AccountId: 011433970860
ContactId: bc03e1e0-6f62-439d-afee-00a40382876f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355769 ms
Total Talk Time (AGENT): 152525 ms
Total Talk Time (CUSTOMER): 186659 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/bc03e1e0-6f62-439d-afee-00a40382876f_20250203T21:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, we previously had insurance um with you guys and no longer do, but I'm kind of trying to take care of some old uh medical bills and I had gotten, um, an explanation of benefits, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And for um some of the the bills that were um were on there they were marked with like a number 2 which means that um you need to get itemized statements from the service provider. Yeah, so I'm just I'm just checking to see if if you guys have gotten anything from the provider or if I need to follow up with them because I'm still they're like put this in the collections and I don't know what's going on.
[AGENT][NEUTRAL] Further information, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure, OK, yes, I'll definitely check on the statuses of those um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And then um can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you and are you the group admin?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, um, can I have that group number please?
[CUSTOMER][NEUTRAL] Yes, um, let's see here.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Um, alright, there's a policy number on here.
[CUSTOMER][NEUTRAL] Um,
[AGENT][POSITIVE] We can do that. I can get it that way.
[CUSTOMER][NEUTRAL] OK, alright, the policy number is 02396205.
[AGENT][NEUTRAL] OK, and this was the policy for one of the claims we're needing to check, correct?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, is this for your individual policy?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, OK, sorry, I completely misunderstood. Alright, let's see, I'm just gonna verify some information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] It's um [PII]. OK.
[AGENT][NEUTRAL] Um, I've got a different one. It might be because it's a bit older.
[CUSTOMER][NEUTRAL] Do you have the one you probably yeah we moved we moved since um this claim happened that was the old one was the um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, an [PII], yeah, yeah, we've since then.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, perfect, thank you. um, last thing I need is the email address that we've got on file for you uh looks like it's a [PII] account.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and then uh who was this claim for?
[CUSTOMER][NEUTRAL] Yeah. Mhm.
[CUSTOMER][NEUTRAL] So there's a bunch, but that there's two big ones I'm trying to resolve. The one is for uh Gulf Coast Medical Center, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It was for a hospital stay and it was like like $20,000.
[AGENT][NEUTRAL] OK, uh, for which member under this policy?
[CUSTOMER][NEUTRAL] Oh, it was for [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Do you happen to have a claim number or the date of service?
[CUSTOMER][NEUTRAL] I do. I have the claim number here. It's 3476786.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you see that and that looks like that is the only piece of claim information that we have received for [PII] so no we have not received any additional information just yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, so does it just show like on your own like Gulf Coast medical and then you still need like.
[CUSTOMER][NEUTRAL] Um, do I have to contact them and then have them send it to you or how does this work?
[AGENT][NEUTRAL] You can or you can get it from them and send it to us yourself um in which case that's most of the time what people end up doing just because it's easier than relying on somebody else doing it if that makes sense um so if you just tell them that for these dates of services you need those itemized statements that show diagnosis and procedure codes, most of the time they'll just email it to you and then you could just send that right to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK, um, and then can you give me like an email address where I should forward it to?
[AGENT][NEUTRAL] Um, I do have an email. I've got a, uh, fax number if you've got access to a fax machine, um, and then I've got a mailing address.
[CUSTOMER][NEUTRAL] So it's either mail or fax it's not email?
[AGENT][NEUTRAL] Right, yeah, unable to do email. I can give you our email if you'd like, but they don't take claim information.
[CUSTOMER][NEUTRAL] Is that what you're saying? OK, OK, I'll take, OK.
[CUSTOMER][NEUTRAL] OK, alright, just give me the the what um address I should send it to then.
[AGENT][NEUTRAL] OK, mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, is that the Ok [PII] um address? OK, I do have that here. OK, so send it to that address.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK awesome yes.
[AGENT][NEUTRAL] Yes, did you need that fax number as well?
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Um, uh, sure, I don't think I h[PII] that, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah it is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so from your end it shows that like you, you guys haven't seen received anything from them and that's why nothing's being paid or? OK, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Right, uh, nothing for [PII] anyway, that's all I'm looking at. I do just see this one instance of claim information that we received that looks like [PII] of last year and nothing since then.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, OK, alright, so I will contact them and then um send that over thank you.
[AGENT][NEUTRAL] OK, yeah, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think that's it.
[AGENT][POSITIVE] OK, well thanks for giving us a call, [PII]. I hope you have a great rest of your day, of course.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] Thanks. You too. Mm bye-bye.
[AGENT][NEUTRAL] Bye bye.