AccountId: 011433970860
ContactId: eb07b38b-d41a-4e26-8243-5b40fab0c51f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1175119 ms
Total Talk Time (AGENT): 384164 ms
Total Talk Time (CUSTOMER): 462421 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/eb07b38b-d41a-4e26-8243-5b40fab0c51f_20250204T13:01_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes ma'am
[CUSTOMER][NEGATIVE] Uh, my name is damn thing. I had seen my dermatologist, um, the [PII]. Um, I think they outsourced, um, a, um, sample off my back to get, um, pathology report on it. I got a bill from them. I'm still confused, um, whether or not y'all may have gotten the bill, you know, whether it's being reviewed by y'all because on my card I got 90 degrees benefits. I got American Public Life, um, that y'all spent.
[AGENT][NEUTRAL] Spell your name for me.
[CUSTOMER][NEUTRAL] Sure. [PII]
[AGENT][NEUTRAL] Spell your first name for me again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], OK, and what's the the APL policy number on the card?
[CUSTOMER][NEUTRAL] Uh, that I can't, uh, hold on one second please if I can find it.
[CUSTOMER][NEUTRAL] Um, well, on the paperwork that I have, I don't see it on the card.
[CUSTOMER][NEUTRAL] But the paperwork says policy number 02174923. I don't know if that pertains to that particular bill or if that'd be my um policy number.
[AGENT][NEUTRAL] No, that's a policy number for American Public Life. What's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Give me a second to pull up your file.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] And verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] [PII] and then.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And your email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for that information. So the policy number that you gave me is what you will present or give to the provider's office so that they can call us and verify your benefits under that policy number with American Public Life.
[CUSTOMER][NEUTRAL] No, I mean, I'm just wondering if y'all have gotten a bill from um this um.
[CUSTOMER][NEUTRAL] Uh, doctor, um, [PII].
[AGENT][NEUTRAL] For what date of service?
[CUSTOMER][NEUTRAL] It was for um the statement date is the [PII], but the actual day I was um seen was on the [PII], but it might have been that that's when they filed it.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] What month?
[CUSTOMER][NEUTRAL] January.
[AGENT][NEUTRAL] In what year?
[CUSTOMER][NEUTRAL] of this year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the name of the doctor or the doctor's office?
[CUSTOMER][NEUTRAL] Well, the um.
[CUSTOMER][NEUTRAL] The uh doctor I actually saw was Advanced dermatologist Associates, but again, they sent out a sample off my back to apparently Skin Pathology Associates LLC um in [PII].
[AGENT][NEUTRAL] OK, so are you wanting to know if we received the claim from advanced dermatology or the provider that did the skin testing?
[CUSTOMER][NEUTRAL] I think the one that the provider that did the skin is what I'm wondering, the skin pathology associates.
[AGENT][NEUTRAL] OK. And when was that done?
[CUSTOMER][NEUTRAL] That they got a statement date of [PII] of this year.
[AGENT][NEUTRAL] And what's the name of the location?
[AGENT][NEUTRAL] Skin pathology.
[CUSTOMER][NEUTRAL] It was in [PII]
[CUSTOMER][NEUTRAL] It says skin pathology Associates, um, [PII]. It's uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Technology, I don't show that claim on file yet.
[CUSTOMER][NEUTRAL] OK, cause, um, but I'm confused. I just went to Advanced dermatology Associates here in [PII], and then they sent out the sample to this skin pathology associates. So do I need to follow it up with that or is that something that advanced dermatology associates would take care of, do you know?
[AGENT][NEUTRAL] You know, so we, we did receive the claim from Advanced Dermatology of Georgia. And if, if, uh, yeah, you would need to verify with them or even get a phone number to the skin pathology location to see if they'll be sending us a bill.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, alright, and then can you, um, shed some light, um, please, thank you for your time. Can you shed some light? I'm, I'm still get so spun around with this thing, um, benefits in the card 90 degrees, um, benefits, I mean, that's all on my card. It's like multiplan it's like 3 different company names on this card.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. So multi-plan.
[AGENT][NEUTRAL] Is a a network of contracted providers, medical providers. So if you see any of those providers that are in that network, um, it could entitle you to a discount on your medical claims. So that's a, that's a, so that's not an insurance company.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] OK, it's a network of providers.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Correct. The 90.
[CUSTOMER][NEUTRAL] A 90 degree benefits.
[AGENT][NEUTRAL] The 90 degree benefits they perhaps could cover any wellness services um you would need to contact them directly though to verify what your benefits are and what type of plan you have with them. Do you have their phone number? Is there an [PII] number on your card? I think it's [PII].
[CUSTOMER][NEUTRAL] Yeah, I mean they
[CUSTOMER][NEGATIVE] They make this card so small.
[AGENT][NEUTRAL] [PII], I mean [PII]. Let me see.
[CUSTOMER][NEUTRAL] Yeah, I think it's on there, but any, any bills, uh, medical bills because I'm covered would be sent to y'all. Is that where it should be sent to? American Public Life?
[AGENT][NEUTRAL] So do you have a copy of your card?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK, so turn to the back of the card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it should have the address in which to send your claims.
[CUSTOMER][NEUTRAL] Medical claims submission.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] We have mail benefits in the card BIC it looks like.
[CUSTOMER][NEUTRAL] PO box right.
[AGENT][NEUTRAL] What's the PO box on the card?
[CUSTOMER][NEUTRAL] Uh, [PII] um.
[AGENT][NEUTRAL] Yes, that's where your, your vegan.
[CUSTOMER][NEUTRAL] Rig[PII].
[AGENT][NEUTRAL] Mhm. So that's where your medical claims are submitted to that address.
[CUSTOMER][NEUTRAL] OK, alright, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm still confused, but that's OK. I'll just wait for any, um, word from y'all or anything like that.
[AGENT][NEUTRAL] Yeah, it looks like you have a medical policy which is with American Public Life, which is the one that we're talking about now.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] The 90 Degree is with a totally different company. 90 Degrees is the name of the company, and they may offer a wellness benefit. I'm not sure you would have to call them directly to verify what their benefits are.
[AGENT][NEUTRAL] And of course multi plan is just the network of providers and what other what other information is on the card that you don't understand?
[CUSTOMER][MIXED] No, I'm, I, I honestly multiplay is a network of providers. I get that part and I do appreciate you help with this, but I'm still getting, I still don't get, I'm still confused on whether there's American public life in this um 90 degrees. I don't get the difference between the two.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Yeah, American Public Life, uh, your hospital indemnity plan or policy is with American Public Life. That, that's medical services, your medical services. It's just not hospital. Um, and it's, um, you know, there's an office visit, benefit under the policy, urgent care, emergency room, diagnostic testing, physical therapy.
[CUSTOMER][NEUTRAL] OK, the hospital.
[CUSTOMER][NEUTRAL] In
[AGENT][NEUTRAL] Inpatient hospital as well, but it just does not cover inpatient it's other services under that policy and what you can do.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So any routine
[AGENT][NEUTRAL] Routine, routine is not covered under the medical policy, but it may be with 90 but it may be with 90 degrees.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] So they're being
[CUSTOMER][NEUTRAL] Oh my [PII], OK, alright, um, so.
[AGENT][NEUTRAL] Yeah, so it's like you have two different.
[AGENT][NEUTRAL] Two different um policies perhaps, and the 90 degrees may provide wellness or screening benefits and then your American Public Life card is more of any medical, you know, services like office visits, hospital stays, emergency room, urgent care, those types of things.
[CUSTOMER][POSITIVE] OK, so urgent care. So I, I think it's funny clear it up for me a little bit and thank you for your time with this. American Public Life is for like urgent care and for hospital visits and things like that, but for a routine, just if I want to go to any doctor or something like that, just a general practitioner, then that's likely gonna be 90 degree benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, so 90 degrees is any wellness if you wanted to have a PSA screening, that's considered wellness.
[AGENT][NEUTRAL] Um, a well checkup is wellness, routine is wellness. And so that would perhaps be under 90 degrees, but you would need to call them to verify specifically what their benefits are. Anything as a result of an accident or sickness is under the American Public Life Policy, which is your doctor's office visits. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sir.
[CUSTOMER][NEUTRAL] OK, but the
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the major, yeah, major health, major health issues would be covered by American public life. Minor health cares, it sounds like um just routines, visits and stuff like that sounds like, again, they need to check with the 90 degrees that um for what particular stuff they might carry but cover, but that would be their forte, that would be their um their stuff.
[AGENT][NEUTRAL] Yeah, yeah, any, any wellness benefits, a PSA testing, anything to do with doing with wellness.
[CUSTOMER][NEUTRAL] OK, and then as far as the dermatology associates, then, um, do I need to, um, give, do I give them y'all's information or do I need to give them 90 degree benefits when I call the um when it.
[AGENT][NEUTRAL] So, so, American public life cause dermatology would then be medical.
[AGENT][NEUTRAL] Like you said, yeah.
[CUSTOMER][NEUTRAL] OK, alright, so give, give them American call this one that's in [PII] and then give them the um the um pathologist, give them the, give them y'all's information, right?
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] Is there a number on your card? A medical ID number?
[CUSTOMER][NEUTRAL] The what, ma'am?
[AGENT][NEUTRAL] Is there a number on your card that begins with a D?
[CUSTOMER][NEUTRAL] Yeah, it
[CUSTOMER][NEUTRAL] Man, they make this thing so small. Um, I gotta get, gotta get my, my, I find glass. I'm sorry, one moment, it's right here.
[AGENT][NEUTRAL] It may not be just asking.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] They try and fit so much information on a small little card.
[AGENT][POSITIVE] Good morning.
[CUSTOMER][NEUTRAL] And I'm looking for.
[CUSTOMER][NEUTRAL] Uh, medical ID number, right?
[AGENT][NEUTRAL] Yeah, is there, so you gave us the um American Public Life number, which is what you gave me this morning.
[AGENT][NEUTRAL] Well, I had to look it up under your name.
[AGENT][NEUTRAL] No, you did give me the number, didn't you?
[AGENT][NEUTRAL] The 0 number?
[CUSTOMER][NEUTRAL] I'm gonna
[CUSTOMER][NEUTRAL] Well, that, yeah, but that's in the paperwork. I don't actually see American Public Life on the actual card itself. I see um the pharmacy, I see medical multi-plan, I see virtual care, I see.
[AGENT][NEUTRAL] Are you, are you on the back of the card or the front?
[CUSTOMER][NEUTRAL] I'm on the front of the card and then the back of the card is see 90 degrees benefits and then benefits and card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, would it be a separate card maybe? I look at MetLife for vision.
[AGENT][NEUTRAL] Yeah, it it's u[PII], it's usually on the same card. Give me just a second. Let me pull up your card. Let me see if I have a copy of your card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] During your open enrollment period, um, do they go over any of this information with you?
[CUSTOMER][NEUTRAL] They might have, but, um, unless I'm gonna make changes, um, I've done that like.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3 years ago.
[AGENT][NEUTRAL] OK, who is your employer?
[CUSTOMER][NEUTRAL] Or something like that.
[CUSTOMER][NEUTRAL] My employer is TRC is a staffing service.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think um when I couldn't find the cards for um American Public Life, I think someone, a prior agent.
[CUSTOMER][NEUTRAL] I think they um send them to me via email and I've got them on my phone here.
[AGENT][NEUTRAL] Turn to the front of your card and tell me what's on the front. Just read off what's on the front of your card.
[CUSTOMER][NEUTRAL] If I were to look for him.
[AGENT][NEUTRAL] From top to bottom.
[CUSTOMER][NEUTRAL] Well again I think I'm looking try at the wrong card actually um.
[CUSTOMER][NEUTRAL] Again it says member TRC and the employee ID number and then um it's got the pharmacy and then it's got medical multiplan.
[CUSTOMER][NEUTRAL] And then it's got the um.
[CUSTOMER][NEUTRAL] That's all that's on the front.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And then I think there's again I think it's a paper card that I got from y'all um American Public Life, and I think that a prior agent.
[CUSTOMER][NEUTRAL] Email me copies of that when I can find it so I'd have to go to that.
[AGENT][NEUTRAL] And what's on the front of that card?
[CUSTOMER][NEGATIVE] I'd have to look on the phone. It's buried in my email somewhere.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I I don't wanna keep on that, but I will, um, contact theologist and just tell them to um submit the um their request for um for payment to y'all and then y'all review and then I wait to hear back from you all right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, so when the when your health care providers submit the claim.
[CUSTOMER][NEUTRAL] Mhm yes ma'am.
[AGENT][NEUTRAL] The, the, the payment will go to them, but you will receive an explanation of benefits from American Public Life, um, that shows you uh what amount was paid if, if anything, and then, um, an explanation of benefits will also of course go to the healthcare provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate all your time, ma'am. I really do thank you for your um help.
[AGENT][NEUTRAL] Yeah and I'm I'm getting ready to send you an identification card, an APL card. I know you said it was buried in what you may have in your emails.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Because I want you to see it while I'm on the phone and understand it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm bringing my email now, one moment please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me one moment, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, right.
[CUSTOMER][NEUTRAL] In future times, ma'am, do y'all have any Saturday hours where I can call in because I work overnights and I normally, um, I'll be getting to bed soon.
[AGENT][NEUTRAL] We close at [PII] Central Standard Time, so that would be [PII] your time. Are you Eastern Time zone?
[CUSTOMER][NEUTRAL] Right, I'm in [PII], Eastern same time, um, so on Saturday, um, on Saturdays I can call in.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We're not open on Saturday.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] It's coming from [PII].
[CUSTOMER][POSITIVE] OK, thank you for your time.
[AGENT][POSITIVE] No, you're welcome.
[CUSTOMER][POSITIVE] Ma'am, I appreciate your time, but I'm gonna have to go because, um, I don't have much more time I can stay up. I've gotta get to bed soon, um, and so I've got my shower to take, but thank you for your time, and I'll look for that email when you, when it gets sent through. I appreciate your help, ma'am.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] All right then. You're welcome. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][NEUTRAL] You too bye bye.