AccountId: 011433970860
ContactId: b41ec45d-11b9-4148-a73f-206e59d7c557
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1692910 ms
Total Talk Time (AGENT): 219189 ms
Total Talk Time (CUSTOMER): 801628 ms
Interruptions: 4
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/b41ec45d-11b9-4148-a73f-206e59d7c557_20250303T17:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I needed to call you guys and possibly 3 way call um Edge Park, which is where I get my daughter's diabetic supplies from, um, because they needed to verify that you guys were our secondary insurance.
[AGENT][NEUTRAL] OK. Um, let me have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Uh-huh, my name is [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, Miss [PII]. And do you have a policy number for me?
[CUSTOMER][NEUTRAL] Yes, policy number is 01749311.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's through my husband's job. His name is [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And may I have your date of birth and mailing address for verification?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And our address is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that they're needing to verify this information for one of your dependents and what's what's the name and date of birth of that dependent.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, that dependent is [PII]. Her date of birth is [PII].
[AGENT][NEUTRAL] OK. And do you have the a representative on the line or you're gonna do the three-way call right now?
[CUSTOMER][NEUTRAL] No, well, I don't know how to do the three-way call. I have the number that I can give to you. Do you know how to do that?
[AGENT][NEGATIVE] I can, but you will have to be the first one that answers the call because they don't talk to us without permission.
[CUSTOMER][NEUTRAL] OK, so how, how do you
[AGENT][NEUTRAL] From the main holder.
[CUSTOMER][NEUTRAL] I don't know how to do a 3 way.
[AGENT][NEUTRAL] OK, uh, what is the number that you're trying to dial?
[CUSTOMER][NEUTRAL] OK, the number, um, that's a direct line to their billing is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, we can try that and see if they will answer. Um, OK, and if not, uh, for future, they can always call this number to get this information, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, let me try it. Uh-huh.
[CUSTOMER][NEUTRAL] Well I think that they did try but I I don't, I don't really know why they were unsuccessful, um, to verify it on their end, so that's why they suggested that I call you guys and then just three way and call them so that um that we can just kind of speed up the verification process.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and you said it was for what type of service was a DME? Global Medical Equipment?
[CUSTOMER][NEUTRAL] So now, so yeah, so this is um the company that we're calling their Edge Park and so they are who we go through to order my daughter's diabetic pump supplies.
[AGENT][NEUTRAL] No, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's DME that's doable medical equipment, and I don't see a cover benefits for that. Let me go ahead and pull your benefits before we do all that, OK? One moment.
[CUSTOMER][POSITIVE] OK, OK, that sounds good.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, it's gonna be one more minute. I just need for the paperwork to pull up, OK?
[CUSTOMER][POSITIVE] You're OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] You're waiting.
[AGENT][NEUTRAL] All right, here it is.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He's an outpatient, outpatient services going to be for.
[AGENT][NEUTRAL] Yeah, this one doesn't have coverage for durable medical equipment, so probably that's why they say they was not able to verify it.
[CUSTOMER][NEUTRAL] OK, OK, so, so what do we need to do, um, what do I need to do with them then? Because I tried to see if they could just remove the APL because it was just added by my husband just thinking that maybe it would come in handy, um, but they said that they couldn't remove it because it was noted as a secondary insurance to our primary insurance I don't know it was.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It seems, of course, harder than I wanted it to be but um I don't, I don't really know what I need to do now.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, uh, if they just need for us to just say that it is a secondary, we can say that if they still need to send a claim, they can still do that. It's just gonna be denied. Um, so if you still want me to call them just to let them know that it's a secondary, but it doesn't have any coverage, um, I can do that. Is that what you wanna do? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I mean, is that, is that OK? I mean, because then.
[AGENT][NEUTRAL] I mean, yeah, it's fine, it's fine.
[CUSTOMER][NEUTRAL] Hopefully they'll get there because really what the problem is why there's a sense of urgency is because my daughter needs her pump supplies like because she's almost out of what she has and the order that we placed last week is being held up because of this um and so I'm just trying to get.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Her order process so that we can get her supplies you know in a timely manner that's all so if you calling could kind of hurry up their ability to like maybe drop the APL part of it and then we could just get that order processed um maybe that would help you know what I mean?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, we can try and see if um that will help. OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Edge Park. This call may be monitored or recorded, but espanol or primaueve. If you know your party's extension, press 1. If you're a healthcare professional or an insurance company, press 2. All other callers press 3 or remain on the line.
[CUSTOMER][NEUTRAL] If you are calling regarding your breast pump order, press 1. If you need to place, change, return, or confirm an order, press 2. If you are an insurance provider or doctor's office, press 3. If you are calling to make a payment, press 4. If you are calling about a bill you received or a refund, press 5. For order status, press 6. To repeat the menu, press 9.
[AGENT][NEUTRAL] Miss [PII], you can go ahead and make the decision on which ones you want to go to, OK?
[CUSTOMER][NEUTRAL] If you are calling regarding your breast pump order, press 1. If you need to place, change, return, or confirm an order, press 2. If you are an insurance provider or doctor's office, press 3. If you are calling to make a payment, press 4. If you are calling to make a payment or if you have questions about a bill you received, press 1.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] To place an order, press 2. If you received an incorrect item, need to return a product, or have a lost package, press 3. For all other inquiries, including checking status of an order, press 4.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Can I press 4. To make a payment or if you have questions about a bill you receive.
[AGENT][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] After you talk with a representative, a short survey may be available for you to rate the service you received. To take the survey, just stay on the line after the representative hangs up. A representative will be with you shortly.
[CUSTOMER][NEUTRAL] There are currently 5 calls ahead of you.
[AGENT][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Hey, while we're waiting for them to pick up, is it possible for you to look at our coverage and see if with APL, does that help with um doctor's visits like co-pays and stuff like that?
[AGENT][NEUTRAL] It doesn't. And this is only for outpatient facilities, hospital, urgent care, surgery centers, and diagnostic centers.
[AGENT][NEUTRAL] And physical therapy.
[CUSTOMER][NEUTRAL] OK, OK, OK, that's good to know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I think my husband just didn't realize.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] To the extent of like what the APL actually helps with.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] A representative will be with you shortly.
[CUSTOMER][NEUTRAL] There are currently no other calls ahead of you.
[CUSTOMER][NEUTRAL] Inle Edge Park. My name is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, uh, yes, ma'am. I, um, I am on the phone with, um, in my secondary insurance, uh, representative because I was having an issue with you guys and a pump supply order um that we needed to verify our secondary insurance.
[CUSTOMER][NEUTRAL] Um, so I kinda had like a 3 way so that they could tell you, um, like so that we could get the verification for that secondary insurance. Does that make sense? That is, let me have you speak to the insurance department just one minute for me and thank you so much guys for one second. OK, thank you.
[CUSTOMER][POSITIVE] A representative will be with you shortly.
[CUSTOMER][NEUTRAL] There is currently one call ahead of you.
[CUSTOMER][POSITIVE] A representative will be with you shortly.
[CUSTOMER][NEUTRAL] There are currently no other calls ahead of you.
[CUSTOMER][POSITIVE] Thank you for calling Edge Park. My name is [PII]. Who do I have the pleasure of speaking with?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII].
[CUSTOMER][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] Um, I have, uh, a representative for our secondary insurance on the line with us. Um, I have a current order for pump supplies for my daughters through Edge Park, and there was a hold up with like needing verification of our secondary insurance.
[CUSTOMER][POSITIVE] Um, so I have that person on the phone so that they can communicate with you guys. So hopefully we can just kind of hurry past this and get my daughter's pump supply order taken care of.
[CUSTOMER][NEUTRAL] Let me go ahead and get you connected um to the provider department to see if they can do that over the phone um do you mind holding while I get them on the phone for you?
[CUSTOMER][NEUTRAL] Well, you are the 2nd person that I've been handed to for this.
[CUSTOMER][NEUTRAL] I'm order placement um so if you need to place an order or check the status of an order, but I don't work in insurance.
[CUSTOMER][NEGATIVE] Well somebody was transferring me to insurance and then you answered and so I assumed that. Uh, I'm think I'm thinking because it is Monday and the calls have been very high so that so that the whole time isn't too long they're sending you over to a representative. Let me get someone on the phone. I'm gonna stay on the line instead of transfer you to make sure they answer OK? that way you're not sent over to another regular customer service agent.
[CUSTOMER][POSITIVE] OK, thank you very much. You're welcome ma'am please hold.
[CUSTOMER][POSITIVE] Hello, thank you for holding. I'm still just waiting for them to answer the line. I haven't forgot about you. I'll make sure we get you to the correct representative. OK, thank you. Please hold very much. You're welcome.
[CUSTOMER][POSITIVE] Thank you for calling Edge Park. This is [PII]. With whom do I have the pleasure of speaking with today?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, my name is [PII].
[CUSTOMER][NEUTRAL] And I'm not showing your account with this phone number.
[CUSTOMER][NEUTRAL] OK, uh, it's maybe under my daughter's. Uh, her name is [PII] and her number is [PII].
[CUSTOMER][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you. And any time I view an account, I have to verify I've got an address of [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Aetna commercial with um American Public Life but that's not been verified yet that's just been added. So that's that's why I'm calling um I have an APL uh representative on the line with us um because I was trying to get that verification um set up because we need her pump supply.
[CUSTOMER][NEUTRAL] OK and is this a new insurance or let me see. No, it's not my husband thought that he was being helpful and he added it on our account online and it's not helpful at all um so I just need the APL portion to be verified so that we can just hurry up and process the order that she placed last week.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Secondary insurance American Public Life is the insurance, the group number. OK, let's see.
[CUSTOMER][NEUTRAL] And may I have the representative's name from American Public Life?
[AGENT][NEUTRAL] Yes, my name is [PII] last initial M.
[AGENT][NEUTRAL] From APL?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. And may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, Miss [PII].
[CUSTOMER][NEUTRAL] Alright, let me take a look here.
[CUSTOMER][NEUTRAL] Being ordered
[CUSTOMER][NEUTRAL] The patient is ordering the A4230s, the AutoSoft infusion sets.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let's see, so we have Aetna commercial as the primary covering.
[CUSTOMER][NEUTRAL] 80% after deductible's been met.
[CUSTOMER][NEUTRAL] And then there's a $7350 deductible with the primary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, does American Public Life cover the deductible?
[AGENT][NEGATIVE] Uh, not for doable medical equipment. This one doesn't have any benefits for doable medical equipment.
[CUSTOMER][NEUTRAL] OK, so it's not, they don't cover deductible, and how much will they cover after patients' primary deductible has been met?
[AGENT][NEUTRAL] We do not
[CUSTOMER][NEUTRAL] The remaining 20%?
[AGENT][NEUTRAL] No, um, there is no coverage under this policy for durable medical equipment.
[CUSTOMER][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] So can we just remove APL from this account?
[CUSTOMER][NEUTRAL] Yeah I'll notate that on here one moment. Yeah, please I mean my husband thought that he was being helpful and um it's OK and it wasn't helpful so uh with that information knowing that it doesn't cover these medical supplies um I was hoping that with that representative on the phone that you know you could see that and then we could just remove it and then just kind of.
[CUSTOMER][POSITIVE] Be in progress with this order.
[CUSTOMER][NEUTRAL] All right, and then um with regards to American public life, um.
[CUSTOMER][NEUTRAL] Is there a reference number for the call today?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date, Miss [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Do you need any other information from me, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yep, one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so I removed that from the account.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is there any?
[CUSTOMER][NEUTRAL] And then it's going through that.
[CUSTOMER][NEUTRAL] And the only other thing is that we'd have to collect towards the deductible, so. OK.
[CUSTOMER][NEUTRAL] Alright, and I show $300 to be applied to the Visa credit card, and that will get applied when the order ships. Let's see, so that's removed. Next step it's going to go to is medical documentation. Let me take a look here and see if I can get this.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][NEUTRAL] OK, so it is verifying that um I've got to get a supervisor will be reviewing that uh we need to mark this as urgent patients office supplies.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Take a look and see if I can.
[CUSTOMER][NEUTRAL] Alright, so it is already marked as urgent, so they have to review that information that I wrote down here that per the um American Life representative they do not cover DME so I did notate that on the account and removed it.
[CUSTOMER][NEUTRAL] OK, thank you, you should be getting it, yeah, a phone call or email message letting you know it ships, and then once the order ships we submit the claims to the insurance and the additional amount due you would be billed, and I do have to let you know that there is a past balance on the account and you're making monthly payments it looks like.
[CUSTOMER][NEUTRAL] Alright, anything else I can help you with today? Uh, do I need to take care of any balance?
[CUSTOMER][NEUTRAL] Take a look and see.
[CUSTOMER][NEUTRAL] It looks like this is towards that um past balance for the um.
[CUSTOMER][NEUTRAL] Did she recently get a pump?
[CUSTOMER][NEUTRAL] Maybe last year or the year before.
[CUSTOMER][NEUTRAL] No, she's had her pump.
[CUSTOMER][NEUTRAL] Like we're almost done paying that pump off.
[CUSTOMER][NEUTRAL] Oh, that might be what it's showing as, uh, if you're almost done then that's what it's well I show like $700 though on the account.
[CUSTOMER][NEUTRAL] 702 50.
[CUSTOMER][POSITIVE] I believe the $700 is the balance that we have remaining uh to pay off. All right perfect all right is there anything else I can help you with today? I don't think so. I really appreciate your help.
[CUSTOMER][POSITIVE] You're welcome thank you for calling Edge Park have a wonderful day take care bye bye. Thank you so much OK bye bye.
[AGENT][POSITIVE] Thank you for holding Miss [PII].
[CUSTOMER][POSITIVE] Yes, thank you so much for staying on for that. I really, really appreciate it.
[AGENT][POSITIVE] OK. You're welcome.
[AGENT][NEUTRAL] No problem. Yeah, I didn't want to hang up because if I hang up, I'd probably hang up the whole call since I initiated the call.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] That's why I say in the end.
[CUSTOMER][POSITIVE] OK, gosh, I think, thank you so much. I really do appreciate that because then I mean just you being there telling her that, you know, I feel like it was good because then she was able to remove it, so that's perfect.
[AGENT][NEUTRAL] You want.
[AGENT][POSITIVE] Mhm. All right. Well, I'm glad to help. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] I don't think so. I really appreciate you so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a good afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.