AccountId: 011433970860
ContactId: c527b438-036a-47c0-9bfc-7ffbb7d0b26a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1137619 ms
Total Talk Time (AGENT): 190059 ms
Total Talk Time (CUSTOMER): 347542 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/c527b438-036a-47c0-9bfc-7ffbb7d0b26a_20250505T15:03_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] I think this stolen. I have a cancer claim there. My policy is 0073688888.
[CUSTOMER][NEGATIVE] I called before to check on the status, and the girl told me that I have to get an itemized bill from my hospital. Now, I sent in an itemized bill.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And this is my 2nd claim. The first one I sent in, which was fine. Nobody said it wasn't acceptable. It was the same style of bill. It was showing my name on it and showing the uh codes.
[CUSTOMER][NEUTRAL] Um, for the service and all of that, and they did pay on that claim. Now she's saying that I have to get another bill. I called the hospital. They don't know what other bill they need to send us because I want you to take a look at it and see if the information I got was correct to look at this bill to see if it's acceptable.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I can definitely help you with your bill. And Ms. [PII], may I have your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, what you said address [PII]. What was it again?
[AGENT][NEUTRAL] And the, the, oh, it's OK, the email address?
[CUSTOMER][NEUTRAL] Forgot to ask me.
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] Thank you and all the information provided is a verification of benefits, not a guarantee of payment. Um, do you mind if I place you on just a brief hold while I look at the um claim and see what's going on?
[CUSTOMER][NEUTRAL] Yes, and one other thing just to keep in mind, I don't want them to finalize this claim out because there's another bill that's coming it's supposed to be in the mail and I would like it to just be all together. Well, go right ahead please check on it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] That's the [PII]. OK, that's not me. OK, so what now?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 4:15.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, uh.
[AGENT][POSITIVE] Alright, thank you so much for holding. I apologize for that wait. So, yes, I do see the difference between the two. so for one, the itemized bill is needed. If you like, I can reach out to Northside.
[AGENT][NEUTRAL] And let them know what we're requesting, but the reason your first claim versus this one was was paid because your first claim had about 40 pages of notes and your bill that even though it's not on the bill, the diagnosis code was still within the documents you received, so they were still able to um get the diagnosis or see the diagnosis, which is what they're asking for the itemized bill for for this claim.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, so we can go ahead and pay out or get the decision, but I can call Northside.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What could you reach out for me?
[CUSTOMER][NEUTRAL] But yeah, could you reach out for me because they sent me the same bill again. So maybe I'm saying it wrong or whatever. Can somebody help me?
[AGENT][NEUTRAL] Yes, um, do you mind if I place you on just a brief hold? I'm gonna call them on the other line.
[CUSTOMER][NEUTRAL] Yes please and tell them they have two bills, one for February and one for March, and you wanna have both in because there's another amount for $800 and I think $44 that needs. I have not received it yet. OK, go ahead.
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling the Northside Hospital Business Office. Please listen carefully as our menu options have recently changed. To continue in English press one at any time, pair continue in espanol.
[CUSTOMER][NEUTRAL] For your convenience, our automated system is available 24 hours a day. It can be used to check your account balance, request a copy of your bill, hear insurance payment information, here previous patient payment please hold on while I transfer your call to a representative.
[CUSTOMER][NEUTRAL] Thank you for calling the Northside Hospital Business office. Please listen.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes, I
[AGENT][NEUTRAL] Thank you for holding. Um, what number do you have for Northside because the number I have, it just keeps, no matter what number I push, it just keeps saying the same thing over and over. I can't get to anybody.
[CUSTOMER][POSITIVE] All right, stay right there. I'm gonna get you somebody. Hold on for me one second.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm just trying to get back upstairs one minute.
[AGENT][POSITIVE] Oh, take your time.
[CUSTOMER][NEUTRAL] OK that's.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] The number
[CUSTOMER][NEUTRAL] To get directly to somebody because I called them and I got them [PII].
[AGENT][NEUTRAL] OK, [PII]. Sorry, I was choking.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, well, I'm gonna call them on the other line. Hold on one moment, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Northside Hospital with Northside Hospital Business office. How may I help you?
[AGENT][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from American Public Life. How are you?
[CUSTOMER][POSITIVE] I'm doing good. How are you doing?
[AGENT][NEUTRAL] I'm doing good. Um, we have a mutual patient. Um, I'm trying to get either the UBO4 form or the surgery bill, just
[AGENT][NEUTRAL] Y'all itemized bill that has the diagnosis, procedure and all the charges on it, so we can um process our claim.
[CUSTOMER][NEUTRAL] Um, you're gonna have to send in um.
[CUSTOMER][NEUTRAL] If a request for that or the patient can contact our medical records.
[CUSTOMER][NEUTRAL] You're not, you're her insurance.
[AGENT][NEUTRAL] Right, typically we don't need a
[CUSTOMER][NEUTRAL] You say you're calling from America Packet Life?
[AGENT][NEUTRAL] Right. Usually we don't need to release the information for a bill because we're paying the bill. Um, there was a claim filed.
[CUSTOMER][NEUTRAL] But you're a third party, right?
[AGENT][NEUTRAL] I mean, she's on the line as well. We just need the bill so that we can pay it. It's not like medical records.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] She's got
[CUSTOMER][NEUTRAL] That's where she would need to get the claim form. If you're a third party, we don't, we're not gonna send it to you. She has requested herself to send it to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] She's on the line as well. I'm just, she didn't know how to ask for what we needed, so I'm just trying to help her.
[CUSTOMER][NEUTRAL] So she would need to call them.
[CUSTOMER][NEGATIVE] Yes, I'm on, I'm here. I um I requested it before. They sent me a statement and I sent it to my insurance company, but it's not the right thing. They said that whatever she's telling that they need, what I am asking for, I, you're sending it to me, but I'm still not getting what the insurance company needs. Yeah, the only thing I we can send out is the itemized bill if you want to get the claim form.
[AGENT][NEUTRAL] Yes, yes, and
[CUSTOMER][NEUTRAL] You have to call and request it from medical records to send it to you.
[AGENT][NEUTRAL] OK, no, that's, that's, that's not what she's asking.
[CUSTOMER][NEUTRAL] I said that.
[AGENT][NEUTRAL] So you all are sending her her patient.
[CUSTOMER][NEUTRAL] You said that you'll be 94.
[AGENT][NEUTRAL] UBO for a universal bill.
[CUSTOMER][NEUTRAL] I cannot send that out. It has to come from medical records.
[CUSTOMER][NEUTRAL] OK. All right. I tell you what, uh, that's OK. Let me give you another number which is medical record and you stay on the line for then we can talk to them. There's another number I have for them. Or um can you verify, ma'am, the number for medical record for us?
[CUSTOMER][NEUTRAL] Yes, um, the number is 404.
[CUSTOMER][NEUTRAL] 851.
[CUSTOMER][NEUTRAL] 8772.
[CUSTOMER][POSITIVE] OK, mhm. OK, OK. All right. OK, thank you so much. I appreciate you. OK. OK, bye bye. OK, I'm gonna, yes, thank you, ma'am. I'm going to make a call myself and could you stay on the line please?
[AGENT][POSITIVE] Yes, I'll stay on the line.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, let, let me see because this is, this is crazy here. Hold on one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, go back over.
[CUSTOMER][NEUTRAL] Lord, have [PII]. I don't wanna lose you.
[AGENT][NEGATIVE] Oh no, I'm not gonna hang up. I'm not going nowhere. If we do get disconnected, I'll call you back.
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] OK, alright, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Are you still with me?
[AGENT][NEUTRAL] Yes, ma'am, I'm here.
[CUSTOMER][NEUTRAL] OK, right, um, I'm just going around in a circle with that person. I'm trying another line. Stay with me. Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh boy, I tell you.
[CUSTOMER][NEUTRAL] Alright let's see 4.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh God.