AccountId: 011433970860
ContactId: ef2a8db3-f07e-4ada-8041-735b8a1516df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 544219 ms
Total Talk Time (AGENT): 286502 ms
Total Talk Time (CUSTOMER): 243769 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/ef2a8db3-f07e-4ada-8041-735b8a1516df_20250428T14:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. How, how are you?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEUTRAL] Good, I'm calling on behalf of um [PII], my fiancee. His, he has APO, um, public life, um, in in the card, and, um, I just called on a medical bill that he had, and they're saying that it's not active anymore. Um, I have his ID number, the coverage group. I don't need information on it, obviously. I just wanna need to make sure he has the right card. If not, maybe you can mail out a new one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Um, for him.
[AGENT][NEUTRAL] We can verify that that's active and uh if he needs an updated card absolutely um what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] OK, and then I'm sorry, what did you say his name was?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Got it. And then, uh, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, and then uh I'll go ahead and take that policy number please.
[CUSTOMER][NEUTRAL] So the um the group number or I have the payer ID number which one is that is what you need?
[AGENT][NEUTRAL] Are you uh looking at the card right now?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] Um, do you see anywhere on there that says, uh, in hospital or outpatient, uh, certification number? OK, yeah, even one of those please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, the
[CUSTOMER][NEUTRAL] OK, so 017 19419 ML 7.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] OK, and I'm sorry you you said your name was [PII], right?
[CUSTOMER][NEUTRAL] It is, yes.
[AGENT][NEUTRAL] OK, just a moment.
[AGENT][NEUTRAL] And uh [PII] is not available but I could speak with him?
[CUSTOMER][POSITIVE] Um, I could maybe conference him in on a call if you want for a second I'll see if I can get him on the line with us.
[AGENT][NEUTRAL] Yeah, unfortunately since you are not uh listed under the policy, I'm unable to give anything um specific regarding the policy. Um, may I ask uh who uh was he told um or who told him about the policy not being active? Was it a physician?
[CUSTOMER][NEUTRAL] Alright, let me
[CUSTOMER][NEUTRAL] Let me see if I can
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I just
[CUSTOMER][NEUTRAL] Just called, yeah, I just called um Primary Care Medical and um they have this card on file, this number and they're saying it's no longer been it's no longer active.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's how I found that out and he's like well just call and see if there's a new card maybe.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] If you would just really quick, [PII], um, could you verify uh [PII]'s date of birth for me?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK and then uh if you would, can you verify the um.
[CUSTOMER][NEUTRAL] I can give you the last four of the social too.
[AGENT][NEUTRAL] That's OK. Uh, can you verify the mailing address we've got on file?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect alrighty so I will go ahead and just let you know it is active, uh, the policy number that you gave me is active.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] So I don't know why they're saying that it's not then.
[AGENT][NEUTRAL] I'm not sure either, um, but they are, uh, they need to, you can tell them that you called, you know, and verified, and if they need to they can definitely give us a call, um, we can, you know, tell them that it's active for sure.
[CUSTOMER][NEUTRAL] It's very weird because I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so he doesn't need a new card. These cards are, oh, because I know it says on here effective date was [PII], so it doesn't need a new card. These are the same bright cards.
[AGENT][POSITIVE] Correct. Yes, that's the effective, absolutely. It is, this one is currently active.
[CUSTOMER][NEUTRAL] Now my other question to you, maybe you can answer this, maybe you can't. This card is not for co-payments, it's just to cover the deductibles.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No, OK, so I, I can't explain the plan type to you, of course, uh, so this, in short, it is a secondary medical policy that is designed to help with co-pay, deductible and co-insurance, um, after his major medical pays. Some things may not be covered under this policy, of course those kinds of specifics, you know, obviously I would need to speak with [PII].
[AGENT][NEUTRAL] Um, but some of them cover like, uh, for example, office visits, sometimes office visits are not covered, in which case it wouldn't help with, uh, co-pays or deductibles, but, um, for just about most everything else that's what this is supposed to be for.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So this is the problem, and I'm just gonna explain it to you maybe then I'll have [PII] call you obviously or something. So [PII] was in a motorcycle accident in November and in the state of [PII]. He's responsible for the medical bills, blah blah blah blah blah. Um, I guess even when you're in an accident, so now we're getting all these medical bills and some of them are.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] They're not being paid and that's what [PII] thought was this is a secondary insurance that it should pick up everything maybe but a copayment that we should have left over, but it hasn't been and I don't know.
[AGENT][NEUTRAL] Right, so as long.
[CUSTOMER][NEUTRAL] If the bills have been submitted through.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] [PII] I how do we know if you guys have gotten these bills.
[AGENT][NEUTRAL] OK, there's a couple of different ways um of course [PII] can he's more than welcome to give us a call we can check that way um we've also got an online, uh, service center, an online portal that I could create an account and view claims uh and claim status that way. Um, most of the time, and of course we could look more specifically, uh, a lot of times, you know, it could.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Deny as we might be missing information or something like that um so you know of course you can always have those providers give us a call to check um that way but it is um has his the primary been picking up the bills at all?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It, it has, yes, so, so some of them have, but now we're getting, so but now the problem is like, OK, so why, what is APL doing if we're still getting bills that's what we wanted to know because some of these bills obviously are much more expensive. So you're saying if I call the, the where we get the bills from and say did you guys talk to APL you guys will be able to talk to them because they're billing.
[AGENT][POSITIVE] OK, awesome.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Absolutely if they would, yeah, if they can get, um, they would be the one to give us a call. All they would really need to do is be able to verify [PII]'s information um if they were the ones who filed the claim we can speak to them, uh, regarding those claims and if there was any information that we're just missing or anything like that, then we can let them know.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, and now if [PII] wanted to put, uh, obviously I'm not on his same insurance, um, but at the, is there a way for [PII] to put me on so if I call you guys that you guys could talk to me because I handle all all of this obviously all these bills, is there?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Absolutely, absolutely, yes, that does happen quite a bit um so there is a form, uh, and you know we can send it to y'all or you can get it on our website that's uh essentially an authorization form that he could fill out, put your information on, um, and that way we could discuss anything on the policy with you, uh, without needing to bother [PII] every time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, is there a way to email him that form?
[AGENT][NEUTRAL] Sure, let's see. Give me just a moment, let me see.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] One email I've got for him.
[CUSTOMER][NEUTRAL] I know he's out of the office right now, but he's because he's at a doctor's appointment, but I'm sure when he gets back he can do that.
[AGENT][NEUTRAL] I've got a Yahoo account for him is that where you'd want me to send it?
[CUSTOMER][NEUTRAL] Uh, can I give you his work email? No, can I give you his work one that he checks all the time. So that's [PII]
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] At
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][NEUTRAL] So it's just [PII], not [PII], just [PII].
[AGENT][NEUTRAL] OK, OK got it alright yeah I can go ahead and send that form to this email.
[AGENT][NEUTRAL] And then he could just email it right back to you since it's completed.
[CUSTOMER][NEUTRAL] OK, and then in the meantime I'll try to.
[CUSTOMER][NEUTRAL] In the meantime, I'll try to get a hold of these bills, these people that need the bill paid and let them know that there is APL and it is active.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Absolutely, yes, and if there's any further information or if they haven't gotten a response, uh huh, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when I give them the number.
[CUSTOMER][NEUTRAL] Sorry, when I call the doctors and say, listen, this isn't here. What number do I give him? It says in hospitals benefit card, is that if he was in the hospitals, those are the bills that he was admitted to the hospital and the other ones are for the outpatient?
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Right, and that's really just going to be for billing purposes of the ML7 or ML8. The policy number itself is the number just before the M, so the one ending in 419, all you would have to give them is that the 01719419 is perfectly fine.
[CUSTOMER][NEUTRAL] Oh they don't need the ML number OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] It especially we don't just look at the policy, that's perfectly fine. Yes, I know it's a bit confusing.
[CUSTOMER][POSITIVE] OK perfect that makes it a little bit clear.
[CUSTOMER][POSITIVE] OK, thank you so much for your help. Yeah, no, it's been, you've been helpful. Thank you. I do appreciate it. Not at the moment, thank you very much.
[AGENT][NEUTRAL] Yeah, was there anything else I can help you with?
[AGENT][POSITIVE] Of course, alright, yeah, thanks for giving us a call have a great rest of your day bye bye.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] You too bye.