AccountId: 011433970860
ContactId: c1574833-2e47-41b9-a54b-a4dce0943252
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 678710 ms
Total Talk Time (AGENT): 165290 ms
Total Talk Time (CUSTOMER): 433451 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/c1574833-2e47-41b9-a54b-a4dce0943252_20250331T19:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I sent bano, please. I sent a claim via email, um, to you guys, I believe that we're part of your insurance and then
[CUSTOMER][NEUTRAL] My health care provider, uh, or my child's health care provider told me that that basically gave me um some mail that came from you to her office that had all the information that I sent over email.
[CUSTOMER][NEUTRAL] Like with our policy number and then like my super bill from my therapist and my son's super bill to their therapist. So I'm just confused on what's going on over there and why my information is being sent over to like
[CUSTOMER][NEUTRAL] Uh, other people.
[AGENT][NEUTRAL] May I have your policy number?
[CUSTOMER][NEUTRAL] And then also
[CUSTOMER][NEUTRAL] Yeah, um, my policy, like I guess what I want to know is, OK, my policy number is [PII].
[AGENT][NEUTRAL] OK, that is not our policy number.
[CUSTOMER][NEUTRAL] OK, so then I don't understand how on the back of my insurance card I got your the email to send to you guys.
[AGENT][NEUTRAL] OK, because we do not.
[CUSTOMER][NEUTRAL] Like I'm just really confused then because this is.
[CUSTOMER][NEUTRAL] OK, so you AP right, but also why are you guys not my.
[CUSTOMER][NEGATIVE] My, um, my address is on that, so if you guys got a claim that wasn't mine, why are you sending it to a medical person to send it to me is also what I'm concerned about.
[AGENT][NEUTRAL] May I have your first and last name and I'll try to pull you up in our system.
[CUSTOMER][NEUTRAL] The policy number, the policy's under my husband's name. His name is [PII], and his birthday is [PII], no sorry, [PII], so [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you spell the last name again?
[CUSTOMER][NEUTRAL] Yeah, [PII]
[AGENT][POSITIVE] Thank you. One moment. And can I have a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] And [PII] did not pull up in our system. One moment.
[CUSTOMER][NEGATIVE] OK, yeah, I'm just confused. Like I called the number on the back of the card and they told me to email my claims to a certain email and I was like this is weird. I haven't heard back. No one there's no check in the mail. There's no like correspondence over email, nothing and then today I.
[CUSTOMER][POSITIVE] Took my kid to a therapy session, and his therapist was like, oh, I got, I also got something for, for you in the mail. She's like, I'm so sorry. It was addressed to us. I didn't realize it had your like, you know, she was like, and so I'm just really confused, and she stapled it all together.
[AGENT][NEUTRAL] And I apologize for that. We don't send insurer's information to the provider at any time and we do not utilize the email to submit a claim. So do you know the email?
[CUSTOMER][NEUTRAL] OK, so I'm, I'm just confused. It says [PII] are you American Public Life?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It says American Public Life Expanding the Benefits Horizon [PII] delivered via USPS mail to Bethesda Play Therapy. Dear regarding [PII] [PII], dear business partner, the enclosed information was submitted to APL. However, we're unable to locate the policy with the information provided. If you'd like us to further research our files, please send the following information, including a copy of the insurance ID card and any recent name changes, marriage marriage, or divorce.
[CUSTOMER][NEUTRAL] And then the the insurance that I have is PHCS.
[AGENT][NEUTRAL] OK. So do you
[CUSTOMER][NEGATIVE] Just like utterly confused by all of this.
[AGENT][NEUTRAL] Do you have a group number?
[CUSTOMER][NEUTRAL] It's PHCS let me see.
[CUSTOMER][NEUTRAL] Um, I have it in my bag. Give me one second.
[CUSTOMER][NEUTRAL] OK, way in the in the kitchen trash kitchen trash goes in the kitchen bano.
[CUSTOMER][NEUTRAL] Uh, one second, I'm sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Oh my God, why is this car?
[CUSTOMER][NEUTRAL] OK, it says PHCS group ID G1203274.
[AGENT][NEUTRAL] OK, that's not our number either. Who is, let's see, let's try a social security number.
[CUSTOMER][NEUTRAL] Um, it says plan name at the Americare 500.
[AGENT][NEUTRAL] That
[CUSTOMER][NEGATIVE] I don't know how I got your guys' email. I can tell you who I what email I sent it to as well. She's like, really, this is just like I'm like, who the hell am I sending things to and how did I get connected to a person who told me.
[CUSTOMER][NEGATIVE] It's like super frustrating.
[CUSTOMER][NEUTRAL] Give me one second.
[CUSTOMER][NEUTRAL] do
[CUSTOMER][NEUTRAL] They sent me to customer support at [PII].
[AGENT][NEUTRAL] No, ma'am. That is not us at all.
[CUSTOMER][NEUTRAL] So then if I send that to you then, how did you guys get this email and how was that sent over because it like the system claim form that I received is that the woman who sent me it was just like I got one from APL.
[AGENT][NEUTRAL] And then does it have Medlink claim form on it?
[CUSTOMER][NEUTRAL] MetLink
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, I don't know what it says.
[CUSTOMER][NEUTRAL] Hospital and Everyday Solutions claim for, I don't know, this is what I was sent to. I'm just so confused by, I think her name was [PII].
[CUSTOMER][NEUTRAL] [PII], me, me, me, me, [PII], was it [PII]? I believe it was [PII].
[CUSTOMER][NEUTRAL] [PII] claim form [PII] [PII] member services.
[CUSTOMER][NEUTRAL] Business Workers of America's Association claim support [PII].
[AGENT][NEUTRAL] And that is not us. It sounds like maybe that is the broker or the agent for the group, maybe?
[AGENT][NEUTRAL] Or would it be his employer?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] No, he's not, he's self-employed. I just feel like this person has no clue what they're doing then.
[AGENT][NEUTRAL] Yeah, cause I do apologize, that is not us.
[AGENT][NEUTRAL] And I'm searched through everyone with the same last name.
[AGENT][NEUTRAL] And I'm not pulling up.
[CUSTOMER][NEGATIVE] Yeah, that's OK. I'm just so annoyed that like.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] I'm just so annoyed that these people gave me this thing. It's like how
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEGATIVE] It's really confusing.
[AGENT][NEGATIVE] Yeah, and I went through everything and there's nothing.
[CUSTOMER][NEGATIVE] Really confusing.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, it's probably, then I don't know what this person is talking. I'm just gonna do it's on the back. And now we got a new card, medical.
[CUSTOMER][NEUTRAL] Bill
[CUSTOMER][NEUTRAL] Right, right. Is, is your claim?
[CUSTOMER][NEUTRAL] Medical bill [PII] or is it?
[AGENT][NEUTRAL] No, the old email that we used to use was [PII].
[CUSTOMER][NEUTRAL] OK, but you're, you're not part of PHCS network then.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Is PHPS your primary insurance maybe?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I, I, he's the only one I have right now.
[AGENT][NEUTRAL] OK, so that sounds like that would be the primary.
[CUSTOMER][NEGATIVE] I'm just, I'm just so confused.
[CUSTOMER][NEUTRAL] Right, but I don't know how Lord.
[AGENT][NEUTRAL] Yeah, and I apologize. I don't have.
[CUSTOMER][NEGATIVE] I never can.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEGATIVE] It's just it's, it's, it's just infuriating how complicated they make these things in the [PII] so that you like you can't make a claim. It's just, it's really
[CUSTOMER][NEGATIVE] Really terrifying.
[AGENT][NEUTRAL] And that sounds like one of those private healthcare systems, maybe. I'm not for sure if there's
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Multiplan providers under that umbrella or not?
[CUSTOMER][NEUTRAL] Yeah, I guess I'm just gonna try to figure this out, um, OK.
[AGENT][NEUTRAL] I do apologize for that. So if it did come from?
[CUSTOMER][NEGATIVE] No, I mean, it's not your fault, clearly, I, but it's just super crazy that like I mean luckily I didn't have anyone's social security number on those files, so like if they're just being sent to like whoever that's just, that's just is what makes me really concerned and kind of angry at APL. So I just like I don't know if there's someone I can talk to to be like, can you guys not do this? Or like if you see that there's a claim, can you send it to the person who's making the claim not to.
[AGENT][NEUTRAL] Sent around.
[CUSTOMER][NEUTRAL] The provider because
[CUSTOMER][POSITIVE] I mean, luckily this woman is like, you know, decent human being.
[AGENT][POSITIVE] Exactly. And I do apologize.
[CUSTOMER][NEUTRAL] As I assume most people are, but
[CUSTOMER][NEUTRAL] Right, so I don't know.
[AGENT][NEUTRAL] And from my understanding when we get things that we cannot locate in our system, if it was mailed to us, we would return to the person that mailed it. We would not.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Right, I didn't, I emailed like why wouldn't they send me an email or like I feel like this is whoever got the email or like call me, like my phone number's on every page of this document.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So it sounds like whoever received the email mailed it in to APL. It's what it sounds like because we never received an email.
[CUSTOMER][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, so I apologize. This is a lot.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] To be dealing with trying to submit a claim.
[CUSTOMER][NEGATIVE] This is annoying.
[CUSTOMER][NEGATIVE] Um, and now I'm getting an automatic, OK, at least these people send you an automatic response. That's better than the other people. I'm just gonna like have to email that girl and just be like, I just want you to know that this happened and I'm really annoyed.
[CUSTOMER][POSITIVE] OK, thank you. I really appreciate your help. What was your name?
[AGENT][NEUTRAL] Moi, last initial is [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you. I appreciate it. Just wanna say thank you.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] OK. Thank you. All right.
[CUSTOMER][NEUTRAL] OK bye bye.
[CUSTOMER][NEUTRAL] Yeah