AccountId: 011433970860
ContactId: ab8922de-832e-482a-9c04-66f722372e4f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 980820 ms
Total Talk Time (AGENT): 308335 ms
Total Talk Time (CUSTOMER): 339507 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/ab8922de-832e-482a-9c04-66f722372e4f_20250206T20:06_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], excuse me, [PII], this is [PII].
[CUSTOMER][NEUTRAL] And um my policy number with you folks is 00639063.
[CUSTOMER][NEUTRAL] Where you can get all the information. Up until now, my uh
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The billing company.
[CUSTOMER][POSITIVE] Has sent me the itemized bill with all the codes and details of the surgeries performed.
[CUSTOMER][NEUTRAL] They cannot do that now. They have to send it directly to you or get permission from you to send it to me. And what they need is a fax number and an email number.
[AGENT][NEUTRAL] OK, so for claim information we um.
[AGENT][NEUTRAL] I would prefer that they do not email claim information because email is not secure and we want to protect your health information.
[AGENT][NEUTRAL] Um, they can actually fax the information directly to our claims department.
[AGENT][NEUTRAL] And I can give you that fax number if you're ready.
[CUSTOMER][POSITIVE] I am ready.
[AGENT][NEUTRAL] Mr. [PII], that fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] 365.
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942 3.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And that will give them permission then to send the information directly to me so I can file it with you.
[AGENT][NEUTRAL] Now that fax number is so if they want to send the um itemized bills directly to us and that's fine if you want them to send it directly to us.
[CUSTOMER][NEUTRAL] Well, I've done it all myself through the years.
[CUSTOMER][NEUTRAL] Because I've filed with you for 30 or 40 years in claims.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] I'm [PII] almost [PII] old.
[CUSTOMER][NEUTRAL] And I want to make sure that you understand and that because there's several documents that have to come with it.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] That I have to send in.
[AGENT][POSITIVE] That's right, absolutely.
[AGENT][NEUTRAL] OK, hang on just a second. Let me check on something for you. Do you mind? Hold on just a second? Thank you.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Give me just one second.
[AGENT][NEUTRAL] And so they are wanting an authorization form from us to be able to send the.
[AGENT][NEUTRAL] Documents directly to you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, if you don't mind holding just a second, I'm gonna check on that for you, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I understand. I like to make sure everything I, I'm, I'm kind of the same way, Mr. [PII]. I kinda like to make sure things are done correctly, so I'd prefer to do it myself.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Yeah, I don't think we would give that information to them, but I'm checking on it for you, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And do you mind if we, while I'm, I'm checking on that, can you verify your current, your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Well, almost happy birthday.
[CUSTOMER][POSITIVE] Mhm thank you.
[AGENT][NEUTRAL] And then what is a good callback number just in case we get disconnected I can get right back to you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you know what, we have an [PII] number on the file. Do we need to update that? No, OK.
[CUSTOMER][NEUTRAL] OK, that's my cell phone.
[CUSTOMER][NEUTRAL] No, it's my cell phone.
[AGENT][NEUTRAL] That's fine.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] Alright, hang on just a second. I'm still checking on to see if we would provide.
[AGENT][NEUTRAL] An authorization form for you. Hang on just a second.
[AGENT][NEUTRAL] Go check one more place.
[AGENT][POSITIVE] I appreciate your patience.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEGATIVE] I just don't know why they would need an authorization form to from us.
[AGENT][NEUTRAL] Is that something new that they've changed, do you know?
[CUSTOMER][NEUTRAL] Apparently so.
[CUSTOMER][POSITIVE] Because I've been able to get this just by a simple phone call.
[AGENT][NEUTRAL] For years, yeah.
[AGENT][NEUTRAL] Did they say that they had an authorization form that you could sign?
[AGENT][NEUTRAL] Or they need it from us?
[CUSTOMER][NEUTRAL] They need it from you.
[CUSTOMER][NEUTRAL] That you can send it to me, that they can send it to me.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] I just not heard of that, but I'm checking on it.
[AGENT][NEUTRAL] Not getting an answer yet. I just, if you'll just keep holding, I'm gonna find out that answer for you.
[CUSTOMER][NEUTRAL] I've been working on this for an hour.
[AGENT][NEGATIVE] Oh my goodness. And see, that just gets exhausting, doesn't it?
[AGENT][NEGATIVE] It does to me when I will keep working on something and it doesn't get resolved.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Because they're going to have to call you, fax you.
[CUSTOMER][NEUTRAL] And then you're going to have to respond to
[CUSTOMER][NEUTRAL] Turnova billing office.
[CUSTOMER][NEUTRAL] And then they'll have to respond to me.
[AGENT][NEGATIVE] Well, that just seems like a lot of nonsense. I'm, I didn't say that. I'm so sorry.
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEGATIVE] Sounds like going around in circles to me.
[AGENT][NEUTRAL] OK, hang on just a second. I'm gonna check one more place, OK? I'm gonna put you on a brief hold. Thank you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], it's [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][POSITIVE] I'm doing well, thank you. Got a question for you. I have an insured on the line. It's policy number 639-063, Mr. [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] He's [PII]. Anyway.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] He has been submitting claims for us, as you can see forever.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now his provider is telling him that he needs an authorization form from us to be able to send the claim information to him.
[AGENT][NEUTRAL] So he can submit the claims. Have you ever heard of that?
[CUSTOMER][NEUTRAL] So he's needing the authorization from us in order for them to send the claims to us.
[AGENT][NEUTRAL] Yeah, an authorization that.
[AGENT][NEUTRAL] It it doesn't make sense to me. We can.
[CUSTOMER][NEUTRAL] No, I haven't heard of that.
[AGENT][NEGATIVE] I haven't either and I don't know what to tell him. I mean, they're telling him they can't send him the information anymore.
[CUSTOMER][NEUTRAL] Yeah, I have not heard of that before.
[CUSTOMER][NEUTRAL] And he's giving them consent. Usually if they let he provide our information to them and give them consent to file the claims on his behalf, they can file it to us, but we don't send any authorization to them to file the claim to us directly.
[AGENT][NEUTRAL] Mm mm so what he's wanting is for them to send him the information because he says there's, you know, yeah, we need more information than just the claim information.
[AGENT][NEUTRAL] You know, when he sends in a claim.
[AGENT][NEUTRAL] And so he wants to get the information from them so that he can get all the information together and then send it to us.
[CUSTOMER][NEUTRAL] So he's just trying to get, he's just trying, he's not wanting them to file a claim with us, he's just trying to get the information from them to file it for him to file a claim with us instead.
[AGENT][NEUTRAL] Right, but they're telling him that they have to get an authorization form from us.
[AGENT][NEUTRAL] To be able to send it to him.
[CUSTOMER][NEUTRAL] No, I definitely have not heard of that before then.
[AGENT][NEUTRAL] OK. Can you talk to Mr. [PII] and
[AGENT][NEUTRAL] Cause I told him I had not heard of him.
[CUSTOMER][NEUTRAL] I can talk to him. All I can tell him, yeah, I haven't heard of that. All I, yeah, you can send them to me. I'm just pretty much gonna tell him that he is, he, yeah, the same thing, yeah, yeah, the same thing.
[AGENT][NEUTRAL] The same thing, huh?
[CUSTOMER][NEUTRAL] Yeah, I'm gonna tell him the the same thing.
[AGENT][NEUTRAL] But bless his heart, what if they're not gonna give him that information?
[CUSTOMER][NEUTRAL] I mean, the only other thing we can do is conference call with them and talk to them and let them know what type of coverage it is. I mean, uh, that's the only thing that I can probably suggest is conference call with the provider to clarify exactly what they're telling him.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Well, if you don't mind talking to Mr. [PII], see if you can.
[AGENT][POSITIVE] Figure it out cause he's really concerned. I, I mean, he's just the sweetest he could be in 97, I'm like, let's help him all we can. Let's start.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Cause I see in notes that we have providers calling to check eligibility, so I'm just curious. Hmm, OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right. Thank you, [PII].
[CUSTOMER][NEUTRAL] You've already verified his information?
[AGENT][NEUTRAL] I have now his uh the callback number in the system is his home number. Now he's calling from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thank you, [PII]. Let me get him on the line. I appreciate it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you for your patience. Um, I have [PII] in our cancer department. She's going to um talk with you further and see what we can do for you, OK?
[CUSTOMER][POSITIVE] Oh my goodness.
[AGENT][POSITIVE] We're gonna try to get you taken care of.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Hi, hello, Mr. [PII], this is [PII].
[CUSTOMER][NEUTRAL] And [PII] had explained to me you had you were trying to obtain some billing from a particular provider for file with American Public Life for me to file. I need.
[CUSTOMER][NEGATIVE] Billing statement and the codes, and they can't give that to me without permission from you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Normally the provider, they wouldn't have any issue with as long as you as the patient is requesting for us to send the claim information to you directly, do you by chance have their their contact number so maybe I can conference call to get.
[CUSTOMER][NEUTRAL] Clarity exactly what they're needing because normally, as long as you as a patient is requesting that information, there shouldn't be no issue for them to provide that information to you directly. We wouldn't give consent. It will be your consent to to request that information as a patient from them.
[CUSTOMER][NEUTRAL] The billing department number is [PII]. OK, I'm gonna repeat it back to you, that's [PII]?
[CUSTOMER][NEUTRAL] Yes, and what's the name of the provider?
[CUSTOMER][NEUTRAL] What's the name of the what's the what's the name of the billing.
[CUSTOMER][NEUTRAL] It's the billing for uh surgeries that I had on [PII] and [PII].
[CUSTOMER][NEUTRAL] was at Turnova Turkey Creek. OK. [PII].
[CUSTOMER][NEUTRAL] OK, I am going to get them on the line, give me one moment.
[CUSTOMER][NEUTRAL] Good afternoon. Hospital billing department. This is [PII]. With whom do I have the pleasure of speaking with today? Hi, [PII]. This is [PII] and I'm calling with American Public Life Insurance Company and I have one.