AccountId: 011433970860
ContactId: cfddd239-894e-442b-bf0c-390703c807e9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407390 ms
Total Talk Time (AGENT): 196394 ms
Total Talk Time (CUSTOMER): 171546 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/cfddd239-894e-442b-bf0c-390703c807e9_20241231T17:20_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][NEUTRAL] [PII], my name is uh [PII], and I'm calling on behalf of my husband. um, he's standing right here. um, you wanna, you can verify everything with him that he I can talk to you.
[AGENT][NEUTRAL] All right. And what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is 01897865.
[AGENT][POSITIVE] Thank you, Ms. [PII]. And if I can just get his, him, him to verify his information and give permission to speak with you, it would be my pleasure to assist you.
[CUSTOMER][NEUTRAL] Sure, I'm here.
[AGENT][NEUTRAL] Oh, hi, Mr. [PII]. How are you doing?
[CUSTOMER][POSITIVE] I'm doing well and you?
[AGENT][NEUTRAL] I'm doing well, thank you for asking. I just need to verify your date of birth, current mailing address, email, and phone number, please.
[CUSTOMER][NEUTRAL] Uh, my date of birth is [PII]. My mailing address is [PII].
[CUSTOMER][NEUTRAL] Um, I'm sorry, what were the other questions?
[AGENT][NEUTRAL] Email and phone number, please.
[CUSTOMER][NEUTRAL] Uh, my phone number is [PII]. Uh, if we get disconnected, you can call back at [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] 19, yeah, my email address is [PII]. That's [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] All right. Thank you, sir. And do you give me permission to speak with your wife, [PII]?
[CUSTOMER][NEUTRAL] I do, here she is.
[AGENT][POSITIVE] All right, and it will be for this call only. And thank you, Mr. [PII]. You have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too.
[CUSTOMER][NEUTRAL] And you said your name's [PII]?
[AGENT][NEUTRAL] Yes ma'am, and that's [PII]
[CUSTOMER][NEUTRAL] OK, um, I have a bill in front of me and I have notes that on [PII] I submitted this to um APL, but I'm not seeing it.
[CUSTOMER][NEUTRAL] Um, it's a Saint Louis Pathology Associate's bill for March of this past year of [PII].
[AGENT][NEUTRAL] Do you have a specific date in [PII]?
[CUSTOMER][NEUTRAL] Um, 35.
[AGENT][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] All right, and what is the bill amount?
[CUSTOMER][NEUTRAL] Um, the buildout is 2:10.
[AGENT][POSITIVE] All right, thank you, Ms [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And our insurance wrote off $137 that was the Aetna write off, and then it, uh, $73 is the bill that, that we owe, um, and it looks like Aetna applied it to the deductible. So would that, would that have been paid by APL or not?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I do see, and that was for Saint Louis Pathology Associates.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I do see that they sent us a claim back in May on [PII], and we are requesting the primary EOB. They did not send in your primary insurance explanation of benefits. We sent them a letter requesting that, and as of right now we have not received that primary EOB for this claim.
[CUSTOMER][NEUTRAL] OK, um, so, um,
[CUSTOMER][NEUTRAL] If I went into um.
[CUSTOMER][NEUTRAL] Aetna
[CUSTOMER][NEUTRAL] Uh, I, uh, he went to the dermatologist.
[CUSTOMER][NEUTRAL] I'm pretty sure that was one of his dermatology bills, um.
[CUSTOMER][NEUTRAL] And they did a
[CUSTOMER][NEUTRAL] Biopsy?
[CUSTOMER][NEUTRAL] Um, if I sent the explanation from Aetna, would that
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And you know what, I was just checking Mr. [PII]'s claims. It looks like they sent another claim in for [PII].
[AGENT][NEUTRAL] 24 and
[CUSTOMER][NEUTRAL] Right, he goes, yeah, and that one got paid, so.
[AGENT][NEUTRAL] Well, actually, we're requesting a primary EOB for that one as well. And 829. Looks like all of these from Saint Louis Pathology Associates.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] That they've submitted.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Well, the 829 was paid.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're right, the 829 was paid, but the 9-12-2024.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And 12
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] 24, OK. And um and then this [PII], those are the two that are outstanding?
[AGENT][NEUTRAL] That's right, they're just waiting for that explanation of benefits to be sent in so we can continue processing and I see that y'all have an active portal address uh account on our website.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And if you can get those EOBs, you can just upload them on Mr. [PII]'s policy and we can get those processed.
[CUSTOMER][POSITIVE] OK, that I, I'll, I'll work on that and I'll get that taken care of. I appreciate your help, [PII].
[AGENT][POSITIVE] Oh, it's been such a pleasure to assist you, Miss [PII]. Is there anything else I can help you with, Mr. [PII] with today?
[CUSTOMER][NEUTRAL] I don't think so.
[AGENT][NEUTRAL] Well, listen, if y'all have any further questions or concerns, give us a call and also if Mr. [PII] wants to give you permanent permission to speak with us, there is a HIPAA form or an authorization form online, and he can complete that.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And we filled it out but it once they want us to fax it and we don't have a fax so I'm mailing it today.
[AGENT][NEUTRAL] OK, that's fine, or you can email it to our care team that you can do that as well.
[CUSTOMER][NEUTRAL] What do you, what would be the email address?
[AGENT][NEUTRAL] It's, it's [PII].
[AGENT][NEUTRAL] At a.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I'll have him do that.
[AGENT][NEUTRAL] And then that way we'll have that on file and he wouldn't have to give you permission for each call and this what whatever his preference is.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] It's my pleasure to assist you. Anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] Thank you for calling APL Miss and you and Mr. [PII] have a very happy [PII] and thank you for calling APL.
[CUSTOMER][POSITIVE] You too. Thank you very much.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.