AccountId: 011433970860
ContactId: ee4756bb-fc3f-4215-936f-b28a4b690aa5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 461950 ms
Total Talk Time (AGENT): 192523 ms
Total Talk Time (CUSTOMER): 220837 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/ee4756bb-fc3f-4215-936f-b28a4b690aa5_20250117T21:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], um.
[CUSTOMER][NEGATIVE] My insurance changed back in July and I no longer have APL but I keep getting letters in the mail saying that you've received the claim on my policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And I need to just figure out why I keep getting those because I shouldn't, I shouldn't be getting anything um sent to you at all for like the last 6 months.
[AGENT][NEUTRAL] OK, Ms. [PII], uh, can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is the policy number that you keep getting the letters on?
[CUSTOMER][NEUTRAL] Well, um, I don't have that information. The the letter has like very little information my name and address and the date. I don't have that policy anymore so I don't have access to the policy number.
[AGENT][NEUTRAL] OK, I can look it up with your social security number if you wanna give me that I can pull it in.
[CUSTOMER][POSITIVE] But I'm hope
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] OK, let me find you real quick and get your policy pulled in.
[AGENT][NEUTRAL] So we can find out why you're getting those letters.
[AGENT][NEUTRAL] OK, Ms. [PII], for security reasons, can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then also we'll need to get your address, phone number and email address that's on the policy or was on the policy for you.
[CUSTOMER][NEUTRAL] OK, the address is [PII]. Do you need me to spell that?
[AGENT][NEUTRAL] No, ma'am, I see it, but I would have if I could, if I didn't see it.
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's A [PII] and um it could be one of two emails it's probably [PII].
[AGENT][NEUTRAL] The one I have is the Thrive email address.
[CUSTOMER][NEUTRAL] [PII]. That's my work my work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then um the number that you gave me to call you back on if we get disconnected is that your cell phone?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. I appreciate you verifying that information. OK, I see that a claim was filed.
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] Let me look. It's affiliate dermatologist.
[CUSTOMER][NEUTRAL] OK, so we're talking almost a year ago. I did have coverage at that time. Why is it taking a year for that claim to be reviewed?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's not, uh, the claim was actually reviewed on.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, that's well I mean all I can tell you is I have a letter dated [PII] that says we've received the claim on your policy and a review of the claim has started.
[CUSTOMER][NEUTRAL] I've gotten that identical letter like 3 times since about September or October.
[AGENT][NEUTRAL] OK. Who is [PII], who is [PII]?
[CUSTOMER][NEUTRAL] So something needs to be.
[CUSTOMER][NEUTRAL] He's my husband who is on my insurance.
[AGENT][NEUTRAL] OK, that's um.
[AGENT][NEUTRAL] Where it's from.
[CUSTOMER][NEUTRAL] I don't think he's been to that provider. Is that from the affiliated dermatologist? Because that would have been for me.
[AGENT][NEUTRAL] For lab work.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, lab work was done.
[CUSTOMER][NEUTRAL] OK, so his I think his doctor, he has tried to update his insurance, but I think they're probably still sending information to you guys which we need to make sure they would stop doing that but.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I would think you would just see that the coverage is no longer there.
[AGENT][NEUTRAL] Right, that's true.
[AGENT][NEUTRAL] That's true. Um,
[CUSTOMER][NEGATIVE] And let and let them know that it's been denied but but I keep getting this letter saying it's being reviewed.
[AGENT][NEUTRAL] OK, so that's happening because every time they try to send in the claim we have to inform you too of the findings of the claim and they are being denied because the policy is lapsed um the best thing to do is just go to them and let them know that you no longer have that insurance so they can take it out of their computer because a lot of the times it's um done electronically.
[AGENT][NEUTRAL] And they'll just keep on sending so that's why you keep getting multiple letters is because by law we have to let you know also that the claim was filed.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you give me um does it give an exact name of who it is that keeps sending that in?
[AGENT][NEUTRAL] No, ma'am. It's just, um, let me tell you.
[AGENT][NEUTRAL] The facility.
[AGENT][NEUTRAL] Lab Corp of America.
[CUSTOMER][NEUTRAL] OK, Labor of America and then do you have any um anything that tells you like when they first sent that in?
[CUSTOMER][NEUTRAL] So we can kind of try to pinpoint it to what date of service that was if, if, if you have that it may be helpful but.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm looking to see.
[AGENT][NEUTRAL] When they first started sending it.
[CUSTOMER][NEUTRAL] Or if they give, if they have um a phone number associated with it that you have access to I mean it's a huge network of labs so.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, I don't have a phone number. I can only see like how the claim was processed as far as um.
[AGENT][NEUTRAL] The denial codes and why it was denied and the facility is all I'm able to see is just the facility name um and I don't see any other information that can give us.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] So I would, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I, um, it's looking like I would think that if you could just ask him when the last time he went to the doctor and did he have blood work done and ask him which doctor he went to and if he had blood work.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, yeah, I know he's
[CUSTOMER][NEUTRAL] Yeah, OK, so you just have Labor of America as.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] The one filing this, OK, alright, we will take it from there. Thank you so much for your help. I really appreciate it.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a blessed three-day weekend and we appreciate you calling APL. Thank you.
[CUSTOMER][POSITIVE] Yes, you too.
[CUSTOMER][POSITIVE] OK, take care.
[AGENT][POSITIVE] All right you too bye bye.
[CUSTOMER][NEUTRAL] Bye bye.