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEGATIVE] Right, uh, it will be, I pay my doctor, you know, whatever it's $50.30 dollars, uh, uh, my co-payment. But then, you know, you go and they send you things to do. So I don't understand. Let me, let me call my insurance first then.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, well, it would be a pleasure to assist you further if, if you need anything, don't hesitate to call us, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] My pleasure, Mr. [PII]. I hope you have a lovely day.
[CUSTOMER][NEUTRAL] [PII], let, let me, let me ask you something, because right now um on the [PII] I'm gonna do a surgery for my eyes because they're the, you know, uh, and the, and the, my insurance already approved the, the.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And then whatever they don't pay, you're gonna pay or have to meet.
[CUSTOMER][NEGATIVE] It's deductible, but I don't understand.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK, so it depends on what your insurance applies to your deductible amount, but on this policy we can pay up to $1000 per calendar year towards your deductible or co-pay or co-insurance.
[CUSTOMER][NEUTRAL] O in a small area.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So be sure that they have your APL information so they can submit that claim to us.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] there's so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] My pleasure. Now we'll need to tell you that any benefits given over the phone is a verification coverage, not a guarantee of payment.
[AGENT][POSITIVE] It just simply means we can't process the claim before we have it in the in-house, but it has been a pleasure to assist you, Miss [PII], and if you need anything further, never hesitate to give us a call.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] OK