AccountId: 011433970860
ContactId: db60058f-417b-4c23-9c24-133c68278ec5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436570 ms
Total Talk Time (AGENT): 251961 ms
Total Talk Time (CUSTOMER): 182581 ms
Interruptions: 5
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/db60058f-417b-4c23-9c24-133c68278ec5_20250509T17:48_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, can you hear me?
[AGENT][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] Yes, yes, um, hi, so I have, um, a policy with you guys through my workplace as like a secondary insurance to cover things that the regular insurance won't, um, and I recently went to a well woman's visit with my gynecologist and, um, we did like a regular annual testing.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but I guess I, I don't really know what happened. Um, they, we did like standard blood work that I normally do with her every year that typically is covered by insurance, um, but, uh, I
[CUSTOMER][NEUTRAL] Apparently I owe Quest Diagnostics like 35, almost $4000 like it's like $3600 or something.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And there, I spoke with United Healthcare and they said that I do owe that, which is crazy, um, because it was supposed to be like a preventative testing, um, but they told me, because I was telling them like, well, that's why I have like you, this company is like a gap.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how do I get you guys to like file a claim with the Quest Diagnostics?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, we would not, oh, that's OK. So we're, we're just like a United Healthcare. Uh, we are GA, so they would submit the claim to us. So they would submit the claim to us along with uh UnitedHealthcare's uh explanation of benefits. Do you know if those amounts were not covered or applied to a deductible? What was the issue in which you owe that amount of money?
[CUSTOMER][NEUTRAL] Sorry, I'm like new to all this, so I probably sound.
[CUSTOMER][NEUTRAL] Um, I believe what she was telling me it's something toward the deductible. I'm not really sure, um.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK. Let me get your policy pulled up with us. Uh, can I get your first name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And [PII], if I could get a call back number for you.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you and what is your outpatient cer certification number with us?
[CUSTOMER][NEUTRAL] Um, it is 02572958.
[AGENT][NEUTRAL] OK, if you could verify your date of birth and mailing address.
[CUSTOMER][NEUTRAL] 7397. I do need to update my address, but the one on file should be [PII].
[AGENT][NEUTRAL] Oh, OK, OK, thank you. I'll get that information from you and we can uh get that updated for you before we get off the phone. OK, so thank you for verifying your policy and this is for Quest Diagnostics, correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] The services, OK, let me see if you have the benefit that pays for independent laboratories.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so you do.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh, so you do have, um, a benefit for, uh, lab charges. Please be advise verifying benefits does not guarantee payment. So your, your policy, uh, for lab charges it would be covered under your outpatient benefit. Your outpatient benefit pays $500 a day. So if it's a cover charge, it would only pay up to $500 towards the $3000 that you owe.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, but as I stated, uh, they can file a claim with us, Quest, um, um, they can send, um.
[AGENT][NEUTRAL] The um claim along with UnitedHealthcare's explanation of benefits showing uh that you had.
[AGENT][NEUTRAL] The lab charges rendered and they were applied to your deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you would, you know, contact Quest, let them know you have a secondary insurance, second, uh, and if they could file secondary to us, uh, and you just provide the mailing information, um, the, you know, the mailing address for claims is on your card, they can fax it.
[CUSTOMER][NEUTRAL] Um, so, contactless.
[AGENT][NEUTRAL] Um, or they can send it electronically.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] Should I contact my provider too because like I was under the impression that I was doing preventative care stuff and I didn't know that this is gonna cost me.
[CUSTOMER][NEGATIVE] Thousands of dollars that I don't have.
[AGENT][NEUTRAL] Uh, well, that is something that you, yeah, you would definitely wanna speak with them if they ran blood work that's not covered under your preventative. Um, I, uh, that, I mean, that's not something we would be part of, but, you know, as a patient, I would definitely
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Right, right, right.
[CUSTOMER][POSITIVE] You're just here to like help out where the other wouldn't so yeah no I get it so I'll I'll have to do a bunch of phone calls.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah. So, um, but as the patient, definitely, um, you know, if you were not advised that additional blood work was being ran or they asked for, most providers know what's covered under your routine and they will come back and say, uh, you know, well, these particular
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. No one told me anything.
[AGENT][NEUTRAL] Uh, you know, this particular lab is not, uh, covered under routine with your insurance. So they normally let you know that before, before they even run it, um, or submit, you know. So I would definitely speak with them and see if something can be done about that. I'm not sure. um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Because ultimately that is a bill with Quest, you know, it's, I don't, I don't know what they would be able to do, um, but I, I would definitely speak with them regarding that.
[CUSTOMER][NEUTRAL] Right. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate your help.
[AGENT][NEUTRAL] You're welcome. And did you wanna go ahead and update your mailing address?
[CUSTOMER][POSITIVE] Oh yeah, let's do that.
[AGENT][NEUTRAL] OK, and what is the new mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so the apartment is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what is the city again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, OK, [PII], and what is the zip?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I will get that updated um today uh.
[AGENT][NEUTRAL] And is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] OK. Awesome.
[CUSTOMER][POSITIVE] No, that's all. Thank you so much.
[AGENT][POSITIVE] You're welcome you have a wonderful day. Thank you for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.