AccountId: 011433970860
ContactId: 1d7b7390-302d-4e13-9c06-25283579670f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 333070 ms
Total Talk Time (AGENT): 165424 ms
Total Talk Time (CUSTOMER): 110357 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/1d7b7390-302d-4e13-9c06-25283579670f_20250128T18:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. I'm giving you a call because I just logged into the portal and I, this is the first time I'm trying to do a claim, so I uploaded, uh, I guess like the receipt of, um, a medical appointment I went to, but I'm going back now and I just wanna make sure when did I do it correctly and I don't know if there was more to it other than just uploading the receipt.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, yeah, let's take a look. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah it is.
[CUSTOMER][NEUTRAL] 240.
[CUSTOMER][NEUTRAL] 4599.
[AGENT][POSITIVE] OK, thank you so much. Let me pull this up.
[AGENT][NEUTRAL] And can I get your first and last name with your date of birth?
[CUSTOMER][NEUTRAL] Is [PII] [PII].
[AGENT][NEUTRAL] Thank you and then I just need to verify please your uh.
[AGENT][NEUTRAL] Physical address on file and email address please.
[CUSTOMER][NEUTRAL] Email is [PII]. Address is [PII].
[AGENT][POSITIVE] Alright thank you so much. So let me see.
[AGENT][NEUTRAL] What we got here.
[CUSTOMER][NEUTRAL] I also realized that I think I uploaded a 2nd file that did not go with it, so I don't know if I have like I, I don't know if you can delete that second attachment for me or if I have to start it all over again.
[AGENT][NEUTRAL] Yeah, let's see. I don't know if I can delete it, but if it was an error, it's not a big deal. They'll just, it'll just get um canceled and tonight out, so.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK. So the only other thing that you're gonna, you're definitely gonna need is, you're gonna need the claim form.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, to go with it, so do you want me just to email that to you or you can get it from our website, whatever is easiest for you.
[CUSTOMER][NEUTRAL] I'm on the website. I just didn't know which one was the one that would um.
[CUSTOMER][NEUTRAL] That would correspond with this claim I guess.
[AGENT][NEUTRAL] Oh OK yeah absolutely so you need the uh Medlink claim form.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And um let's see.
[AGENT][NEUTRAL] It should say.
[AGENT][NEUTRAL] On because the med link is gonna be on the 2nd page.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I found it.
[AGENT][NEUTRAL] OK, great, so you've got the itemized bill, um, but we're gonna need an explanation of benefits from the primary insurance showing what they paid towards it and then what the uh remaining amount is and then you're gonna need something from the provider that has um diagnosis code on it um as far as like what was done as well.
[CUSTOMER][NEUTRAL] So the provider being the person I paid this co-pay to right though.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh, that would be the provider, yup.
[CUSTOMER][NEUTRAL] The provider with diagnostic code.
[AGENT][NEUTRAL] And they should know what you mean just let them know that you're submitting um a claim to your secondary insurance and they should understand what you're needing.
[CUSTOMER][NEUTRAL] OK, perfect. So, so I need to fill out the form and those two attachments that I'm missing.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Mhm, yeah, so just go to your, whoever your primary insurance is and you should have an explanation of benefits from that date of service.
[CUSTOMER][NEUTRAL] OK, so that's from the insurance and the other one I have to reach out to in this case Acumen that it uh for the provider code.
[AGENT][NEUTRAL] Right, exactly. Uh-huh.
[CUSTOMER][NEUTRAL] The diagnostic code, sorry.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect. OK. All right. Um, so then I
[CUSTOMER][NEUTRAL] Do I add on to this? Is there a way to add on to this or you just upload the files separately?
[AGENT][NEUTRAL] Yeah just go ahead and upload the files then again separately and if you wanna do the receipt again with everything else you can absolutely do that like I said that when the claims examiner goes in they can just um deny this one and move on to the next one it's not a huge deal.
[CUSTOMER][NEUTRAL] Oh perfect OK and then how will I, so all I have to do is upload it and then that's it, that's considered a submitted claim?
[AGENT][NEUTRAL] Yes ma'am and then we'll um reach out to you once it's been processed or you can check on it online.
[CUSTOMER][NEUTRAL] And that would be under the the status, right?
[AGENT][NEUTRAL] Mhm. Yup.
[CUSTOMER][NEUTRAL] OK, do you know how long they take to review it?
[AGENT][NEUTRAL] Um, generally once a claim's been submitted, we ask for 5 to 7 business days for it to process.
[CUSTOMER][POSITIVE] Perfect. OK.
[CUSTOMER][POSITIVE] OK, I think that was all the info I needed. Thank you so much.
[AGENT][POSITIVE] You're welcome have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.