AccountId: 011433970860
ContactId: ee878c10-5c46-4d93-a2c9-9cd42e72cec4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557169 ms
Total Talk Time (AGENT): 198895 ms
Total Talk Time (CUSTOMER): 184524 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/ee878c10-5c46-4d93-a2c9-9cd42e72cec4_20250324T14:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I need some help with a um with a bill that wasn't paid.
[AGENT][NEUTRAL] May I have your policy number?
[CUSTOMER][NEUTRAL] Sure, it's um 01842070 M as in Mary, L as in Larry 7.
[AGENT][NEUTRAL] May I have your first name and a good callback number, please?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] Can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] [PII]. My mailing address is [PII] and my email is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of claim. Do you have a data service?
[CUSTOMER][NEUTRAL] Yeah, [PII] and [PII].
[AGENT][NEUTRAL] And total bill amount?
[CUSTOMER][NEUTRAL] One, I have a residue of value of 17, 176 cents, and the other one's $60.86.
[AGENT][POSITIVE] Thank you for
[CUSTOMER][NEUTRAL] Those are uh amounts.
[CUSTOMER][NEUTRAL] Oh, after Aetna payment.
[AGENT][NEUTRAL] OK, thank you. One moment, I'll get this pulled up for future reference, you may visit our website at [PII] to check claim status as well.
[AGENT][NEUTRAL] Just waiting on the system to load one moment.
[AGENT][NEUTRAL] I'm only showing one claim on data service 712. It was an inpatient from Eastside Hospital.
[AGENT][NEUTRAL] But that one was.
[AGENT][NEUTRAL] Bill 278 and your responsibility was 7422.
[AGENT][NEUTRAL] And this one process to the provider.
[AGENT][NEUTRAL] That's the only claim we received on [PII].
[AGENT][NEUTRAL] 7:13.
[AGENT][NEUTRAL] OK, there's several 7:13, 1 moment.
[AGENT][NEUTRAL] Would that also be from East Side Hospital?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] I'm sorry that you're asking me. I was in, I was in [PII].
[AGENT][NEUTRAL] With that
[CUSTOMER][NEUTRAL] For, for 4 days, from the [PII].
[AGENT][NEUTRAL] OK, let me pull this one up.
[AGENT][NEUTRAL] I do apologize. The system is extremely slow this morning.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] The provider was [PII].
[AGENT][NEUTRAL] And do you have the group name?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] No, I, that's the, that's the doctor's name. The group name South Florida, no, South Broward Hospital District Miramar.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's the pathology.
[AGENT][NEUTRAL] This one is.
[CUSTOMER][NEUTRAL] It was uh gastrointestinal. So it's called Gastrointestinal and motility Center LLC.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. Let me see what this one is, radiology. So it doesn't look like we received that one on [PII] cause the only doctor one we received was the first one.
[AGENT][NEUTRAL] Let me see, I'm gonna pull up the claim image and see who the actual doctor is on that one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because this is stating that it's under East Side Hospital. I just wanna see who the provider is on this one.
[AGENT][NEUTRAL] OK, so this is a doctor's office visit on [PII] and it was for [PII].
[CUSTOMER][NEUTRAL] OK, no, that's not her. So maybe they just don't, for whatever reason, they only have Aetna's information and they don't have American public life. Um, I want to verify my benefits. So, when I have the American Public Life Advance, basically it covers 7, up to $7500 in deductible. So any payment that Aetna makes.
[CUSTOMER][NEUTRAL] The difference would be part of the deductible that I would owe so those differences are paid up to $7500 correct?
[AGENT][POSITIVE] It's 7900. That is correct.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] OK, so then these two charges should be going through American Public Life, they just probably don't have your information.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, and they can always fax it over as well along with the major medical EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, fax number here ends in [PII].
[AGENT][NEUTRAL] Uh yes, ma'am. That is correct. And you still have benefits available for 2024.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what do you mean by that? Like I still have benefits available, they still can get paid, right? That's what.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Yes, ma'am, because the benefit was not maxed for inpatient for [PII].
[CUSTOMER][POSITIVE] Correct, correct. OK, perfect. OK, thank you so much for your help. I appreciate it.
[AGENT][POSITIVE] You're so welcome. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Actually, I have you on the phone. I'm so sorry. So, I have also 4, I'm allowed 4 specialist visits.
[CUSTOMER][NEUTRAL] That get paid, um, my co-payment.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Can you tell me if I already, if, if who has already put through and who's already gotten paid because I think I might owe some money because I think I went over my 4, so I think someone's gonna start asking me.
[AGENT][NEUTRAL] Is it
[AGENT][NEUTRAL] Is it for [PII]?
[CUSTOMER][NEUTRAL] No, yeah, uh, no, 2025. Sorry, sorry, sorry, 2025.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for [PII], you have used two visits. Let me see who the providers are.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Looks like you had one on 26. Let me see who this provider is.
[AGENT][NEUTRAL] South Florida Spine and sports.
[CUSTOMER][NEUTRAL] And how much was paying?
[AGENT][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] $50 OK.
[AGENT][NEUTRAL] And then there was one on 127.
[AGENT][NEUTRAL] And let's see who this provider was.
[AGENT][NEUTRAL] Cardiovascular specialist.
[AGENT][NEUTRAL] And that was for 127 and those are the only two that we have so far for [PII].
[CUSTOMER][NEUTRAL] And then cardio specialist, you paid how much?
[AGENT][NEUTRAL] Um, this was $50 visit as well. Your specialists are $50.
[CUSTOMER][NEUTRAL] OK, so then I have 2 left. OK.
[CUSTOMER][POSITIVE] Which are the two that I probably just used recently. They should be billing you soon. OK, um, thank you so much for your help. I appreciate it.
[AGENT][POSITIVE] You are so welcome, [PII], and thank you for calling American Public Life. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][POSITIVE] Perfect.