AccountId: 011433970860
ContactId: 154947f7-0355-4e19-ba16-7d421d098ee9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 431010 ms
Total Talk Time (AGENT): 251386 ms
Total Talk Time (CUSTOMER): 163825 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/154947f7-0355-4e19-ba16-7d421d098ee9_20250319T20:52_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Yes, good afternoon. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling cause um I went to the orthopedic yesterday and I forgot to give them my APL uh card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My God, and I would like to submit a claim for the outpatient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] All right, I can help you with that. And do you have your policy number available?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] For the outpatient, I have 01723472 M as in mother, L as in Larry, number 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, Miss [PII]. And what is your date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Do you mind verifying your current mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you. And what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and also Ms. [PII], we do have an email on file for you. Do you mind, it looks like maybe your work email. Can you verify that or I can change it to your personal email, whichever you would prefer.
[CUSTOMER][NEUTRAL] Um, you can send it to [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] It's [PII] and [PII] my last name.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] All right, I have updated that to your personal email. Now, the policy number you gave me is no longer an active policy. You do have active policy coverage.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Under policy number 2337119, have you received that updated card?
[CUSTOMER][NEUTRAL] No, never.
[AGENT][NEUTRAL] OK. No.
[CUSTOMER][POSITIVE] Thank you. This one is from [PII].
[AGENT][NEUTRAL] Yeah, the other policy, it, you know, it turned in [PII] and then you, it changed.
[CUSTOMER][NEUTRAL] Beautiful. I never received a card.
[AGENT][NEUTRAL] And so you
[AGENT][NEUTRAL] Would you like for me to email you a copy of your card?
[CUSTOMER][NEUTRAL] Please
[AGENT][POSITIVE] I'm doing that right now for you. I don't mind at all.
[CUSTOMER][POSITIVE] If you don't mind. Thank you.
[CUSTOMER][NEUTRAL] Alright then.
[AGENT][NEUTRAL] I'm fixing to email a copy of your new card and.
[CUSTOMER][NEGATIVE] Yeah, even if I gave it to them yesterday, it's expired.
[AGENT][NEUTRAL] Well, it, you know, they probably would have called us maybe, hopefully, and we would have given them the active policy number.
[CUSTOMER][POSITIVE] You're so funny.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] So, we'll take care of you.
[AGENT][NEUTRAL] And did you happen to pay for that? Or because if you didn't, you can call them back and give them your APL information and they can still file a claim for you.
[CUSTOMER][POSITIVE] All right thanks.
[CUSTOMER][NEUTRAL] No, I pay with my credit card. I have the receipt with me. Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me finish this email real quick.
[AGENT][NEUTRAL] Now what we're gonna need, and certainly you can file for reimbursement.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We're going to need something from.
[AGENT][NEUTRAL] The doctor's office, was it a doctor's office?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So we're going to need.
[CUSTOMER][NEUTRAL] Orthopedic.
[AGENT][NEUTRAL] Something from the doctor's office with the diagnosis codes and procedure codes.
[CUSTOMER][NEUTRAL] You mean the progress note?
[AGENT][NEUTRAL] Yeah, so from the doctor's office we'll need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did they happen to give you a walkout paper maybe, given the reason that you were seeing?
[CUSTOMER][NEUTRAL] No, I don't have it. No, but I call them tomorrow morning that's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So if it, it can be a walkout paper, you know, that'll give us the diagnosis reason that you have been, were seeing.
[CUSTOMER][NEUTRAL] Yeah, no, I don't have it.
[AGENT][NEUTRAL] OK. And then we'll need, you're gonna give you have to give your primary insurance time to process a claim because we will need the explanation of benefits from your primary insurance. Was this for an office visit?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No. It was for the procedure.
[AGENT][NEUTRAL] OK, and they bill you think they bill as an outpatient facility?
[CUSTOMER][NEUTRAL] Yeah, they say that I have an, yeah, they said that I have a deductible and they charged me for the injection. $324. Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, once your primary insurance processes that claim,
[AGENT][NEUTRAL] Then we'll need a copy of the explanation of benefits from them that will show us what they applied to your deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] You can submit that. Uh we also have a claim form on our website for Medlink M E D L I N K.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we'll need that claim form, so we'll need the claim form.
[AGENT][NEUTRAL] Uh, itemized bill from the provider from the facility where you went with the diagnosis codes and procedure codes, and a copy of your primary insurance explanation of benefits. It's also known as an EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yes. OK.
[AGENT][NEUTRAL] Yeah you're familiar with that, aren't you? You sound like you know these terms.
[CUSTOMER][POSITIVE] Yeah, yeah, yeah. Yeah, I work in the doctor's office, so, OK, perfect, yeah.
[AGENT][POSITIVE] OK, then you know a good deal. Yeah.
[AGENT][NEUTRAL] And on the, I sent you that copy of your new card.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Are you where you can just check it and see if you've received it and can open the attachment?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Give me a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I take issue with the internet.
[CUSTOMER][NEUTRAL] Give me a second cause I'm on the phone. Hold on. Just 1 2nd.
[CUSTOMER][NEUTRAL] Let me verify it now.
[CUSTOMER][NEUTRAL] I got it.
[AGENT][NEUTRAL] OK, so that's gonna be your new card. It will also have our portal address on there. You can create a login and password, you can upload those claim documents directly on your policy.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] I will do that. Thank you.
[AGENT][POSITIVE] And it's been such a pleasure to assist you, Miss [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, I won't be off.
[AGENT][POSITIVE] And thank you for calling APL. Hope you have a lovely evening.
[CUSTOMER][POSITIVE] Thank you. You too. Have a nice day.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Mm mhm bye bye.