AccountId: 011433970860
ContactId: 2e0144a6-db5a-40ae-8c80-ab2a56064ec4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 406230 ms
Total Talk Time (AGENT): 221310 ms
Total Talk Time (CUSTOMER): 95370 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/2e0144a6-db5a-40ae-8c80-ab2a56064ec4_20250124T16:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, [PII]. Um, I just wanna find out how I go about submitting a claim to you guys.
[AGENT][NEUTRAL] OK, so you're wanting to find out how to file a claim, is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Yes, I can help you. Are you the insured or are you calling from a provider's office?
[CUSTOMER][NEUTRAL] I'm the insured. Well, my husband is, I'm on the policy.
[AGENT][NEUTRAL] OK. Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And Ms. [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your policy number please?
[CUSTOMER][NEUTRAL] 2,454,910
[AGENT][NEUTRAL] OK, thank you. So give me a couple of moments to get the policy and your information pulled up, then I will have to verify several things with you, Miss [PII], first for security and also any information that I do provide for you today will be a verification of benefits and not a guarantee of payments. So just one moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, Ms. [PII], what is um your husband's name and date of birth and then your date of birth, please?
[CUSTOMER][NEUTRAL] My husband is [PII], and it is [PII]. And my date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. Your home mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, your husband's phone number?
[CUSTOMER][NEUTRAL] Um, oh gosh, hold on. I don't know it off the top of my head. Hold on a sec.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you and do you know his email address, his work email maybe?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, thank you so much um for verifying all of that information with me. OK, so you all are going to need to file your own claim your provider would not file and you're needing to find out how to file a claim, is that correct?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] So on this supplemental policy, is the claim going to be for you or for Mr. [PII]?
[CUSTOMER][NEUTRAL] It's for me.
[AGENT][NEUTRAL] OK, so we do have a portal in which Mr. [PII] could set up a profile and you can actually upload your claims information excuse me, into that portal for our review. Now I can email him the user guide to his email address that we have on file. I can also include.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim form for this type of policy that you all have with us and on the first page of the claim form it does have instructions at the top for how to complete the claim form and the additional documentation that you would would need to submit along with it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, because we will, and you don't have to write this down again, it is on the claim form on those instructions, but we will have to have a copy of your primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then we will also have to have an itemized bill.
[AGENT][NEUTRAL] Including the that includes the diagnosis code from your provider again, once the profile has been set up, you all can submit this information in the portal that user guide will explain how to do that if for any reason you're not able to upload, you can also fax it or mail it rather we cannot accept claims information via email.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] So the email, give me just a moment. I'm gonna go ahead and do that while we're on the phone, so give me just one second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and so you can let him know, you know, to be expecting this email so that he won't think that it's junk mail because again it's gonna come the email will come from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, [PII].
[AGENT][NEUTRAL] Uh-huh. [PII].
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And I did put APL in the subject line of it so that that's easy to recognize, but I'm sending that now so he should have that, you know, within the next.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Few minutes. Yeah, it should be, it should be quick.
[CUSTOMER][POSITIVE] A few seconds. Yeah, perfect.
[CUSTOMER][POSITIVE] All right, perfect. Thank you very much. I appreciate your help.
[AGENT][POSITIVE] Yes, ma'am. Well, you're very welcome and if you all again have any other questions that come up, just give us a call back and we'll be more than happy to help you.
[CUSTOMER][POSITIVE] Thank you very much. Have a good day.
[AGENT][POSITIVE] Yeah yes ma'am, you too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.