AccountId: 011433970860
ContactId: 236a7578-e112-4fe0-9119-9924d5ab28d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280470 ms
Total Talk Time (AGENT): 91745 ms
Total Talk Time (CUSTOMER): 139278 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/236a7578-e112-4fe0-9119-9924d5ab28d8_20250203T20:51_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yeah, I just had a couple questions. One, I had my policy through this, uh, to December of last year. I'm on the line that just says coverage lapse. I can still file claims, right, for last year.
[AGENT][NEUTRAL] Yes, sir, you should be able to. Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][POSITIVE] Yes, I do.
[CUSTOMER][NEUTRAL] Is it the benefit certificate or is it the group number or payer ID?
[AGENT][NEUTRAL] Be certificate number, I'm sorry.
[CUSTOMER][NEUTRAL] OK, um, 02457148.
[CUSTOMER][NEUTRAL] Mary Larry 8.
[AGENT][NEUTRAL] OK, and what was your name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] Uh, um, [PII].
[CUSTOMER][NEUTRAL] And um email address is [PII].
[AGENT][POSITIVE] Thank you, Mr. [PII].
[AGENT][NEUTRAL] And you wanted to know if you could file claims after the policy lapsed?
[CUSTOMER][NEUTRAL] Yeah, uh
[CUSTOMER][NEGATIVE] Yeah, it's lapsed because the coverage was until the end. I canceled the policy at the end of the year.
[AGENT][NEUTRAL] OK, yes, I can help you with that. You can file any claims prior to [PII] to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And I was like looking, I've asked like the Quest Diagnostic to submit and they keep sending me bills and I'm looking at claims and I don't see anything for Quest.
[CUSTOMER][NEUTRAL] So I figured I might as well pay it myself and file a claim because it's, it's now it's, it's been since April of last year.
[AGENT][NEUTRAL] April of last year.
[CUSTOMER][NEUTRAL] Yeah, I've been asking them to file file I have secondary and they haven't.
[AGENT][NEUTRAL] Yes, sir, you can file it yourself. We would need an itemized bill with procedure codes and diagnosis codes on it.
[CUSTOMER][NEGATIVE] Oh jeez, I don't think that I'll have to call him for that then.
[AGENT][NEUTRAL] And a copy of your explanation of benefit from your primary insurance.
[CUSTOMER][NEUTRAL] What from my primary?
[AGENT][NEUTRAL] Your explanation of benefits.
[CUSTOMER][NEUTRAL] Where would I get that?
[AGENT][NEUTRAL] You, from your primary insurance?
[AGENT][NEUTRAL] Because this policy coordinates with your primary insurance. We have to have an explanation of benefits showing what was applied to your deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yeah, uh.
[CUSTOMER][NEUTRAL] Yeah, I got all kinds of things that just didn't get file. I need to file and OK, um, explanation of benefits. OK, I'll have to call the insurance because they have to call the insurance company and find out what that is.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Very good. And then I get a call question and you need an EOB you said?
[AGENT][NEUTRAL] No, from Quest, we need an itemized bill.
[AGENT][NEUTRAL] That has a procedure code and diagnosis code on it.
[CUSTOMER][NEUTRAL] Procedure code and diagnostic.
[AGENT][NEUTRAL] Code
[AGENT][NEUTRAL] And diagnosis code.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, and when I file I see that I can upload files, but do I have to fill out a claim form to go with it?
[AGENT][NEUTRAL] You do not, you do not have to. You can just upload the Beatles.
[CUSTOMER][NEUTRAL] OK, and that's what I'll do. I'll get the bills and upload them.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a good day.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, you've been the help.
[AGENT][POSITIVE] Thank you, Mr. [PII], for calling APA. You have a good day.
[CUSTOMER][POSITIVE] You too take care bye.
[AGENT][POSITIVE] Thank you. Bye bye.