AccountId: 011433970860
ContactId: fdba9d7f-b594-4278-b93e-0833226e6964
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 310000 ms
Total Talk Time (AGENT): 116594 ms
Total Talk Time (CUSTOMER): 200685 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/fdba9d7f-b594-4278-b93e-0833226e6964_20250213T20:30_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], um, my name is [PII], and my husband is the one with the insurance, um, through Mormon's Electric, and he just sent me something that, uh, Quest, evidently Quest must not be sending any EOBTs over to y'all. Um, he had it done in January, like January, maybe the [PII], and, um, they're telling him that he's gonna be getting a paper bill in 55 days. So do you want me to send that paper bill over to you when I get it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me pull up the policy. Give me one second.
[CUSTOMER][NEUTRAL] You need the number, honey.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, it's 2321217.
[AGENT][NEUTRAL] OK, what's a good phone number? OK, what's a good phone number in case?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][POSITIVE] OK, thanks.
[CUSTOMER][NEUTRAL] And I'm his wife [PII], y'all should have something on file because I submitted it to y'all, I believe.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] Sounds like you're not feeling good.
[AGENT][NEUTRAL] Yeah, I have the call.
[AGENT][NEUTRAL] It's like
[CUSTOMER][NEUTRAL] Mm, I know my sister's got the flu A, whatever that is.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Some going around
[AGENT][NEUTRAL] It is, it is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, let's see. OK, we did receive your form.
[AGENT][NEUTRAL] And you said that is it so Quest Diagnostics is gonna send the.
[AGENT][NEUTRAL] The billing to you
[CUSTOMER][NEGATIVE] They told him they sent him a text that they sent him a text that they were gonna send him a paper bill in 5 days, but I don't know if Quest is, shouldn't Quest be sending y'all something when they get something from his insurance company? Shouldn't they be sending that to y'all like electronically or something?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so itemized.
[AGENT][NEUTRAL] Uh-huh, they're itemized bill. What date of service is it for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, well,
[CUSTOMER][NEUTRAL] Oh, I'd have to look it up on it and I probably can't remember my password. I can call you. It was sometime in January.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, yeah, I don't show any [PII] claims for [PII], um.
[CUSTOMER][NEUTRAL] Yeah, well, this new insurance company, they, I don't know, this insurance company they got now.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, they might not have.
[CUSTOMER][NEUTRAL] See, we thought he still had the old insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And then lo and behold, you know, on the [PII], they said, oh no, y'all had new insurance since the [PII]. I'm like, well, you didn't give us no cards, you didn't tell us nothing about it.
[AGENT][NEUTRAL] Who is the primary insurance now?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Um, it's allied.
[AGENT][NEUTRAL] It's allied OK.
[CUSTOMER][NEUTRAL] Yeah, y'all don't have that information?
[AGENT][NEUTRAL] We do.
[CUSTOMER][NEUTRAL] Oh, OK. It, it used to be, um, UnitedHealthcare.
[AGENT][NEUTRAL] Yeah, I was just, I was just verifying. Mhm.
[CUSTOMER][NEUTRAL] Huh? Yeah, it was UnitedHealthcare.
[AGENT][NEUTRAL] I was just verifying with you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, OK, yeah. Um, but, um, I'll try and get that information because, you know, if you call them, you're not gonna get in touch with nobody.
[AGENT][NEUTRAL] Right now, you know,
[CUSTOMER][NEUTRAL] Or you, I'll just wait. Can I, uh-huh.
[AGENT][NEUTRAL] You know, because the APL policy is secondary, we'll need a copy of allied explanation of benefits as well, as well as quest itemized bill.
[CUSTOMER][NEUTRAL] OK, I'll have to look that up and, and see what they, I mean, they're not, I don't know if they pay any, they have a contracted right and they said we owe like $11 and something, $11.54 you know, so, but, um, OK, let me see if I can, um, I'm at work, but when I get home I might see, I might be able to look it up on the online site if they, if they tell me anything and they be able to maybe print something out then maybe I can fax it to y'all.
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] Yes, but
[AGENT][NEUTRAL] Yeah, request the explanation of benefits from Allied.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're wanting and you you're wanting to let them know that it needs to be the one that shows um [PII]'s deductible co-insurance and co-pay amounts. There's one that has that information on it that's the one that we need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. In other words, y'all need to see if he's met the deductible or not.
[AGENT][NEUTRAL] Well, we need to know, have that one because that tells us what we owe him if anything and whatever is registered or listed in the deductible column, the co-insurance co-pay column is what we will reimburse.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] To [PII], to [PII].
[CUSTOMER][NEUTRAL] Yeah, because this is what happened. OK, they're saying.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, this insurance company is a $5000 deductible.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Um, they're saying that, uh, I have to pay, they applied his Humira, which we have to pay $5500 for to the deductible. So he's met his deductible. But when this took place, he didn't meet his deductible because they didn't do what they were supposed to do is send you the EP, whatever you call that. I don't know what, yeah, so, you know, somebody's not doing what they're supposed to do, but um I'll call you back tomorrow and I'll tell you what I find out, OK?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The EOB mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that'll be fine.
[CUSTOMER][POSITIVE] OK. Thank you so much. You have a good day. Bye-bye.
[AGENT][POSITIVE] Alright, Miss. You're welcome, Miss [PII]. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK bye bye.
[CUSTOMER][NEUTRAL] OK. I hope you feel better.
[AGENT][NEUTRAL] OK, thanks. Bye-bye.
[CUSTOMER][NEUTRAL] OK.