AccountId: 011433970860 ContactId: e3f70989-f239-45d9-960f-30fdef723512 Channel: VOICE LanguageCode: en-US Total Conversation Duration: 1459380 ms Total Talk Time (AGENT): 422929 ms Total Talk Time (CUSTOMER): 865094 ms Interruptions: 8 Overall Sentiment: AGENT=0.4, CUSTOMER=0.5 Redaction Types: PII Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/e3f70989-f239-45d9-960f-30fdef723512_20250325T16:21_UTC.wav -------------------------------------------- [AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you? [CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm a member and I have on the phone call with me someone from Quest Diagnostics billing because we're trying to sort out a billing issue, so I just wanted to say that you have 2 of us on the phone and do you need my policy number? [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Um, yes, please, and a good contact number in case we're disconnected. [CUSTOMER][NEUTRAL] Sure, OK, my policy number is 02462882 and my phone number is [PII]. [AGENT][NEUTRAL] Thank you for that, and I have you here, Ms. [PII]. I just need you to verify your date of birth, your mailing and email address on file. [CUSTOMER][NEUTRAL] Sure, [PII]. My mailing address is [PII]. I'm not sure what email address you have on file, maybe [PII]. [AGENT][NEUTRAL] Yes. [AGENT][POSITIVE] And thank you so much for um verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. And um how may I help you today? [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Well, I have Quest Diagnostics on the phone because I'm having a recurring problem with Quest bills, um. [CUSTOMER][NEGATIVE] Where Quest is sending them, but they, they're not, it's like they're not being either received by APL or they're, they don't have the right codes on them. I've gotten some different feedback when I've called APL and basically Quest is saying. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] It's the insurance's responsibility and when I call insurance you guys say it's Quest's responsibility and I don't know what to do and one of them has gone to collections now so I'm and we need to get the three of us it was the quest um person's idea to get a call together which was a great uh great idea. We need to get this figured out because I'm only having this problem with my quest bills every other. [AGENT][NEUTRAL] OK. [CUSTOMER][POSITIVE] Bill is being processed and going through and I'm not having any problems with it. [AGENT][NEUTRAL] What's the date of service, so I can pull up the claims and see the decision. [CUSTOMER][NEUTRAL] OK, so the one I'm looking at right now, well, let's go first to the first one that's already gone to collections that date of service is um. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Well, I can't find it because the collection bill. OK, I'm gonna give you the [PII]. [AGENT][NEUTRAL] 86 [CUSTOMER][NEUTRAL] [PII] he said [PII]. [AGENT][NEUTRAL] [PII] [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] Hold on one moment. [AGENT][NEUTRAL] 815 or 816? [CUSTOMER][NEUTRAL] [PII] and I mean I'm in I'm in my portal. I can see that there's no claim from that date in the portal on APL. [AGENT][NEGATIVE] Right, that's why I just want to make sure because I don't have a claim on file that day, but there is no timely filing. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] No, there's not a claim on file now I. [AGENT][NEUTRAL] There's no timely filing so there's no timely filing limit, so Quest can file the claim at any time, um, and that can be processed. [CUSTOMER][NEUTRAL] Do what? [CUSTOMER][NEGATIVE] Well, they say that they sent it multiple times. I've called, I've called, listen, I told, listen, here's the deal. The 3 of us on this call, I'm not mad at either one of you and we can we not be mad at each other. I have spent hours on the phone on this. I have called. I have been told that Quest has sent it. APL keeps saying we haven't received it. Now this particular one has gone to collection, so I'm just pretty much screwed on it. I mean, I don't even know what to do. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Well, no, we're gonna find a resolution. Let me speak sou, how are you sending the claims? Are they being faxed? Are they being? [AGENT][NEUTRAL] How, how is it being sent to us? Cause there's [CUSTOMER][NEUTRAL] We're mailing them out. [AGENT][NEUTRAL] What's the mailing address you're sending it to? [CUSTOMER][NEUTRAL] So the address that is listed on here is [PII]. [AGENT][NEUTRAL] Yes, [CUSTOMER][NEUTRAL] Out of [PII] I'm sorry [PII]. [AGENT][NEUTRAL] Yeah [AGENT][NEUTRAL] Yes. OK, so that's the correct address. If we've mailed it there and we haven't received it, we also have a fax number and a payer ID so we can get this fax, this uh claim process. [CUSTOMER][NEUTRAL] What's the fax number? [AGENT][NEUTRAL] [PII]. [AGENT][NEUTRAL] [PII]. [AGENT][NEUTRAL] [PII]. [AGENT][NEUTRAL] And that'll be attention. [CUSTOMER][NEUTRAL] And what's your payer ID? [AGENT][NEUTRAL] That will be attention APL claims department. [AGENT][NEUTRAL] And our payer ID is 60. [AGENT][NEUTRAL] 801. [CUSTOMER][POSITIVE] Alright, I'm gonna place you on a brief hold just a moment thank you. [AGENT][NEUTRAL] OK. [CUSTOMER][POSITIVE] OK, thank you so much for helping. I have called. [AGENT][POSITIVE] Oh, you're welcome. [CUSTOMER][NEUTRAL] I spent, I have another current bill. Can you check this other day while she's doing that? So 8:27, 8-27-24. [AGENT][NEUTRAL] Of course. [AGENT][NEUTRAL] 827, 24. OK, hold on one moment. [CUSTOMER][NEUTRAL] This one I am seeing, um, OK, it's hard to hear it. [AGENT][NEUTRAL] Oh, I see what happened. So they submitted it twice. We paid out on this claim, but then they also submitted it again and it was denied as a duplicate, but I can give you the amount that we paid. Hold on one second. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Mm [AGENT][NEUTRAL] So on this one we paid. [AGENT][NEUTRAL] OK, let me see how many it was in total. 123. I'm looking at all the lab charges. Hold on one second. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] 1 [AGENT][NEUTRAL] 23 [AGENT][NEUTRAL] Alright, so there's a total of 6 lab codes on here. Of the 63 were paid, the other 3 weren't paid because the major medical coverage provided full benefits. So there it wasn't a balance there because major had already paid everything. [CUSTOMER][NEUTRAL] OK [CUSTOMER][NEUTRAL] OK, and how much did you pay out? [AGENT][NEUTRAL] Let me see, hold on one second. [CUSTOMER][NEGATIVE] I can't see that on my end. I don't see one from 827-24 for um class that was paid. I only see a mercy bill that was paid. [AGENT][NEUTRAL] [PII]. Well, this is all on one claim. That's why I had to count them up because it's the lab charges and then at the top of the claim, it's like pathology and radiology. So it's like all together. [CUSTOMER][NEUTRAL] I, I don't see that's not what mine looks like. Um. [CUSTOMER][NEUTRAL] I see a [CUSTOMER][NEUTRAL] I see an EOB from I know it's hard to hear what that music. I see an EOB from 827 24 that was $68.64 was paid out for physician treatment to [PII], but I don't see anything paid to Quest that day. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Wait, we might be in a different one because I don't see anything from [PII] on mine. Hold on one second. Let me see if there's more than one. [CUSTOMER][NEUTRAL] OK, OK. [CUSTOMER][NEUTRAL] I only see 3 EOBs from that date. [CUSTOMER][NEUTRAL] 827. I don't see one from Quest in your system. I mean it's not showing up on my end. [AGENT][NEUTRAL] Uh, one moment, 6:15 and then 12. [AGENT][NEUTRAL] So the total, the total um that was paid to Quest on this claim is $27.40. Um, I'm looking at claim number. [CUSTOMER][NEUTRAL] OK, which is what it says they owe. [AGENT][NEUTRAL] See, I don't know. [CUSTOMER][NEUTRAL] That's exactly what they say I owe. What's the claim? What's the claim number? [AGENT][NEUTRAL] This one is 3,541,400. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] 140 what? [AGENT][NEUTRAL] 1400. [CUSTOMER][NEUTRAL] OK, sorry, I don't that is not showing up in my portal. [AGENT][NEUTRAL] You want me to send you, I can send you a copy of the explanation of benefits if you need it. [CUSTOMER][NEUTRAL] That would be great because yeah I don't have that one. All right, thank you guys so much for holding so I did um get that rebuild out to that fax number um ma'am if you do not receive it um or if your insurance does not receive it after we submit the fax, um, we're going to uh have to have you self file at that point because we have done everything on our end to to get it to them. [AGENT][NEUTRAL] Because it looks like [AGENT][NEUTRAL] OK. [AGENT][POSITIVE] You're welcome. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK, is there any way that um the lady from American Public Life, can you go see if the fax came through? Is that possible? It's not going to come through right now. It has to generate that paper bill, correct. OK, OK, well let's move on to that. Thank you for doing that. Let's move on to [PII] date of service because while you were working on that we were looking at that and she's actually showing that APL has paid $27.40 on that claim. [AGENT][NEUTRAL] It won't be that quick, but [CUSTOMER][NEUTRAL] When? [AGENT][NEUTRAL] We paid it. Hold on one second. Um, hold on one moment. [CUSTOMER][NEUTRAL] I don't know. Can you say when? [AGENT][NEUTRAL] So it's check number. [AGENT][NEUTRAL] 20185997. Let me see when that was issued. Hold on one moment. [AGENT][NEUTRAL] 597. [AGENT][NEUTRAL] It was issued on [PII]. [AGENT][NEUTRAL] Actually, hold on one second. Wait a minute. [AGENT][NEUTRAL] This looks like it went to Ms. [PII]. Hold on one moment. [CUSTOMER][NEUTRAL] Mhm. [AGENT][NEUTRAL] OK, so there was a claims payment of the total is $63.80 of that was the 2740 cents for the lab charges, but yes, this was submitted from Ms. [PII], so the payment went to Ms. [PII]. [CUSTOMER][NEUTRAL] It came to me. [AGENT][NEUTRAL] Um, but now it is still listing it as outstanding, so it hasn't been, it hasn't been cash. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEGATIVE] It hasn't, it didn't count. I didn't get that check. [AGENT][NEUTRAL] OK. Let me send this one over to [PII] so she can check on the check and then uh we can reissue it. Um, she'll let me know at that point, but I can go ahead and send this one over. [CUSTOMER][NEUTRAL] Can [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK, OK. [CUSTOMER][NEUTRAL] OK, so what is, what else was paid to me on that check? [AGENT][NEUTRAL] Let me see, hold on one moment. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Alright, let me just make a little note to send this one to [PII]. [CUSTOMER][POSITIVE] OK, thank you. [AGENT][NEUTRAL] 2 [AGENT][NEUTRAL] OK, send to [PII] right and then. [AGENT][NEUTRAL] There was $36.40 that was paid towards pathology. [AGENT][NEUTRAL] $12.95 was for a lab, Quest Diagnostic lab for 827. [AGENT][NEUTRAL] $6.15 was for a diagnostic lab for 827 of $24. [AGENT][NEUTRAL] And then $8.30 also was $8.27 for Quest. [CUSTOMER][NEGATIVE] Uh, this, it seems like this was when I was trying to sell file the one from [PII] because it wasn't going through that somehow this one got. [CUSTOMER][NEUTRAL] But regardless, I'm glad to hear you say the check hasn't been cashed because I didn't receive the check, so. [AGENT][NEUTRAL] What [AGENT][NEUTRAL] Yes, it's still outstanding, so we can definitely, um, when I send it to Ms. [PII], she's gonna check on it and then um reissue it and then that whatever that patient response of the 27, I forget to change, that $27. Mhm, you'll have to pay that to request. [CUSTOMER][NEUTRAL] OK. OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Yeah, 40 I OK. [CUSTOMER][NEUTRAL] Yep, so that one that's fine. So when I get that check, I will pay Quest. That one's no problem. So the lady from Quest, I'm sorry, I don't know any of your names, the one from [PII], it sounds like that payment's gonna come to me and I will pay that one, the one from [PII] that you just refiled, can you reach out to the collections people and tell them we're still working on it? [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] Yes, OK. [CUSTOMER][NEUTRAL] Yeah I've already placed it on hold within him thank you OK OK so I'm gonna check back in um. [CUSTOMER][NEUTRAL] In a couple of days on with APL, so APL, can you tell me your name? I'm sorry. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] Yes, it's OK. My name is [PII]. [CUSTOMER][POSITIVE] [PII], thank you and if I wanted to call back in a couple of days just to kind of check on the status of this, can I, how can I get to you so I don't have to rede the whole thing. [AGENT][POSITIVE] Yes ma'am, you're welcome. [AGENT][NEUTRAL] Oh, I'm the only [PII] here. [CUSTOMER][NEUTRAL] OK, so I could just call and ask for [PII]? [AGENT][NEUTRAL] So you won't have, yeah, you won't have a problem getting back to me. I'm the only one on the team. [CUSTOMER][NEUTRAL] OK, OK, OK, and then the lady from Quest, what's your name? [CUSTOMER][NEUTRAL] Yep, my name is [PII]. First initial, my last name is [PII] Oh, say your last name again? [CUSTOMER][NEUTRAL] Uh, the first initial and my last name is [PII], sorry, [PII]. OK, thank you. OK, if I called and tried to get to you, can I just ask for you? [CUSTOMER][NEUTRAL] So no we are an inbound call center so we uh don't have like lines um so it would just be like chance as soon as we disconnect another call comes directly into me. OK, OK, so what I'm gonna do if you can make a note, [PII] um I'm gonna give it a couple of days and then I'm gonna call back to APL and I'm gonna see if they received that fax and I'm gonna see if they got that new check. [CUSTOMER][NEUTRAL] And their their fax isn't going to be, uh, it's gonna take longer than a few days. They they they have to generate paper statement out to them and then it has to go to a department who sent submits out those faxes to them so they can think upwards. [CUSTOMER][NEUTRAL] It can take upwards of 30 days um for it to be submitted via fax fax OK OK well if you'll just make a note. [AGENT][POSITIVE] But the good thing is she held the [CUSTOMER][NEUTRAL] I'm sorry, what was that? [AGENT][POSITIVE] OK. I was gonna say, but the good thing is she's held the collection, so you don't have any, you don't have to worry about anything while it's in processing. [CUSTOMER][POSITIVE] Yes, correct, no, I just, yes, that's right, thank you so much for that. It's really helpful and so, um, I will just make a note on my calendar in 30 days to check back in with APL, see if they've received that fax, confirm the situation with the check for this [PII] claim, and then, um, we'll just, and then I'll talk I'll call Quest back so I will take the responsibility to try to manage the. [AGENT][NEUTRAL] Mhm. [CUSTOMER][POSITIVE] The communication to keep everybody in the loop on um on what's happening. [CUSTOMER][NEUTRAL] Could you on [PII], could you confirm what you show as my policy number just to make sure that. [CUSTOMER][NEUTRAL] That's not the problem. [CUSTOMER][NEUTRAL] Yeah, so I have 01822345. [CUSTOMER][NEGATIVE] That is not the right policy number. That policy has lapsed. [AGENT][NEUTRAL] Oh, is that what's happening? [CUSTOMER][NEUTRAL] Mm that's the one. [CUSTOMER][NEUTRAL] The correct policy number is [CUSTOMER][NEUTRAL] 02462882 [AGENT][NEUTRAL] I'm gonna look on the other policy just to see if there's anything. [CUSTOMER][NEUTRAL] OK, what is it one more time? Yeah, sure, 02462882. [CUSTOMER][NEUTRAL] And what's the group number 23759? [CUSTOMER][NEUTRAL] So here's what's tricky though. The first number you said is the policy number that I had in [PII]. [CUSTOMER][NEUTRAL] The new policy number that I gave you was effective 12-1-2023. [CUSTOMER][NEUTRAL] So they changed my policy numbers at APL so that old number was correct for the. [CUSTOMER][NEGATIVE] Claim that you sent for [PII] but it wouldn't be correct for anything that was submitted. [CUSTOMER][NEUTRAL] From [PII] correct or [PII], so if that's how these are getting submitted then that could be the problem. [AGENT][NEUTRAL] Well, I did just check the old policy number to see if there were any claims, but it hasn't gone there. [CUSTOMER][NEUTRAL] But I'm thinking that's not the case because. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Uh-huh. [CUSTOMER][NEUTRAL] OK [CUSTOMER][NEUTRAL] Yeah, I had given, I mean, I know when I walk into Quest Diagnostics they have my good policy number because I've checked every time I've gone in and so I know they have my new policy number in the system like when I walk in to give my like when I go to take blood, you know, so anyway, but that's the correct policy number is the 2462882. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] OK, I'm gonna place you on a brief hold, um, OK, because that's not what we have, um, and that's not what it was billed with, um. [CUSTOMER][NEUTRAL] I'm pulling the order form right now. OK, well, the one from [PII], it would have been the old policy number though. [CUSTOMER][NEUTRAL] Yeah, I'm only working on the one from [PII], OK, the newer 1 827, OK. [AGENT][NEUTRAL] OK [CUSTOMER][NEUTRAL] OK, so on the order form from the physician's office, the that ID number for your secondary insurance is not listed, so you may wanna make sure your doctor's office is submitting over the correct and updated ID number. [CUSTOMER][NEUTRAL] Um, so tell me how to do that because I've asked and there's, I mean my doctor's office definitely has the right number because their claims are going through correctly, but also when I'm in, well, like when I, the little quest person is in my doctor's office, you know what I mean like I just walk into another room and there's quest, and they are saying like they are saying to me that they have this 246-288-2 number in their computer. [CUSTOMER][NEUTRAL] Which they may, but we don't have a system like a doctor's office does where it saves information on file. Everything is submitted um on the order form and it starts the process all over for us. So even though they are seeing it in the system, it doesn't mean that we're gonna bill us as as that. [CUSTOMER][NEUTRAL] We have to go by our legal document which is the order form from the physician's office so if they're selecting if they're selecting the um previous American public life ID number instead of your current one, then that is going to be the problem. [AGENT][NEUTRAL] Oh, I understand. OK. [AGENT][NEUTRAL] Current [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] OK, so [CUSTOMER][NEUTRAL] I need to find out. [CUSTOMER][NEUTRAL] How do I, so I just need to say like, I know you have, I mean, how do I tell what? That's [AGENT][NEUTRAL] So basically, basically it's in, they have both in their system, but what they're putting on the order form to be processed is the old one. So that's, they need to take this old number out their system period, and then just leave the current one so that when they generate the order form. [CUSTOMER][NEUTRAL] Right, right. [CUSTOMER][POSITIVE] Correct. [CUSTOMER][NEUTRAL] OK, I'm in, so I'm in. [CUSTOMER][NEUTRAL] I'm in there my system right now on my [PII], and they don't have the old number in here. I've already, it's out. Right, but you're, you can't see everything that the doctor's office does on their end. So when they're submitting an order to us, they have to select your insurance information through their system. [CUSTOMER][NEUTRAL] So even though they are not showing it in your portal that it's listed in their system that is what is going somewhere you're saying OK, correct, so I just need to. [AGENT][NEUTRAL] Right, like it has to be somewhere because that's what's generating for the order form, which is what they're using to process. [CUSTOMER][NEUTRAL] OK, so I just need to call them and say somewhere this number is still living and we need to get rid of it. [AGENT][NEUTRAL] You need to just tell them. [CUSTOMER][POSITIVE] Correct and I'm updating your order or your your ID number right now. OK, thank you. [CUSTOMER][NEUTRAL] OK, so it sounds like the main one that we still have to deal with is the one from [PII], which is the old number because it looks like the [PII] payment is gonna come to me and then I will get on my quest portal and pay it. That's no problem. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] And then I will double check back on all these things in 30 days and I will also try to figure out with. [CUSTOMER][NEUTRAL] [PII] where where they have this old number and if they can get that deleted. [CUSTOMER][NEUTRAL] Right, so I'm gonna place you on a brief hold so I can push this out just a second, OK, thank you. [AGENT][POSITIVE] I know it's a lot, but you're making a lot of progress. [CUSTOMER][NEUTRAL] I've been working on that [PII] bill for, I mean a year and a half. [AGENT][NEUTRAL] Good Lord, I didn't know it was that long. [CUSTOMER][NEUTRAL] But yeah. [CUSTOMER][NEGATIVE] Uh, yeah, I mean, I've been fighting I kept called I and apparently when I sell filed, I self filed the wrong claim or something. I don't know. [AGENT][NEUTRAL] Well, it's already confusing by itself, and then, so, so are you clear on what to do with the policy number? So it doesn't, so they don't keep billing to the old one? OK. [CUSTOMER][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] Yeah, yeah, I'll call [PII] here in a little bit and I'll ask them to check their system and take that number out. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] So have you been able to uh. [AGENT][NEUTRAL] So I just said [CUSTOMER][NEUTRAL] The the the question about the check. [AGENT][NEUTRAL] Mhm. So I, I just sent it over to [PII]. I did send it urgent, so for that part, you'll hear, you'll hear back from us more, you know, quicker than the 30 days, but for the other part that might take a while, but I did send it urgent, so um. [CUSTOMER][POSITIVE] OK, thank you. Thank you. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Yeah, yeah, understood. OK, will you guys call me or will I need to call back? [AGENT][NEUTRAL] Oh no, Ms. [PII] is gonna reply to the um request once she, you know, with her update if it's cleared or whatever, and then I'll call, I'll reach out to you. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][POSITIVE] Oh, thank you so much. I really appreciate that so much, [PII]. This has been, oh my goodness. [AGENT][POSITIVE] Well I'm glad I could assist you. I'm glad we got it all taken care of because it sounds like it's been a lot. [CUSTOMER][POSITIVE] I'm really glad she thought yeah I'm glad she thought of um getting all together that was a really good idea, yeah, so I did get that submitted out um with the with that ID so it'll go across uh submitted to your insurance with that ID number um via fax. [AGENT][NEUTRAL] It was [CUSTOMER][POSITIVE] OK um anything else that I can assist with? No, thank you for having the idea of getting us all on the phone together because this I feel like we're gonna get it sorted out and we figured out what the issues are and I think we can get it resolved now. [AGENT][NEUTRAL] Mhm. [CUSTOMER][POSITIVE] Correct, um, alright, well I hope you guys have a wonderful rest of your day take care thank you all bye bye bye bye. [AGENT][NEUTRAL] Alright, Ms. [PII], was it