AccountId: 011433970860
ContactId: 11209783-b128-411b-9262-6c547f9f6e7a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 746500 ms
Total Talk Time (AGENT): 332058 ms
Total Talk Time (CUSTOMER): 298034 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/11209783-b128-411b-9262-6c547f9f6e7a_20250509T20:23_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], how are you doing today? I'm uh I've been
[AGENT][POSITIVE] I'm doing good.
[CUSTOMER][NEUTRAL] I need your, your, your guidance to be uh OK so I got a bill from the I was in the hospital right? and I got a bill from from uh my first bill is here. I don't know how to do the claims or how to proceed or whatnot so I have the cards for my APL APL, it's uh an additional insurance that I have correct? that I purchased.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes, sir. I'll have to look at the policy itself. Can you give me your name and your callback number just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, absolutely. [PII]. And my name is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, and [PII], do you know your policy number?
[CUSTOMER][NEUTRAL] Yes, ma'am. I have the card here.
[CUSTOMER][NEUTRAL] Hold on policy number.
[AGENT][POSITIVE] Yes sir, what's that please? Yes.
[CUSTOMER][NEUTRAL] Is, is it the
[CUSTOMER][NEUTRAL] The one that says.
[CUSTOMER][NEUTRAL] Group number?
[AGENT][NEUTRAL] No, it may say inpatient certification number or outpatient certification number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got it. I got it in hospitals benefit card certification number and outpatient. I got two. OK. In in hospitals benefit certification number, OK, 024.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, either one.
[CUSTOMER][NEUTRAL] 86901 ML 7
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], can you please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you sir and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] OK, thank you. And your
[CUSTOMER][NEUTRAL] My email address is
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK thank you um looks like I have um your work email address.
[CUSTOMER][NEUTRAL] Oh, you have [PII].
[AGENT][POSITIVE] Yes, that's it. Thank you, [PII].
[AGENT][NEUTRAL] Mm OK, so you're calling because.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You don't know how to file a claim, um, now I do see some claims.
[CUSTOMER][NEUTRAL] I got my, I got my first bill.
[AGENT][NEUTRAL] OK, what is the data service on that bill?
[CUSTOMER][NEUTRAL] OK, the date of service on the bill.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then what is the name of the uh facility that you went to?
[CUSTOMER][NEUTRAL] Baptist Health Emergency care at West Kendal.
[CUSTOMER][NEUTRAL] Cigna, Cigna was my insurance company.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] OK, thank you. Let me look and see if they filed for you.
[AGENT][NEUTRAL] OK, what is the amount that's on that bill you said it was 200?
[CUSTOMER][NEUTRAL] That, no, this bill, uh, this bill says, OK, locational service Baptist Health emergency care with scandal, Cigna. It was $351.12 and it says here patient's balance 20 to 18. That's one line, and the other line says the same thing.
[CUSTOMER][NEUTRAL] Uh, another bill, 1,28592, and it says patient balance 8122. It says total due $103.40.
[CUSTOMER][NEUTRAL] For a company called Ra.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me look and see because I've got a couple of claims that have been sitting in and I wanna make sure that they didn't bill it for you. We're gonna check real quick.
[CUSTOMER][NEUTRAL] Right, yeah.
[CUSTOMER][NEUTRAL] This one
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you. This one says radiology.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, MBB radiology.
[CUSTOMER][NEUTRAL] Mm, this one says RASF.
[CUSTOMER][NEUTRAL] Radiology.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Radiology Associates of South Florida.
[AGENT][NEUTRAL] OK. So, I do see that on that date that you gave me, [PII].
[AGENT][NEUTRAL] We did pay, um, $200 to MBB radiology.
[AGENT][NEUTRAL] And I can give you the claim number and the check number.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, let me get this clear because I'm a little bit confused here. OK, so this bill that I got today, right, it says account actually it says the statement date [PII], account it says MBBAC and it's got a number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, and it says pay this amount 10,340. I had Sigma Priority uh insurance. I don't know if I'm calling Sigma right now or it's APL.
[AGENT][NEUTRAL] Mhm. You're, you're calling APL and we're the secondary insurance, and I'm showing that on that data service, we did send a check for $200 to MBBRadilogy.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let me see what day we sent that on and if they've cashed it yet.
[CUSTOMER][NEUTRAL] Yeah, but it's a different amount. It's what I'm saying. It's $103.40.
[AGENT][NEUTRAL] OK, if you wanna file the claim yourself.
[AGENT][NEUTRAL] Let me tell you about the online service center.
[AGENT][NEUTRAL] Have you signed up for?
[CUSTOMER][NEUTRAL] I'm not very literate in computers.
[AGENT][NEUTRAL] Oh no, OK, that's all right. You can send it in by fax.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so let me give you the website to get the claim form. You'll need to fill out the claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll have to go to the website to get that. And let me give you the website.
[AGENT][NEUTRAL] It is
[CUSTOMER][NEUTRAL] OK, hold on one second, hold on 1 2nd.
[AGENT][NEUTRAL] Uh yes, sir. OK.
[CUSTOMER][POSITIVE] Uh, fax I know how to use. I can fax that. I don't have a problem with that. Fax I got the fax number for you. It's [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Mhm. OK, what's the website to get what?
[AGENT][NEUTRAL] You're gonna get a claim form.
[CUSTOMER][NEUTRAL] Plain form.
[AGENT][NEUTRAL] Yes, for Medlink, M E [PII] L I [PII] K.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] A claim form, it says what?
[AGENT][NEUTRAL] Medlink, M E D L I N K.
[CUSTOMER][NEUTRAL] For me link a claim for format link. OK, alright.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Alright, so you're going to go to [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, that's the website.
[AGENT][NEUTRAL] Yes, when you get in the website in the top right hand corner you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Once you get in there to claims and forms, you're gonna go to page.
[AGENT][NEUTRAL] 2
[AGENT][NEUTRAL] And it's the 3rd claim form down is the Medlink claim form.
[CUSTOMER][NEUTRAL] It's a medling claim form that I need.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] There's a big blue button that says download form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're gonna click on that you're gonna download the claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You'll fill out that claim form and you're gonna need to send the claim form.
[AGENT][NEUTRAL] The explanation of benefits from Cigna.
[AGENT][NEUTRAL] And you'll also need the itemized statement with your procedure codes and diagnosis codes.
[AGENT][NEUTRAL] From the facility that you went to.
[CUSTOMER][NEUTRAL] Not the bill. The bill is detailed.
[AGENT][NEUTRAL] Right. You're gonna need the itemized statement that has the diagnosis code and procedure codes.
[CUSTOMER][NEUTRAL] Do I have to call them too for that?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Because what I have.
[AGENT][NEUTRAL] They can only give it to you.
[CUSTOMER][NEUTRAL] Because what I have is the bill, so I have to call this company and tell them to send me the itemized.
[AGENT][NEUTRAL] Statement
[AGENT][NEUTRAL] With procedure codes and diagnosis codes.
[CUSTOMER][NEUTRAL] We procedure code oh this is gonna take a year.
[AGENT][NEGATIVE] I hope not.
[AGENT][NEUTRAL] Now, when you talk to them.
[CUSTOMER][NEGATIVE] It will. I mean, this is the first bill I get, you know, this is the first bill I get. I thought, I thought this company after Sigma clicked in, they would send it to you guys because I provided the APL card when I went to the hospital.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Now you can when you call them, you can ask them and if they're kind enough to file the claim for you.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Let me give you the payer ID number that will help them if they will file for you that'd be the easiest thing, the payer ID.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Payer ID 60801.
[AGENT][NEUTRAL] Yes, and they can file it electronically that way right through the computer so when you call them, ask them if they would be kind enough to file the claim for you and they'll ask for all your information on your card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give them that payer ID number and see if they'll do that for you. If not, then you have the website with the claim form.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you'll need the explanation of benefits and the itemized statement.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] With procedure codes.
[AGENT][NEUTRAL] Yes, and diagnosis codes if there's any.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That's with procedures and diagnosis code.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, alright, thank you so much. This will have to wait until Monday.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] OK, and look, if you get stuck while you're trying to file it, pick up the phone and call us, we'll help you.
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] This is the this is the first bill. Imagine that. I was in the hospital for 4 days. There's gonna be a ton of those. All right, thank you.
[AGENT][POSITIVE] Wow.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh no, we don't want that no more. You're welcome. I hope you have a wonderful weekend. Bye-bye, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] You do bye.
[AGENT][POSITIVE] Thanks for calling APL.