AccountId: 011433970860
ContactId: cd1fadcc-5cb8-4347-8aec-07253054a99e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 610159 ms
Total Talk Time (AGENT): 205548 ms
Total Talk Time (CUSTOMER): 153283 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/cd1fadcc-5cb8-4347-8aec-07253054a99e_20250414T13:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling EPL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, how you doing?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm fine. This is [PII], and I got like maybe 2 issues to try to get resolved.
[AGENT][NEUTRAL] OK. Yes, sir. I can assist you. Uh, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] I got
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get your policy number, please?
[CUSTOMER][NEUTRAL] Uh, I don't have it because I'm driving. Can I give you my social?
[AGENT][NEUTRAL] Yes, sir. One moment. Let me get to that screen.
[AGENT][NEUTRAL] OK. Thanks for your patience. What's your social, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And is this for medical or dental?
[CUSTOMER][NEUTRAL] Uh, it's gonna be for both, but we can try medical first.
[AGENT][NEUTRAL] OK, I found your sys, your policy. How can I help you?
[CUSTOMER][NEUTRAL] Can I ask you a question? Do I have insurance right now?
[AGENT][NEUTRAL] OK, one moment. Please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] And please verify your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir, as of now, I'm showing that your policy is active.
[CUSTOMER][NEUTRAL] OK, when did it get active?
[AGENT][NEUTRAL] Um, I'm showing the effective date on your policy was [PII] and it's showing that it's still active.
[CUSTOMER][NEUTRAL] OK, cause um.
[CUSTOMER][NEUTRAL] They took payments out.
[CUSTOMER][NEUTRAL] From my account for um February and March, but to my knowledge I didn't have insurance on those dates, so I was wondering why they took the payment out.
[AGENT][NEUTRAL] Yeah, well, I'm showing you had active coverage on those dates.
[CUSTOMER][NEUTRAL] On February and March.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK, they told me I didn't.
[CUSTOMER][NEUTRAL] I talked to the lady, um, so, um, at the April, what is the April then? That's what you just told me it was active for April.
[AGENT][NEUTRAL] Right, I'm showing as of today, um, unless they recently updated this in the system because sometimes um it's not updated until we receive the premium. So based on the premium that we recently received, I'm showing that it's active up to [PII], which is, um, which means that it's active for this month.
[CUSTOMER][NEUTRAL] OK, but as far as um February and March, it wasn't.
[AGENT][NEUTRAL] Let me go back one moment.
[AGENT][NEUTRAL] I'm showing that the payments that we received, it covers it for April and uh for those dates.
[AGENT][NEUTRAL] For February and March.
[CUSTOMER][NEUTRAL] OK, but they, when I went to the doctor, they told me I didn't have insurance, and then when I went to the dentist Friday, they told me I didn't have it.
[CUSTOMER][NEUTRAL] So when I called the agency lady, she
[CUSTOMER][POSITIVE] When did something and she said, oh you should be good now.
[CUSTOMER][NEGATIVE] So my thing is I was trying to see why did they take my payment if I didn't have it.
[AGENT][NEUTRAL] Yeah, I'm showing
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But the doctor said it wasn't active.
[AGENT][NEUTRAL] OK, one moment. I'm looking over the notes. One moment.
[AGENT][NEUTRAL] OK. I'm showing that the last call we received um from a provider verifying your benefits was back in January. So I don't even show where they called to verify benefits here recently.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I'm trying, alright, I'm just saying when I went to the doctor, they didn't, they wouldn't see me because they said it and then when I talked to the lady.
[CUSTOMER][NEGATIVE] About it who handled my case, she said something different also. OK, I got another issue. I got a bill that was hit and they saying I owe $500 something dollars, but at that time I had insurance. This was for [PII]. Baylor Medical saying I have a bill that wasn't covered by my insurance.
[AGENT][NEUTRAL] Back in [PII], um, do you have the date of service, the exact date of service so I can look it up and see if we received that claim?
[CUSTOMER][NEUTRAL] I really don't have the exact.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] After that, and they never told me about the bill until.
[CUSTOMER][NEUTRAL] Uh, um, what they call collections called me about it Friday.
[AGENT][NEUTRAL] OK, one moment. I'll see if I can find a claim on file uh from Baylor back in [PII]. 1 moment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Was it for an outpatient visit?
[AGENT][NEUTRAL] Or were you admitted? It was outpatient, OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] No, no, no, yeah, it was off, yes, ma'am.
[AGENT][NEUTRAL] OK, I'm not showing any hospital um claims on file from Baylor back in [PII].
[AGENT][NEUTRAL] So you may want to contact them and um make sure that they have your information so they can
[CUSTOMER][NEUTRAL] OK, what about [PII]?
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] But I'll give him a call and find out.
[AGENT][NEUTRAL] Yeah, and just let them know that there's no timely filing limit and they can always resubmit the claim. We won't reject it because of um the date of service, so.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm not showing any um hospital claims on file for [PII] either.
[CUSTOMER][NEUTRAL] No, it wasn't a hos I didn't stay in the hospital. It was just a um regular clinic visit.
[AGENT][NEUTRAL] Right, but the clinic will um submit a claim for the facility. You'll receive claims um for the facility charges and claims from the provider, from the doctors that you saw.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] OK, alright, let me give him a call. I really appreciate your help, man, ma'am.
[AGENT][POSITIVE] No problem. Um, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Um, I went to the dentist, um, Saturday, I mean, Friday.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And they told me uh they did the X-rays and everything, but then they also told me now that I didn't have no insurance coverage.
[CUSTOMER][NEUTRAL] Like the medical did.
[AGENT][NEUTRAL] Right, I'm sure
[AGENT][POSITIVE] Right. I'm showing that your dental is showing active as well.
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Let me look up that and see if they call us one moment. [PII].
[AGENT][NEUTRAL] OK, yeah, I'm showing that we received a call, let's see, from [PII].
[AGENT][NEUTRAL] In the provider's office and your benefits was actually faxed to her. They verified your benefits and they faxed them over to her.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh yeah, you may wanna give her a call and let her know that you verified with us that we did um verify your benefits and we faxed them over to her. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] No ma'am, I really appreciate you.
[AGENT][POSITIVE] OK, no problem, [PII]. Thank you for calling APL. You have a great day. Mm bye.
[CUSTOMER][NEUTRAL] You too, ma'am bye.