AccountId: 011433970860
ContactId: e0b93e45-686a-406c-a929-d2ec92a03549
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 331380 ms
Total Talk Time (AGENT): 117078 ms
Total Talk Time (CUSTOMER): 130834 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/e0b93e45-686a-406c-a929-d2ec92a03549_20250604T19:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, I have a question about, um, a, uh, uh, a statement actually that I guess you guys, you guys are paying, um, something. I'm getting injections every month and you guys have been paying on it and a question about my last couple of statements if you can help me.
[AGENT][NEUTRAL] OK, do you have your policy number?
[CUSTOMER][NEUTRAL] I do. It is 02496790.
[AGENT][NEUTRAL] OK. And then can you verify your name and date of birth for me?
[CUSTOMER][NEUTRAL] Sure, [PII], [PII].
[AGENT][NEUTRAL] OK, and we're checking on claims for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And can you verify the address on your account?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then lastly, do you have a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, and do you have um one of the claim numbers or a date of service?
[CUSTOMER][NEUTRAL] Um, yeah, well, one of them, it's strange because I've been having these monthly B12 injections and there's one data service for [PII], uh, of this year, and it looks like you paid 3445, so that's good and you've been paying them every month, but one, there's a data service of [PII], but you only paid $1.27 so I was confused about that.
[AGENT][NEUTRAL] OK, [PII], uh.
[AGENT][NEUTRAL] Um, it looks like that's, we just they only build one line, um, and so that's what we paid on.
[AGENT][NEUTRAL] So they, they just usually they build two charges in the past and this one they just build one charge.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, I don't know what that means exactly. Um, so what do they, like, what do they normally bill? Like how, I don't know how they normally do it like that.
[AGENT][NEUTRAL] Um, let me see, so the
[CUSTOMER][NEUTRAL] I'm not sure what that is.
[AGENT][NEUTRAL] One from April, let me pull up this one. So for example, the one that we paid the $1.27.
[AGENT][NEUTRAL] We received a claim for, let me see.
[AGENT][NEUTRAL] Uh, give me just a moment, I'm pulling it up.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Uh, we received a claim for a charge of $4.
[AGENT][NEUTRAL] And so it looks like after your primary paid, we paid the balance of $1.27.
[AGENT][NEUTRAL] And so, and then the one from April.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, let me see what you said [PII], is that right?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] OK, I'm pulling up April.
[AGENT][NEUTRAL] OK, and then the claim we received for April, they billed one charge for $2 and then one charge for $34.
[AGENT][NEUTRAL] So they billed a different dollar amount for April than they did for March.
[CUSTOMER][NEUTRAL] But for March, they, they forgot to build the second part of it. Is that what they did?
[AGENT][NEUTRAL] Well, I, I'm, I'm not sure if are they charging you? Is that what's happening? Are they sending you a statement?
[CUSTOMER][POSITIVE] It it looks good
[CUSTOMER][NEUTRAL] Yes, yes, yes, exactly. I think what they, it looks like they're billing for, or they're sending you to, I think they forgot to send the second part of it because I have, there's two I'm looking at the [PII] 1, which I guess you wouldn't have. Looks like it's a vitamin B12 injection for $4 and then a therapeutic prophylactic DX injection something for $34 it looks like and I think what they sent you is.
[CUSTOMER][NEGATIVE] Only the thing for $4. I think they forgot to submit the second half of that's probably what happened. Oh my [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, it looks like it on that yeah the claim they submitted doesn't have it. So if you wanna give them a call and let them know, they, they can feel free to resubmit that to us. Just make sure they attach your primary explanation of benefits and then we can get that processed.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Obviously they need to send the what is the primary explanation of benefits?
[AGENT][NEUTRAL] So do you have like Blue Cross Blue Shield or United Healthcare or um let me see.
[CUSTOMER][NEUTRAL] Explanation of that.
[CUSTOMER][NEUTRAL] Yeah, my healthcare, yeah, yep.
[AGENT][NEUTRAL] Yes, so they'll need to send that explanation showing UnitedHealthcare process that charge.
[CUSTOMER][POSITIVE] OK. OK. I will do that. I will do that. OK, perfect. All right. Thank you so much. I appreciate that.
[AGENT][NEUTRAL] OK, anything else I can help with today, Ms. [PII]?