AccountId: 011433970860
ContactId: ebaead37-9f48-423c-a59e-8eafaf1b8d57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497950 ms
Total Talk Time (AGENT): 168759 ms
Total Talk Time (CUSTOMER): 236484 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/ebaead37-9f48-423c-a59e-8eafaf1b8d57_20250430T15:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, uh, I have a policy with American Public Life, and I sent them, I sent y'all, uh, a UB04 or 04 whatever it is, and they came back and said I still need some more information. Could you explain what I need?
[CUSTOMER][NEGATIVE] Yeah, I'm just so confused over everything.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 00623211.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And can I have your name and your date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. Do you have a, um, can I get your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then lastly, what is your telephone number in case we are disconnected?
[CUSTOMER][NEUTRAL] OK, well I have two, but I'm using the landline, so it's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my cell, oh do you need my cell?
[AGENT][NEUTRAL] No, that number's fine.
[AGENT][NEUTRAL] OK. We're checking on a claim, is that right?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Um, what date of service was that for? Is that [PII]?
[CUSTOMER][NEUTRAL] [PII] of this year.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Uh, looks like we actually just paid $400 on that, um, that went out on [PII], but that was a direct deposit.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, yeah, I, I know that, but it didn't pay. It says, uh, I, it says, uh, the paper here says anesthesia benefits, uh, send the surgery charges listing the procedure code for this date.
[CUSTOMER][NEUTRAL] And then there was another one that said they need a fully itemized surgery bill that includes the procedure code and diagnosis code.
[AGENT][NEUTRAL] OK, let me see what we have.
[CUSTOMER][NEUTRAL] Ma'am, and I sent a UB04 uh paper that I finally got. It took 2 months, maybe 3, for it to come in and I got that and sent it to American Public Life.
[CUSTOMER][NEUTRAL] And uh it has, you know, the, the bill for everything.
[AGENT][NEUTRAL] OK, let me pull up what uh your policy covers. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All
[AGENT][NEUTRAL] OK, so the UVO4, that's, so that's the hospital claim. Did you have surgery that day?
[CUSTOMER][NEUTRAL] Yes, I had cancer surgery, uh uh uh um ute cancer surgery that day, yeah.
[AGENT][NEUTRAL] OK. So, the UBO4 just tells us what the hospital charges were. Have you received an itemization from your surgeon who did your surgery?
[CUSTOMER][NEUTRAL] No, I mean, no, huh.
[AGENT][NEUTRAL] OK, because that's, so there's, there's a couple different parts here for the hospital, the UBO4 tells us the hospital charges, but then your surgeon and the anesthesiologist, they're gonna bill separately. So they have a separate bill, um, and that's, that's what we're looking for to pay on those charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says this bill may be obtained from your surgeon's office for the anesthesia.
[CUSTOMER][NEUTRAL] And then for the.
[CUSTOMER][NEUTRAL] Surgery bill, procedure code and diagnosis code.
[CUSTOMER][NEUTRAL] So that's what I need.
[AGENT][NEUTRAL] Yeah, so those, those forms from those doctors are called CMS 1500s. So,
[CUSTOMER][NEUTRAL] OK, CMS.
[AGENT][NEUTRAL] Those
[AGENT][NEUTRAL] Yeah, C as in Charlie, M as in Mary, S as in Sam, and then 1500. Those are the claim forms that we need for your anesthesia and your surgery.
[CUSTOMER][NEUTRAL] OK, I didn't know that.
[CUSTOMER][NEGATIVE] I wish people would more clear on that. It doesn't say that anywhere that I know of. I mean, it's a lot of paperwork with all of this. It's confusing for the average Joe who doesn't work with this.
[AGENT][NEUTRAL] Yeah, the
[AGENT][NEUTRAL] Do you have by chance, um, do you have an online account with your doctor's office or anything?
[CUSTOMER][NEUTRAL] Uh, I have to check. I don't know. I probably do, yeah, I probably do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sometimes that information can be obtained on that as well. The medical records will show the diagnosis and the surgical codes, um, so I was just gonna offer that as an option as well. Um, but you can, you can, yes, you could find that potentially.
[CUSTOMER][NEUTRAL] So I can just
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I would just print it out from there?
[AGENT][NEUTRAL] Yes, exactly. And then also, you know, definitely you could give them a call and tell them that specific information that you need and maybe they could print some medical records that show that, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll do that, yeah, because I was been really frustrated. I, you know, other policies have paid well fast and, and so they just needed the UBO4 or UBO4 code or whatever, yeah, OK, well I'll go ahead and do that and then just send it or email it.
[AGENT][NEUTRAL] Um, if you can just fax it or mail it to us or upload it on our portal. Yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh OK, I'll do that. I'll try that. OK, I hope that works out now. The case is not closed yet because it's here it is uh April. I mean it's still good to.
[AGENT][NEUTRAL] Oh no, no, it's
[AGENT][POSITIVE] Yeah, you're totally fine plenty of time there's no there's no timely filing limit so you have all the time that you need to get that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh good. OK, alrighty, I appreciate your help.
[AGENT][NEUTRAL] OK, Ms. [PII] there anything else I can help with today?
[CUSTOMER][NEUTRAL] Well, uh, were y'all did y'all have a different name at one time when my husband took out this account?
[AGENT][NEUTRAL] I don't think so
[CUSTOMER][NEUTRAL] I mean this uh policy, has it always been American public?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] We have, um, for about 80 years, so it's been, yeah.
[CUSTOMER][POSITIVE] OK, OK, so the one I have, he had another one that I didn't know much about and I just thought if they changed names or not, so yeah, OK, well I appreciate it thank you so much.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Yeah