AccountId: 011433970860
ContactId: b28c5cae-578c-418b-aff0-d0de4d10b0d9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 525739 ms
Total Talk Time (AGENT): 173791 ms
Total Talk Time (CUSTOMER): 223436 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/b28c5cae-578c-418b-aff0-d0de4d10b0d9_20250324T20:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APO Tracy. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I have a question. I have a patient with uh APL, American Public Life, and I'm confused. He also has Blue Cross insurance for his main.
[CUSTOMER][NEUTRAL] Um, he said I'm supposed to build both, but is, is APL secondary or I, I guess I'm confused on what to do. I've never seen this insurance before.
[AGENT][NEUTRAL] OK, so you're trying to check eligibility and see what type of policy this is that the member has with us. Is that correct with APL?
[CUSTOMER][NEUTRAL] Well, um, I do the billing uh for the chiropractor and I just don't know what to do because he said.
[CUSTOMER][NEGATIVE] I have to bill both.
[AGENT][NEUTRAL] OK, ah,
[CUSTOMER][NEUTRAL] And then one
[CUSTOMER][NEUTRAL] But as Blue Cross is his primary, but he said I need to do this because it's like a discount or something. I don't really understand.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How or what to do.
[AGENT][NEUTRAL] So yes, I can help you with this. Yes, I can help you, but I should on the member's policy first so I can see what type of plan they do have. Um, and who am I speaking with, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is uh Doctor [PII].
[CUSTOMER][NEUTRAL] Uh my name is [PII]
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] What number do you want to call?
[CUSTOMER][NEUTRAL] A callback number it's [PII].
[AGENT][NEUTRAL] What is a good callback number for you? Uh-huh.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. And the member's policy number for APL?
[CUSTOMER][NEUTRAL] Policy number is 0257.
[CUSTOMER][NEUTRAL] 3342.
[AGENT][NEUTRAL] OK, thank you. One moment while I get the member's information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Or [PII].
[CUSTOMER][NEUTRAL] [PII]:16.
[CUSTOMER][NEUTRAL] He's [PII], is that [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] I can read his writing.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], that wouldn't be right. That would make him [PII].
[CUSTOMER][NEUTRAL] Well, what's [PII] minus.
[CUSTOMER][NEUTRAL] Yeah, that's why I need their license. OK, let me see if I've got.
[CUSTOMER][NEGATIVE] Oh [PII]d, this is always such a headache.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So it looks like a
[CUSTOMER][NEUTRAL] Could it be [PII], 1980?
[AGENT][NEUTRAL] Mm, no, sir, that doesn't.
[CUSTOMER][NEUTRAL] Or at night
[CUSTOMER][NEUTRAL] [PII]0.
[CUSTOMER][NEUTRAL] He's 45. I've got.
[CUSTOMER][NEUTRAL] Name, phone number, address, Social Security.
[CUSTOMER][NEUTRAL] I've got everything except his birth date.
[AGENT][NEUTRAL] Uh, you can give me his social if you have.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] I need, I need either the full social security number or the, or the correct date of birth.
[CUSTOMER][NEUTRAL] Uh, social security.
[CUSTOMER][NEUTRAL] [PII]8.
[AGENT][NEUTRAL] OK, thank you. So he is a subscriber on the supplemental policy. This is a supplemental policy.
[CUSTOMER][NEUTRAL] Can you give me his birthday?
[AGENT][NEUTRAL] I can't. No, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but this is a supplemental policy to his primary insurance.
[AGENT][POSITIVE] It helps with co-pays, deductibles, and co-insurance amounts of covered services.
[AGENT][NEUTRAL] So, you would file with his primary insurance first and then with APL because we will also have to have a copy of his primary insurance company's detailed explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So then I can send you the Blue Cross information along with a secondary claim form.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Correct. When you find, right.
[CUSTOMER][NEUTRAL] So after I get the Blue Cross information then I.
[AGENT][NEUTRAL] You will need to send once you have filed it with.
[AGENT][NEUTRAL] That is correct, because we have to have a copy of his primary insurance company's explanation of benefits as well when reviewing the claims on this type of policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Very good.
[AGENT][NEUTRAL] And then once we have processed our claim, [PII]chael here at APL, we, we have a portal that you should be able to check claim status in. You're welcome to call, but you can also, um, again, you should be able to check it in our portal and our portal website is secured.
[CUSTOMER][NEUTRAL] You know, if I, let, let me stop you right there, um.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Not to complain, but I'm the doctor. I do the billing, I do everything.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And I do not have time for this kind of thing. I probably won't even accept them as a patient because I can't go through this headache because a half hour out of my day is not worth it. So do I have to do anything once I send the secondary in? How will I know? Do I have to then go to a website and check on all this?
[CUSTOMER][NEGATIVE] Because this is a nightmare. I, I don't have time for this or will he know or will I get a EOB back from you or do I have to actually check in?
[AGENT][NEUTRAL] It's just like any other.
[AGENT][NEUTRAL] Yes, no, it's just like any other insurance. You will have an explanation of benefits mailed to you.
[CUSTOMER][POSITIVE] I'm sorry
[AGENT][NEUTRAL] But you may also, if you wanted to log in, yes. Mhm.
[CUSTOMER][NEUTRAL] If they will mail it to me. OK, so OK.
[CUSTOMER][NEUTRAL] But, but do I need to log in for that, or will I just get an EOB back that says what to do?
[AGENT][POSITIVE] It's just a convenience. It's just a convenience if you didn't want to call, you could log into the portal to check. So that's entirely up to you. You can call or you can log in either way.
[CUSTOMER][POSITIVE] Oh thank you. Good good.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Uh, I don't wanna call and I don't want to log in. Will you send me the information?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] There will be an explanation of benefits mailed out just like a primary insurance company does once the claim has been processed.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, from, from APL you'll send me, uh, an explanation of benefits also.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, thank you. That's what I wanted to know. Yeah, I, like I said, I just don't have time in my day for, for this kind of thing, so thank you.
[AGENT][POSITIVE] Well, you're welcome. Is there anything else, Michael, I can help you with today?
[CUSTOMER][POSITIVE] No, have a good day.
[AGENT][POSITIVE] OK, well, you too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye bye.