AccountId: 011433970860
ContactId: f7bb469f-4f8b-4db6-98dd-07e53e2fb8ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 343420 ms
Total Talk Time (AGENT): 177296 ms
Total Talk Time (CUSTOMER): 138032 ms
Interruptions: 2
Overall Sentiment: AGENT=1.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/f7bb469f-4f8b-4db6-98dd-07e53e2fb8ba_20250110T16:53_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi there. I, um, have had some recent medical bills and I think you're our gap provider, so I wanted to see what, I don't know what to do is what I'm basically telling you.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] I do. Um.
[CUSTOMER][NEUTRAL] I think this the outpatient benefit certification number is 02552057 M like Mary L like Larry 8.
[AGENT][NEUTRAL] Alright, thank you and may I ask your name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Alright, thank you and Miss [PII], can you verify your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and my email address is [PII].
[AGENT][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] And what is a good call back number in case we get disconnected?
[CUSTOMER][POSITIVE] Thank you too.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Alright, so yes ma'am, you are correct, this is your secondaryga policy. It does help provide benefits for medical services and.
[AGENT][NEUTRAL] Was it for an inpatient procedure or outpatient?
[CUSTOMER][NEUTRAL] Um, some of them were inpatient, some outpatient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Honestly not sure who North Broward radiologist is.
[AGENT][NEUTRAL] OK, that's probably outpatient.
[AGENT][NEUTRAL] Is this in December? I mean, in November?
[CUSTOMER][NEUTRAL] Uh, let's see, you mean when they sent the bill?
[AGENT][NEUTRAL] For the, when you went to the hospital or the urgent care or?
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] When I went to urgent care, it was November, yeah.
[AGENT][NEUTRAL] OK, so I see that South Miami Urgent Care Hospital did file a claim for you.
[AGENT][NEUTRAL] For that
[AGENT][NEUTRAL] Visit and it was paid.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] So we have a couple other ones I wanna ask you about though?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] There's
[CUSTOMER][NEUTRAL] Um, the one is this one from North Broward radiologist.
[AGENT][NEUTRAL] OK, that one we do not have on file. We do have the Broward Health Imperial for [PII].
[AGENT][NEUTRAL] For an ER visit.
[CUSTOMER][NEUTRAL] Uh, oh, OK, for Imperial, oh, good. Um, somehow I need to get in touch with them, see if they sent me the, um, because they had me pay the deductible, which was $300 and then they said, oh yeah, your gas insurance will cover it.
[CUSTOMER][NEGATIVE] But I don't know that they ever paid me back the $300 to my credit card.
[AGENT][NEUTRAL] Yeah, I would definitely call them. We don't they get enough money anyway. They don't need an overpayment.
[CUSTOMER][NEUTRAL] That is right. That's right. So, uh, how can I
[AGENT][NEUTRAL] We, we, we did pay them $1,712 toward that ER visit.
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEGATIVE] Hold on one second. I hope that I'm not a bother on your time. I don't even see the Imperial number.
[AGENT][NEUTRAL] You are not, you take your time.
[CUSTOMER][NEUTRAL] Oh, thank you, cause it's honestly, I'm a little overwhelmed.
[AGENT][NEGATIVE] and you get so many bills, and they just keep coming. And if you breathe, get a, you're getting a bill for your breathing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I know
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] They just come out of the woodwork. OK, so.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The only uh those are.
[CUSTOMER][NEUTRAL] I'm just gonna write that down that you paid Imperial how much did you pay Imperial?
[AGENT][NEUTRAL] $1,712.
[CUSTOMER][NEUTRAL] OK. I'll call them.
[AGENT][NEUTRAL] And that was, yeah, we actually paid that on let me check and see what date that was paid for you.
[AGENT][NEUTRAL] The claim was processed on [PII], so they may not have received it yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll check on them. And then what about this one that I have for North Broward radiologists?
[AGENT][NEUTRAL] I'm
[AGENT][NEUTRAL] OK, so we don't have that one on file and the easiest thing to do actually is to call them and make sure that they have the meddling your meddling gap policy information.
[AGENT][NEUTRAL] And let them file a claim for you because they've already got all the documents needed to file a claim, it's just easier and then we can pay them direct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I'll call each one of these guys and make sure that they have the gap number.
[AGENT][NEUTRAL] That's the easiest thing. Now if there's a problem and they say that they don't file on secondary policies, most places do, but occasionally there is that provider that just says we don't do it, then you can file for reimbursement, that's not a problem.
[CUSTOMER][NEUTRAL] How do I file for reimbursement?
[AGENT][NEUTRAL] So we're gonna need
[CUSTOMER][NEUTRAL] So, let me just, let me just cross that bridge when I get to it just in case, you know, less information is better.
[AGENT][POSITIVE] Yeah, you just call us back. We can help you through that.
[AGENT][POSITIVE] And they should file it with no problems.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, great. OK, well, thank you so much for your help. You've been such a pleasure to talk to.
[AGENT][POSITIVE] Well, it's been a pleasure to talk to you too, Miss [PII], and anytime you need any assistance, don't hesitate to give us a call and hopefully they'll get those claims over to us and we can get that taken care of for you.
[CUSTOMER][POSITIVE] Great. Thank you so much.
[AGENT][POSITIVE] Thank you for calling APO. You have a wonderful day and a very happy weekend.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.