AccountId: 011433970860
ContactId: 3cd78b40-b92c-4ab8-9317-b35efea63094
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 661979 ms
Total Talk Time (AGENT): 280821 ms
Total Talk Time (CUSTOMER): 236095 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/3cd78b40-b92c-4ab8-9317-b35efea63094_20250424T14:56_UTC.wav
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[CUSTOMER][NEUTRAL] December.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Yes, um, good morning. So I have a situation. I, I already called like twice, um, but nothing has been done so far. I'm not quite sure if you know I didn't provide enough information so my thing is I have this um insurance and I've been paying out of my pocket each time I go to um urgent care, so um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Why I'm here is for the reimbursement and the reimbursement to, you know, to um to this company so um.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Like for me to, you know, reimburse, um, should I have to like call, um, like the Baptist or or wherever that I, I, I went to, to, um, to get service done for them to send like an itemized bill.
[AGENT][NEUTRAL] Well, you have a couple of um options because um it depends, it depends. Um, do you have the policy number so I can pull up your policy and see what type of product you have.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Well, they gave me, um, the, the last time I called they told me to use like the old patient um number which is [PII] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And may I have your name and date of birth for security?
[CUSTOMER][NEUTRAL] My first name is [PII] My last name is [PII], and my date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And I need uh the mailing address, email address, and a callback number for verification.
[CUSTOMER][NEUTRAL] My um.
[CUSTOMER][NEUTRAL] My address is [PII], um.
[CUSTOMER][NEUTRAL] ZIP code is [PII]. My apartment number is [PII].
[CUSTOMER][NEUTRAL] And what was the next thing you require?
[AGENT][NEUTRAL] OK, that's gonna be the email address and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] OK, my email address is my first name [PII]. My number is [PII].
[AGENT][POSITIVE] OK, perfect, thank you.
[AGENT][NEUTRAL] OK, Mr. [PII]. Um
[AGENT][NEUTRAL] If you're trying to get a reimbursement because you already pay out of pocket, is that the case?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So if you already pay out of pocket, if they send in the claim for, for you directly from the provider of service, then more than likely it's going to be paid to them. So if you need to get a reimbursement, what you, you need to do is call the urgent care and have them to send you or if you can go and pick up an itemized bill with the diagnosis code.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] With the diagnosis code.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] You're welcome. And also um remember to send in the claim form and the copy of the explanation of benefits from the primary insurance.
[CUSTOMER][NEUTRAL] OK, so diagnosis code.
[CUSTOMER][NEUTRAL] Claim
[AGENT][NEUTRAL] OK. Uh, the first thing, which is, um, the one you're gonna call the urgent care for is the itemized bill with the diagnosis code. So you will call the urgent care to get the itemized bill with the diagnosis code. The second document, OK, the second document is the claim form. In the claim form, you can find it in our website at [PII]. Again, that's [PII] and you will look for the meddling.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Am like in [PII], [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], so do I have to download, download that form and send it in?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You need to download the, the form, yes, correct.
[CUSTOMER][NEUTRAL] And send that in and and send a picture of it.
[AGENT][NEUTRAL] You had to
[AGENT][NEUTRAL] Um, you can go ahead and just fill it up and um send it to us. You can either upload it to your account if you have registered or you can send it by fax or mail.
[CUSTOMER][NEUTRAL] OK, so it's uh, you, you call a claim form that's what what what do you call it, claim form.
[AGENT][NEUTRAL] OK, it's gonna be under Medlink Medlink.
[CUSTOMER][NEUTRAL] Metlink.
[AGENT][NEGATIVE] Yes, Maling claim form.
[CUSTOMER][NEUTRAL] Metlink.
[AGENT][NEUTRAL] Mhm, claim form.
[CUSTOMER][NEUTRAL] Clean farm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I just go to Met link and and um.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mm, no, you go to AMub, you go to [PII].
[AGENT][NEUTRAL] And then under under their claims and forms, you're gonna look for the meddling claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Malin claim for.
[AGENT][NEUTRAL] If it's easier for you, I can send you an email with the form. Do you want me to do that?
[CUSTOMER][NEUTRAL] OK, please, please, yeah.
[AGENT][NEUTRAL] Yeah, OK, let me go ahead and do that. One moment, OK.
[CUSTOMER][NEUTRAL] So, um, so I have to have this for, for I have to have this form for um any transaction to happen.
[AGENT][NEUTRAL] Correct, yes. You need the claim form for the claim to be completed. So you're gonna need the claim form and then you're gonna need the other two documents that I asked for. Um, those are all in the claim form, like all the information of what you're gonna need, you can find it in the claim form in the first page, but you're gonna need to call the urgent care, get the itemized bill with the diagnosis code.
[AGENT][NEUTRAL] And then you need to get the copy of the explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you're welcome. Bear with me just a second. Let me go ahead and send this out to you before I let you go, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, it's gonna be one more minute.
[AGENT][NEUTRAL] Here it is and attach it.
[AGENT][NEUTRAL] OK, and if you wanna check and see if you got it.
[CUSTOMER][NEGATIVE] OK, I'm gonna, I'm gonna bother you again. Um, what, what should I get from my primary care?
[AGENT][NEUTRAL] The primary um insurance, and the primary insurance, you need the explanation of benefits for that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me check my uh.
[CUSTOMER][NEUTRAL] My email that I that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII] claim form, yes.
[AGENT][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK, so you should see that attachment and just go ahead and um print it out or download it and uh send it in and again, the first page is gonna give you the two the instructions with the items we're gonna need or the paperwork we're gonna need, OK? You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Uh, yes, I have another question because I don't, I honestly, I'm, I'm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, um, I don't quite remember that that I had received a card. So like I think the, the insurance starts at [PII] I gonna be getting a card this time? Because as I said, I can't remember getting a card.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, well, it's gonna be, if, if you don't have the card, it's gonna, if you have a card, it's gonna be the same one as the old one because we don't have new ones. It's gonna be the same one effective date of [PII]. Um, but if you don't have the card and if you lost the card and you need one, I can go ahead and order one.
[CUSTOMER][NEUTRAL] So this is will be the same card that use whatever here.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Because yeah, as I said, I can't remember getting a card to be honest with you, you know.
[AGENT][POSITIVE] OK, that's fine. That's fine. I can go ahead and order one.
[CUSTOMER][NEUTRAL] So if you
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, let me go ahead and do that as well. One moment.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So I went ahead and requested a card to be sent out to you. So, usually it takes 5 to 7 business days for you to get it. It will go regular mail, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] No. You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APO. Have a good day.