AccountId: 011433970860
ContactId: 26d42985-681c-45df-b1e2-21619a0abf8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 550200 ms
Total Talk Time (AGENT): 230384 ms
Total Talk Time (CUSTOMER): 270012 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/26d42985-681c-45df-b1e2-21619a0abf8e_20250620T15:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] And I have a question about uh Sapan. Do you have share I'm sorry, yeah, I'm sorry. I, I said I have my card. I, I just finished from a procedure.
[CUSTOMER][NEUTRAL] Uh, today, and, uh, I have a gap with you, uh, for some reason it was too early for them to call and to verify that so I went and I paid from my pocket.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And how this is work, how I can clear, I have the receipt from the hospital.
[CUSTOMER][NEUTRAL] How this is work.
[AGENT][NEUTRAL] OK, well, you can file a claim for reimbursement through us, um, you can, do you have an online account with us? Do you have an email on file?
[CUSTOMER][NEUTRAL] Do you have an email on file with them. My email, I don't you wanna try. I, I actually usually I will give the cards to the hospital and he will do everything, but this time this is, it's too early and uh.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's too early.
[CUSTOMER][NEGATIVE] You know, and I have, I had to do it and I don't wanna, you know, lose some, uh, that, uh.
[AGENT][NEUTRAL] OK, um, so you will need to send an itemized receipt showing what you paid and all the any procedure codes or diagnostic codes on there, uh, showing what amount went towards each procedure.
[AGENT][NEUTRAL] Um, and then you can send the claim through fax or you can mail it to us.
[AGENT][NEUTRAL] Along with a claim form.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] What you wanna fax it? No, I prefer email. So alright, so, um, so, can you type the email to the mind and what is the email, uh, that, uh.
[CUSTOMER][NEUTRAL] I think it's the name of that, but.
[AGENT][NEUTRAL] You you can't send this through email because it's not secured and it will have your right so you'll want to mail it or fax it to us.
[CUSTOMER][NEUTRAL] Oh, OK, sir.
[CUSTOMER][NEUTRAL] No, I prefer to fax it. What's the fax number?
[AGENT][NEUTRAL] OK, it'll be attention claims department.
[AGENT][NEUTRAL] And it's 877, 0, go ahead.
[CUSTOMER][NEUTRAL] Attention lane.
[CUSTOMER][NEUTRAL] It, yeah, please. 877.
[CUSTOMER][NEUTRAL] 877 then.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942 3
[AGENT][NEUTRAL] Yes, and you'll want to send in any itemized receipts, any um bills that you had showing procedure codes or diagnostic codes, and you'll want to fill that out with a uh send that in with a claim form.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh 77
[AGENT][NEUTRAL] And you can find our claim forms at [PII]. Oh, go ahead.
[CUSTOMER][NEUTRAL] Uh, and how I can get.
[CUSTOMER][NEUTRAL] So let's go, let's go back uh to your fax number again. You have it. Can you repeat 877-365 claims department.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] and the claim is it how I can get it?
[CUSTOMER][NEUTRAL] The diagnostic number.
[CUSTOMER][NEUTRAL] I think it would be on the the I have no I have all that, but their claim, I mean the the the form, the claim form, how I can get it.
[AGENT][NEUTRAL] The claim form, you will go to [PII].
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And on the top right hand corner, you'll see claims and forms and you'll click on that.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you'll find the correct form and if you have the Medlink policy, it'll be a medlink form.
[CUSTOMER][NEUTRAL] What's this midli?
[AGENT][NEUTRAL] Uh, you said you had gap insurance with us?
[CUSTOMER][NEUTRAL] Yeah, I have with AAPL.
[AGENT][NEUTRAL] Yes, our gap insurance is called Medlink.
[CUSTOMER][NEUTRAL] I have a gap, yes
[CUSTOMER][NEUTRAL] Uh, that is, is med meddling right if I give you my uh.
[CUSTOMER][NEUTRAL] Email, do you want me to give you my email or to check if you're there? Yes.
[AGENT][NEUTRAL] Um, no, I.
[AGENT][NEUTRAL] I only needed that to see if I needed to, to, um,
[AGENT][NEUTRAL] If you are going to do it online, but if you're not going to do it online, then you should have all of the information available to you now.
[CUSTOMER][NEUTRAL] All right, so my other question, if I give you a, I wanna just verify that I have the gap. I'm sure I have just I wanna make sure that I'm in the system because they keep changing our insurance. So what number do you want from me in order to find me in the system?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the policy number? It might say uh benefit number or inpatient or outpatient benefit number.
[CUSTOMER][NEUTRAL] I have here outpatient benefit uh CERT number.
[AGENT][NEUTRAL] OK, what's that number?
[CUSTOMER][NEUTRAL] 021.
[CUSTOMER][NEUTRAL] 1998.
[CUSTOMER][NEUTRAL] 2, then M as in Mary, L as in Larry, the number 8.
[AGENT][NEUTRAL] And can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the address that we have on file for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I am showing that you do have a policy with us. Um, the policy number you gave me is for a policy that has already lapsed. Um, if you have a pen and paper down, I can give you your new policy number.
[CUSTOMER][NEUTRAL] Please, uh, are you ready, sir? Yes, go ahead, honey, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 0256.
[AGENT][NEUTRAL] 89887.
[CUSTOMER][NEUTRAL] OK, 025689887.
[AGENT][NEUTRAL] Yes, that is the new updated policy number.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, is there anything else I can help you all with?
[CUSTOMER][NEUTRAL] OK, once I submit uh the claim, uh.
[CUSTOMER][NEUTRAL] How long it will uh take till I get uh the refund, uh, uh, and how I will be informed that uh.
[CUSTOMER][NEGATIVE] I'm receiving this much whatever I pay, how does it work?
[AGENT][NEUTRAL] So, typically, typically once we receive your claim, uh, we ask that you give us 7 to 10 business days to process the claim. Depending on how big the claim is and how many, uh, how much paperwork you send in, it shouldn't take but 3 or 4 days, but we ask that you give us up to 7 to 10.
[AGENT][NEUTRAL] Um, and then if you are filing through fax whenever you put your um.
[AGENT][NEUTRAL] Address on the claim form, we will send you a letter in the mail. It's called an explanation of benefits or an EOB uh you will get that sent over to you or if you want to wait, um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The week after you mail it after 7 days, you can also give us a call back and we can check on the status for you as well.
[CUSTOMER][POSITIVE] Beautiful.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Yeah, that's it. Thank you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The last question, when I do this, the, the, the system will generate claim and number for me when I fill all this information so when I call you I give you the claim number.
[CUSTOMER][NEUTRAL] To find
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You won't get a claim number until you won't get a claim number until it's been processed um but if you have the date of service so the day you were seeing um we can look it up by the date of service.
[CUSTOMER][NEUTRAL] Or not necessarily.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] So as long as you have that we can look it up.
[CUSTOMER][POSITIVE] OK beautiful.
[CUSTOMER][POSITIVE] Great. Appreciate it. Thank you very much. I think you answered all my questions. Have a good day.
[AGENT][POSITIVE] Alright, thank you for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You do the same bye bye.