AccountId: 011433970860
ContactId: 29ce888e-09be-45d2-a870-f7e2dafc7547
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400000 ms
Total Talk Time (AGENT): 265699 ms
Total Talk Time (CUSTOMER): 102789 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/29ce888e-09be-45d2-a870-f7e2dafc7547_20250430T19:34_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. I'm calling um on behalf of my husband, [PII]. So I just want to find out he's going for an MRI tomorrow and I know what the insurance is a huge deductible and we've got the APL gap insurance. So I was just calling to find out how I go about or what I do with how we then put in a claim.
[AGENT][NEUTRAL] OK, yes, I can certainly look at that. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, the policy number is 02519440.
[AGENT][NEUTRAL] Thank you. And are you listed on this policy as well if, if I could just
[CUSTOMER][NEUTRAL] Yes, yeah, yeah, it, it's under me. I'm the it's employee and spouse and I'm the employee.
[AGENT][NEUTRAL] OK, great. Thank you. If I could just verify your name, uh date of birth, and a phone number, please.
[CUSTOMER][NEUTRAL] The date of birth is [PII]. Telephone number is [PII].
[AGENT][NEUTRAL] Thank you. Now, the policy um is meant to pick up the deductible, co-payment or co-insurance for the sort of services that you're, that you're talking about. So, for outpatient services, um, we will pick up the deductible, co-payment or co-insurance for the type of, for the MRI up to $2,025. Um, and what you would do is you, you can submit the claim yourself or you can uh provide both cards at the time that your husband goes in for the MRI.
[AGENT][NEUTRAL] But yes, this is this.
[CUSTOMER][NEUTRAL] Yeah, it's like when I actually ask them and a lot of these cases, they say, oh no, we just take PPO, we don't know how to process, so I'm gonna have to lay out the money and then get reimbursed.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, of course. So what we would, uh, what you would do is, um, when he goes in for the MRI usually they will give you um what is called walking out papers, you know, to let you know who you saw that day, um.
[AGENT][NEUTRAL] Uh, what was done and what, what the reason was for, for the MRI. If not, you would have to ask them for that. And what it is is it's just a summary of, of your visit.
[AGENT][NEUTRAL] Um, and it just, it tells the charge, um, what was done and, and why, uh, why your your husband went in for an MRI. Now, in addition to that, we would need a copy of the explanation of benefits.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Because they, they will file through your major medical.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And you will, uh, and, and in due time you will get an explanation of benefits for this data service. We need that as well because it shows us the deductible, co-payment or co-insurance that we need to find that we need to pay, and that is what we need is just uh the um the papers from the provider letting us know, um of course the data service, what was done, the charge for the service, and then, and then why the service was done um and then the
[AGENT][NEUTRAL] Explanation of benefits from your major medical.
[AGENT][NEUTRAL] Letting us know the deductible co-payment or co-insurance that we would need to pay. Now, there's, once you have those two documents.
[AGENT][NEUTRAL] You can submit the claim to us uh online, which is, um, we do have an online service center. It, it gets to us very, very quickly. Uh that is at [PII]. It's [PII], and the number may actually be there, uh, Robin on your card.
[AGENT][NEUTRAL] Um, you can also mail it to us. Great, well that's the fastest way to get it to us. Um, you can also mail it to us. I can give you our mailing address, which also may be listed on your card, or our fax number, which might be listed on the card as well. But really that if you, if it's possible for you to do that, the, the very fastest way would be um to uh to send it to us online if if you would like to do that.
[CUSTOMER][NEUTRAL] Yeah, it is.
[CUSTOMER][NEUTRAL] OK, let me take the address just in case cause it's not on here.
[AGENT][NEUTRAL] Of course. So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII].
[AGENT][NEUTRAL] Our zip code
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's, of course, it's American Public Live or APL um and uh you can send that to us and and then uh it usually takes us about 8 to 10 business days once we've received it for that to be uh processed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then if I've, if I've laid it out, then they send me what a reimbursement check.
[AGENT][NEUTRAL] Yes, yes, they, they will send you now you will also find online, um, a, uh, a direct deposit slip, but if you would like to do that as well, uh or or rather than having.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, there is that if you did online, you can do direct. OK.
[AGENT][NEUTRAL] Yes, yeah, so if you would like to do that, uh, it's actually online, um.
[AGENT][NEUTRAL] Where the, where the uh um direct deposit is, and that might be the fastest way of getting that to you.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Um, OK, cause yeah, I think she basically said to me that it's covered, but it would be like $800 and something dollars that I'm gonna have to pay tomorrow, so.
[AGENT][NEUTRAL] OK, well, we would certainly, you know, as I, as I mentioned before, we will pay up to 25, excuse me, $2,025 for this service, um, and, uh, you would just need to submit that to us and we can try and get that to you as quickly as possible once we receive it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. I just didn't know what I needed to get, so I thought let me make sure ahead of time so I can ask them for what I need tomorrow instead of trying to get it afterwards.
[AGENT][POSITIVE] Yes, of course. And then if it turns, um, yes, if you'll just get that, that, uh, that documentation from the provider as well as the information from, uh, from your insurance, and that would be great. And then once you do submit that, if you do have any questions for us, um, please just let us know and, and we will be glad to look at the documentation to see that everything's fine before processing it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK perfect thank you I appreciate it.
[AGENT][POSITIVE] Well, thank you for contacting ATL. Have a good.