AccountId: 011433970860
ContactId: 1d39bac5-2d04-40df-bd59-2a36e10a107f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 366260 ms
Total Talk Time (AGENT): 180715 ms
Total Talk Time (CUSTOMER): 151672 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/1d39bac5-2d04-40df-bd59-2a36e10a107f_20250221T15:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, good morning. I hope so. Um, my name is Mr. [PII], and I had a, a, a procedure done back in August.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I, and the, the, my insurance company, United Health, uh, covered it, but then I have a balance of 726 57, and I do have gap insurance. Um, I've been calling the surgical center and they said, oh no, you have to get a hold of APL. So I'm calling to see what, how, how you can help me.
[AGENT][NEUTRAL] OK, I can see if I can assist you, Mr. [PII]. Uh, do you happen to have your policy number?
[CUSTOMER][NEUTRAL] Um, I do on the APL card.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, so, so the payer ID says 60801.
[AGENT][NEUTRAL] Uh, not a payer ID. Do you see a policy slash certificate number or in-hospital outpatient benefit certificate number at the bottom?
[CUSTOMER][NEUTRAL] Yeah, yeah, you want the outpatient one?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, either one is fine.
[CUSTOMER][NEUTRAL] OK. 02549370 M as in Michael, L as in Lincoln, 8.
[AGENT][POSITIVE] Awesome, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Um, I'll yes, I'll give you my cell number, uh, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much, and give me a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and Mr. [PII], verify your date of birth, mail address and email address, please.
[CUSTOMER][NEUTRAL] [PII]. Mailing address is [PII] and my email address will be [PII].
[AGENT][NEUTRAL] Uh, I see a different email address.
[CUSTOMER][NEUTRAL] Alright, how about uh [PII]?
[AGENT][NEUTRAL] No, sir. It's in
[AGENT][NEUTRAL] The Lord, I can't say, and
[CUSTOMER][NEUTRAL] I said, OK, I'll put one more, it's uh [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, OK, thank you.
[CUSTOMER][NEUTRAL] Ah, here you go.
[AGENT][NEUTRAL] OK, and so you said that you had a procedure done, that was, was this, I'm assuming outpatient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the provider told you to contact us.
[CUSTOMER][NEUTRAL] They, they said yes, you, uh, I needed to contact. I was, they had me on the phone for like 45 minutes waiting and then so you have to call AT and I'll let them know and then they will that that you have an outstanding balance on your bill. I, I don't know. The lady, the girl wasn't really late. She was just like, you need to call your, uh, your provider.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, bless it. OK. Uh well, you do have a policy with us, and secondary. What it does, it helps with your primary deductible, co-pay or co-insurance. Uh, typically providers can submit claims, but if they don't or can't, you can uh submit the information we need in order to be reimbursed any payable benefit, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So what we will need is the itemized bill showing the diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] And your primary insurance explanation of benefits for that data service. Who's your major medical with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, United Health.
[AGENT][NEUTRAL] OK, so yeah, you can contact United Health and request that uh explanation of benefits or EOB for that date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can uh submit it to us by mail, fax, and we do have an online service center. I don't know if you set up on there to where you can view your policy as well as uh submit claims and check claim status from the site.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And how do I get that?
[AGENT][NEUTRAL] OK, if you go to [PII].
[AGENT][NEUTRAL] And you will select.
[CUSTOMER][POSITIVE] So it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you go on a site, uh, you would select new user and then individual.
[CUSTOMER][POSITIVE] Got you OK.
[AGENT][NEUTRAL] And then it'll ask for your name, date of birth, social, zip code, and the email address that you um verified with me, and from there you will be able to set up a username and password.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, very good. All right, so just, just to recap, I have to contact United I'll get a copy of my uh EOD, is that what they call it?
[AGENT][NEUTRAL] Correct, the explanation of benefits, yes, sir, and um from the facility or place of service where you um ask for the billing, showing the diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Diagnosis.
[CUSTOMER][NEUTRAL] The procedure code.
[AGENT][NEUTRAL] Yes, sir. And then you, like I said, you can mail it, fax it or submit it to our online service center, and we do have claim forms available on our site at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you would need the one that says Medlink.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Len, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. Thank you. Well, thank you for your time. I appreciate it.
[AGENT][POSITIVE] You are welcome. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, no, ma'am. That'll take care of it.
[AGENT][POSITIVE] OK, thank you so much for calling APL and you have a great day and weekend.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] Mhm bye.