AccountId: 011433970860
ContactId: 2629f70f-13e9-4b8a-823f-8f34978e698e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284369 ms
Total Talk Time (AGENT): 135828 ms
Total Talk Time (CUSTOMER): 110993 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/2629f70f-13e9-4b8a-823f-8f34978e698e_20250224T14:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I have a question. I had a knee replacement performed last year. If I'm filing a claim, do I use a critical illness claim form to do that?
[AGENT][NEUTRAL] Let me pull up your information. What's your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah and
[AGENT][NEUTRAL] And [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah, a group number 18256.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] It's gonna be the policy er number.
[CUSTOMER][NEUTRAL] Uh, I have inpatient benefit cert number and an outpatient benefits cert number.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] The number before the letter M should be the same for each.
[CUSTOMER][NEUTRAL] Oh, I see that now 01410739.
[AGENT][POSITIVE] Thank you and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the data service?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] I'm sorry, not the date of service. What's your date of birth and your mailing address?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you for that information.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So now the policy that you have with us is a meddling policy.
[AGENT][NEUTRAL] So that's the policy. Medin, it's a supplemental Metlink plan. It's a medical policy. And so you would submit that claim under the Metlink policy. What type of surgery did you have?
[CUSTOMER][NEUTRAL] Is a what?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, knee replacement.
[AGENT][NEUTRAL] Yeah, you would submit your itemized bills, uh, the ATL claim form, and the primary explanation of benefits under the meddling policy number that you gave me.
[CUSTOMER][NEUTRAL] OK, so how do I get to where I need to be?
[AGENT][NEUTRAL] As far as filing the claim?
[CUSTOMER][NEUTRAL] Yeah, but where do I find the form that you're mentioning and I actually need to write this down.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the APL metin claim form you can locate that on our website, uh, which is [PII].
[CUSTOMER][NEUTRAL] OK. A, what is it again, please?
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII]. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The word [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you get to the site, uh, there's gonna be a claims and forms link at the uh the upper right corner.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, I think I'm actually on that screen.
[AGENT][NEUTRAL] And you would
[AGENT][NEUTRAL] OK, and so you would click the link, the claims and forms link.
[CUSTOMER][NEUTRAL] Yeah, OK, I'm there.
[AGENT][NEUTRAL] And just scroll down until you.
[CUSTOMER][NEUTRAL] And what
[AGENT][NEUTRAL] [PII], that's the type of policy that you have. So scroll down to.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, med link at the top.
[CUSTOMER][NEUTRAL] Other ways to submit your claim, download it and complete the appropriate form, but I don't see the med link.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From this claims and forms I'm on the [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then I need to get somewhere else?
[AGENT][NEUTRAL] And so you clicked on the claims and forms link at the upper right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And where did that take you?
[CUSTOMER][NEUTRAL] It took me to a whole list of.
[AGENT][NEUTRAL] So the first claim form should be the accident claim form, so they're in alphabetical order.
[CUSTOMER][NEUTRAL] OK, I see that.
[AGENT][NEUTRAL] And you're looking for the med link claim form which could be on page 2.
[CUSTOMER][NEGATIVE] Play form and then mad like.
[CUSTOMER][NEUTRAL] Same form and then I can complete them and upload them.
[AGENT][NEUTRAL] Mhm, so you would download the form, then complete it and then upload it online.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, understood.
[AGENT][NEUTRAL] And on that on the first page it'll give you instructions as to what documents are required.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so make sure you fully complete the claim form, sign and dated, and then have the the the forms that are listed other way otherwise it may delay the processing of the claim.
[CUSTOMER][POSITIVE] OK, all right, I can do that. Thank you very much for your help appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, you're welcome. Any other questions I can assist with today?
[CUSTOMER][NEUTRAL] No, that'll be all today.
[AGENT][POSITIVE] OK, well thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh bye bye.