AccountId: 011433970860
ContactId: cb73cbff-02d4-4113-8c20-75c5de9de65a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 911419 ms
Total Talk Time (AGENT): 135794 ms
Total Talk Time (CUSTOMER): 376872 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/cb73cbff-02d4-4113-8c20-75c5de9de65a_20250304T17:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name. My name is [PII], and I spoke with somebody yesterday about a claim that I had filed.
[CUSTOMER][NEGATIVE] They said that the claim was paid but the provider is saying they never received the money.
[AGENT][NEUTRAL] I can verify
[CUSTOMER][NEUTRAL] And now
[CUSTOMER][NEUTRAL] What was that?
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Uh, I just, I need to find a way to get you guys to talk to the provider to let them know that y'all have sent them the money.
[AGENT][NEUTRAL] OK, may I have your policy number?
[CUSTOMER][NEUTRAL] Um, sure, it is 233.
[CUSTOMER][NEUTRAL] 43
[CUSTOMER][NEUTRAL] 72.
[AGENT][NEUTRAL] And may I have a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] Sure it's area code [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Can you verify your date of birth, your billing address, and your email, please?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] Um, you said.
[AGENT][NEUTRAL] Mailing address?
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] And your email.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. And do you have the claim number or date of service?
[CUSTOMER][NEUTRAL] Um, yes, so the first data service was on, um, [PII].
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] For future reference you may visit our website at [PII] to check claim status as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I get this pulled up.
[AGENT][NEUTRAL] Looks like this one processed.
[AGENT][NEUTRAL] Was it for Bond Secure Medical Group?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it looks like this one processed under claim number 351-8176.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Without
[AGENT][NEUTRAL] Let me see if it allow me to pull it up.
[AGENT][POSITIVE] Now, and I, right, what I'm seeing right now showed that this check has cleared.
[AGENT][NEUTRAL] So I would have to send it over to finance and they can actually get a copy of that canceled check. But do you have the EOB that went to yourself and to the provider?
[CUSTOMER][NEUTRAL] Um, but I have.
[CUSTOMER][NEUTRAL] Are you looking for the APL EOB?
[AGENT][NEUTRAL] Yes, that show.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That payment looks like it was $1,732.50.
[CUSTOMER][NEGATIVE] Yes, um, I, well, hold on, I just downloaded it, but now I can't find it, uh, files downloads.
[CUSTOMER][NEUTRAL] OK. So, yes.
[CUSTOMER][NEUTRAL] I've got the copy of the EOB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] To do, I mean.
[CUSTOMER][NEUTRAL] They, they were telling me they're like, uh [PII] said that American public life can tell me whatever they want, but they're not showing that it's been paid.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so now I'm, I'm stuck in a he said she said bye.
[AGENT][NEUTRAL] OK, so is there any way that you can call? We can actually click over and call, but I can stay on the phone if you can call them.
[CUSTOMER][NEUTRAL] OK, I can do that. Uh would you mind?
[AGENT][NEUTRAL] Yeah, go right ahead.
[CUSTOMER][POSITIVE] That's all right, let's see what I can do. Hang on one second.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Press one. Otherwise, please remain on the line and your call will be answered in the order it was received.
[CUSTOMER][NEUTRAL] [PII], are you still there?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][POSITIVE] OK, good
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Thank you for your patience. If you would like to receive a call back, press one. Otherwise, please remain on the line and your call will be answered in the order it was received.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hello, thank you for calling customer service. My name is [PII]. May I have your account or guarantor number? Sure, the guarantor number is 103.
[CUSTOMER][NEUTRAL] 886
[CUSTOMER][NEUTRAL] 098
[CUSTOMER][NEUTRAL] OK I have the name of the patient. Yes, [PII].
[CUSTOMER][NEUTRAL] And the date of birth? [PII].
[CUSTOMER][POSITIVE] Thank you very much. Are you the patient? I am.
[CUSTOMER][NEUTRAL] Excellent. Can you tell me how can I help you? Um, yes, I have, um, [PII] from American Public Life on the phone with me. I am trying to resolve an issue where, um, there has been a duplicate payment made on services rendered in [PII] by American Public Life and by myself that you are not showing that uh it was paid by the um secondary insurance company.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Uh, well, in this case, actually, we received adjustment from your secondary insurance, and right now your account balance is 0.
[CUSTOMER][NEGATIVE] I know I should have a credit balance since American Public Life made a payment, but you, uh, my account is not reflecting their payment to you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So they already sent us an explanation of benefits of data.
[CUSTOMER][NEUTRAL] I, I believe so with the check.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Is [PII], could you verify is the EOB go with checks?
[AGENT][NEUTRAL] Yes, they do.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] For how much was the check?
[AGENT][NEUTRAL] The check was for $1,732.50.
[CUSTOMER][NEUTRAL] Mm, yeah, we do not have that on file.
[AGENT][NEUTRAL] Would you like the check number?
[CUSTOMER][NEUTRAL] No, because I mean if the check is not on file I will not be able to look it up with the number.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, what is the date of service that you process that payment? Uh, one, go ahead.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And you told me that it's uh [PII] and some exchange, right?
[AGENT][NEUTRAL] 173 2.50.
[CUSTOMER][POSITIVE] Sounds good
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII], did you have another data service?
[CUSTOMER][NEUTRAL] I did, um, [PII].
[CUSTOMER][NEUTRAL] Would have been the 2nd 1.
[AGENT][NEUTRAL] That's processed to bomb secure as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Well, there is weird because we do not receive even the explanation of benefits. There is not any explanation of benefits of that secondary insurance. We just have the one from Blue Cross Blue Shield.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Both checks are showing cleared in our system by Bond Secure Medical Group of Greenville.
[CUSTOMER][NEUTRAL] So in
[CUSTOMER][NEUTRAL] In this case, is there any possibility that you can resend that explanation of benefits to us?
[AGENT][NEUTRAL] Sure. Do you have a fax number?
[CUSTOMER][POSITIVE] Absolutely
[CUSTOMER][NEUTRAL] Um, let me look it up. OK, uh, so the.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mm, OK, so the fax number is [PII].
[CUSTOMER][NEUTRAL] 362.
[CUSTOMER][NEUTRAL] 22
[CUSTOMER][NEUTRAL] 24
[AGENT][NEUTRAL] I have [PII]. [PII], is it OK if I fax both EOB's over?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I'll fax those right over.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And would um this be able to tie my account to a check that was cleared by Bonsa courses?
[CUSTOMER][NEUTRAL] Sir,
[CUSTOMER][NEUTRAL] I'm sorry? Um, with her sending the EOB, is that gonna, uh, would that be able to tie the check that that Bonds of courses has cashed to my account?
[CUSTOMER][POSITIVE] That's correct. In this case, actually, um, let's see.
[CUSTOMER][NEUTRAL] Actually, um, I am going to send your account to review, uh, because at least the, well, your insurance is sending the explanation of benefits to our correspondence email at the time that we received that information. They are going to go ahead and make the necessary adjustments in your account. So that's why I will send your account to you just for you to know that normally takes between 30 and 45 business days. So for now the only thing that you need to do will be wait.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm sorry, what is your first name?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII], thank you.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I just faxed those over, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you very much. I really appreciate it. So yeah, just keeping you just have to wait and as well as your account will be on hold while we do all this process, right? OK, sounds good thank you to both of you. Yeah.
[AGENT][POSITIVE] You're so welcome and thank you for calling American Public Life.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] All right, bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.