AccountId: 011433970860
ContactId: f5cd9467-4edd-4c88-ba7d-0152a8c0cec7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 336519 ms
Total Talk Time (AGENT): 109730 ms
Total Talk Time (CUSTOMER): 183121 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/f5cd9467-4edd-4c88-ba7d-0152a8c0cec7_20250106T17:55_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, [PII]. Um, my name is [PII]. I'm calling because, um, my [PII] had, um, ACL repair surgery. Um, however, I am getting a bill from a company called Carecentric, um, and they sent me a health insurance claim form filled out with the information regarding what they're billing me for, and it's for her knee braces.
[CUSTOMER][NEUTRAL] Um, apparently they went through my primary insurance, which is Blue Cross Blue Shield, and they advised me that they don't go through secondary insurance, so that's why they sent me this claim form and said that I need to submit it to APL if I want them to consider it.
[AGENT][NEUTRAL] OK, so you just need information on how to submit a claim or do you wanna verify if we received the claim?
[CUSTOMER][NEGATIVE] Both. So the young lady, which was not very helpful, said that she would do both. I got the, the form in the mail, so I'm assuming that she sent it to you already.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] May I have your policy number and I'll pull up your file.
[CUSTOMER][NEUTRAL] Uh, is it on this policy number is 024.
[CUSTOMER][NEUTRAL] 73377
[AGENT][NEUTRAL] And may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Yes, it's my cell phone number which is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] So my date of birth is [PII]. Mailing address is [PII]. And I'm sorry, am I missing something?
[AGENT][NEUTRAL] Your email address?
[CUSTOMER][NEUTRAL] It's my first name, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. So let me get this pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for which child is this for?
[CUSTOMER][NEUTRAL] Uh first name is [PII], [PII], last name [PII], and date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Do you have a data service?
[CUSTOMER][NEUTRAL] Uh, what does it say on that?
[CUSTOMER][NEUTRAL] I can only tell based on the bill that they sent. It says it's 5-7-2024.
[AGENT][NEUTRAL] OK, and I'm not showing anything in history for 57 of 24. Let's see.
[AGENT][NEUTRAL] OK, and there's nothing waiting in line to be processed. So you can actually submit the bill yourself. You would need 3 items to submit it. You would need the itemized bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You would need your major medical explanation of benefits.
[AGENT][NEUTRAL] And then you would
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] So I'm
[CUSTOMER][NEUTRAL] I don't know, so the only thing that I've received from this company, Carecentric, is.
[CUSTOMER][NEUTRAL] This bill, but it just says well I, I guess you guys will still figure out what this is for.
[CUSTOMER][NEGATIVE] I don't know. It's, it's not itemized. It's just her, her knee equipment or whatever it is, so I have that letter, um, I have the, it says health insurance claim form that's filled out by that company already with my daughter's information as well as the billing info, and then you said something about explanation of benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] From your primary insurance?
[CUSTOMER][NEUTRAL] I don't know how to get that, so.
[AGENT][NEUTRAL] Who would be your primary?
[CUSTOMER][NEUTRAL] It's Blue Cross Blue Shield.
[AGENT][NEUTRAL] So, they normally would have a website you can go into and match that data service to their EOBs, and we would need the EOB to show what was applied to your copays, your co-insurance, and our deductibles.
[AGENT][NEUTRAL] So that's why we request that.
[CUSTOMER][NEUTRAL] OK, because on the, the this company they do have the adjustment from Blue Cross Blue Shield as far as how much they paid and what's the remaining balance, but you're saying to go on Blue Cross Blue Shield's website and get that.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Explanation of benefits for this date.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and then once I have all of that, then what do I do?
[AGENT][NEUTRAL] Did you register your account with APL?
[CUSTOMER][NEUTRAL] Um, yeah, I think I did. It's, uh, some sort of online link that you have.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am. So you can upload your claim there, you can fax it, or you can mail it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alrighty. I will do so. Thank you very much.
[AGENT][POSITIVE] You're so welcome. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am. That's it.
[AGENT][POSITIVE] [PII], thank you so much for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.