AccountId: 011433970860
ContactId: c256d02b-1a6a-4c9c-bb24-db159f2293df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 583400 ms
Total Talk Time (AGENT): 154515 ms
Total Talk Time (CUSTOMER): 360350 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/c256d02b-1a6a-4c9c-bb24-db159f2293df_20250519T21:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is um [PII]. I have a gap policy with you guys. Um, there was a claim for my son, um [PII]. I, do you need my, let me give you my policy number. Sorry, I'm, I'm jumping ahead and I know that's what you need. Give me a second. Let me give you my stuff.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, 222. How's your Monday going?
[AGENT][POSITIVE] It's going good. How about yours?
[CUSTOMER][POSITIVE] Oh, I'm glad it's going good for you.
[CUSTOMER][NEGATIVE] What the hell of all Mondays. OK. um.
[CUSTOMER][NEUTRAL] You know, sometimes it's a hit or miss, and today it was a mess. OK.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, OK, let me give you my policy number which is 249.
[CUSTOMER][NEUTRAL] 4804.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And this is for your son. May I have your son's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Thank you and I do need to verify the mailing address and the email address listed on file.
[CUSTOMER][NEUTRAL] Sure, my home address is [PII]. Email should be [PII].
[AGENT][NEUTRAL] Thank you and may I have a callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Yes, absolutely, I'm at work, so [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you stated that there was a claim that was submitted in and you had a question in regards to it?
[CUSTOMER][NEUTRAL] Correct, so actually a claim was submitted and they sent payment to Baptist Hospital for Data Service 12-17.
[CUSTOMER][NEUTRAL] Um, 2024 it was an ER visit. Uh, the copay was 1000, um, APL sent 750, and then right after sent $250 but that check, which I have the check number, they never received, so I found out at the end of April on [PII] I actually called and I spoke to um [PII].
[CUSTOMER][NEUTRAL] And um she was able to tell me that um the the track number everything and then when I called uh Baptist building they never got it um so I had to call Baptist um I'm sorry I had to call back to APL and let them know that, let you guys know that they never received the check. I think believe I spoke to, let me see, I spoke to one second.
[CUSTOMER][NEUTRAL] Uh, I can't, I spoke to so many people. I spoke to a [PII], oh, [PII], [PII], that's who I spoke to, um, so yeah, the check never cleared, so they were going to, um, I guess, uh, send a new payment, I guess. Um, however, I just got another invoice for the two remaining 250 from [PII], um, [PII] [PII] I should specify.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, are they saying they still didn't receive the payment?
[CUSTOMER][NEUTRAL] They still haven't gotten it so I just wanted to check and see if a new check was maybe cut and if you have that number then I can, you know, call them and give them that number to see if they've received it because I just got an invoice. I know sometimes those things get mailed out before something's been received um but I just wanted to double check because it has been a bit since I spoke to anybody there.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It looks like as of right now, they have received a total of $2000 from us.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So the first checks that they stated they hadn't received, we never did um.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] That stuff has not been voided out because they haven't stated that they haven't received it. So then there was a new payment that was also issued.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] On [PII] or [PII].
[AGENT][NEUTRAL] In the amount of the full $1000 again, so that is actually a total of $2000 that has been issued to this provider.
[AGENT][NEUTRAL] But let me check to see.
[CUSTOMER][NEUTRAL] And it was to West Kendall Baptist, date of service [PII].
[AGENT][NEUTRAL] So for data service of [PII], let me pull it up because it's saying [PII], let me check.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, there were two different.
[CUSTOMER][NEUTRAL] Correct. [PII]'s children was separate, cause he was transferred over there.
[CUSTOMER][NEUTRAL] Um, so it was a different, he had, they had him at the, at the West Kendall Baptist Hospital ER and then they had to transfer him since he's a minor to [PII] for further testing.
[AGENT][NEUTRAL] Let me pull both of these up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that's [PII].
[AGENT][NEUTRAL] Here we go.
[CUSTOMER][NEUTRAL] So they sent, what, from what I understand, they sent one check to West Kendall Baptist Hospital ER on the [PII]. That was for 750. That cleared, that got paid, was received, and it cleared. But a second check was soon 2 weeks, exactly 2 weeks later for the remaining $250 was sent by APL on the [PII]. That check, which I have the track number, um.
[CUSTOMER][NEGATIVE] [PII] never received and it supposedly was not cleared, at least at the end of April, it hadn't cleared yet.
[AGENT][NEUTRAL] OK, so I do see that the 14,250 has not been cashed, but see, since we haven't received anything from that provider stating that we, they did not receive that check, we can't do anything with that.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So they, they're.
[CUSTOMER][NEUTRAL] OK, so in other words, call their billing and have them reach out to you is basically what needs to happen.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, they're gonna have to contact us because we're just not going to void a checkout and say for instance, they did receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I could do that.
[CUSTOMER][NEGATIVE] Correct, which I told them that back in the end of April, and they haven't done it. It's ridiculous.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, I will let them know.
[CUSTOMER][NEUTRAL] OK, I will let them know. I'll call them again. I, that's so again they sent an invoice and I had already told them. I spoke to two people there and let them know, um, I gave them the check number and everything and said, listen, this is the check number.
[AGENT][NEUTRAL] And see it's weird
[AGENT][NEGATIVE] It's weird that they received the first one.
[CUSTOMER][NEGATIVE] Um, and they said, well, has it cleared and I called back to APL. They said no, it hasn't cleared, so I called them again. I called the hospital back and I said no, you're right, it doesn't show that it's cleared, but you need to call them and let them know so they can cut void that one and reissue another payment.
[CUSTOMER][NEGATIVE] And they obviously have not done it.
[AGENT][NEUTRAL] And what is so weird about it, so the one that.
[CUSTOMER][NEUTRAL] So I will call them.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Was the amount of 750, it went to the exact same billing address as the one for 250.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I know it. Believe me, I don't doubt it at all.
[CUSTOMER][NEUTRAL] I don't doubt it at all. They have lately, I don't know what's going on with that billing department, but lately I'm, I we're, I'm an insurance agent, so I manage a lot of, um, you know, groups that have APL and and all kinds of insurance. Oh, you don't wanna.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Even know the things I've been witnessing lately. It's insane. It's insane. I had one client that they kept this a hospital, which usually hospitals are pretty much on top, usually are on top of things. I had two different separate clients calling me telling me that the hospital was telling them that their coverage was inactive and when I called with them, they had an old insurance information from early [PII] that they were trying to process too.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Oh, wow.
[CUSTOMER][POSITIVE] So I don't doubt what you're saying in the least. So I will, I'll definitely reach out to them and make sure that they contact you guys.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, as long as we get something stating that they have not received payment or if they were just to call in to let us know that they, you know, to just check for the status of that claim and say that they're missing a payment of 250, then that would be a, you know, we can be able to review that.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, excellent.
[CUSTOMER][POSITIVE] OK, excellent I will do that thank you so much for your help. I hope you have a good evening.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome and thank you so much, [PII] for calling American Public Life. You enjoy the rest of your evening as well.
[CUSTOMER][POSITIVE] Thank, thank you. Bye-bye.
[AGENT][POSITIVE] Thank you, bye.