AccountId: 011433970860
ContactId: 46f2f719-e4c7-49dc-8475-c291d9d3a8aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 474510 ms
Total Talk Time (AGENT): 208013 ms
Total Talk Time (CUSTOMER): 186618 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/46f2f719-e4c7-49dc-8475-c291d9d3a8aa_20250217T15:59_UTC.wav
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[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling with for Exotech. I have a group number I can share.
[AGENT][NEUTRAL] OK, go ahead, [PII].
[CUSTOMER][NEUTRAL] It's 21042.
[AGENT][POSITIVE] OK. How can I help today?
[CUSTOMER][NEUTRAL] So we were um.
[CUSTOMER][NEUTRAL] We had APA last year ending [PII]. The reason why I'm calling is because I have an employee who um had a medical service in December of last year. It looks like the doctor's office, although they were provided with the APL card, did not submit a claim to APL.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And our broker has advised us to reach out to you guys to see how we can submit the claim because we no longer have access to the portal so I'm just calling for guidance and see what we can can be done.
[AGENT][POSITIVE] Oh yeah absolutely so the claims can still be submitted either in the mail or they can be submitted via fax and I'm happy to give you the mailing and fax address as well.
[CUSTOMER][NEGATIVE] OK, mailing and fax. One moment. My pen just literally ran out on me. I'm gonna grab another one.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, so let's start with a fax number, please.
[AGENT][NEUTRAL] Absolutely. So fax is going to be [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And [PII] attention [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Can I read it back to you, [PII], to make sure it's correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][NEUTRAL] Um, it's actually [PII], so [PII] at the end.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. OK. So [PII].
[AGENT][POSITIVE] Perfect, [PII].
[CUSTOMER][POSITIVE] All righty. um.
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mailing, uh, mailing address is going to be [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So again, if you don't mind, I'll read it back to you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, go ahead.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] ZIP code [PII].
[AGENT][POSITIVE] Mhm. Perfect.
[CUSTOMER][NEUTRAL] OK. Um, by any chance, is there like an e-fax or just regular fax number?
[AGENT][NEUTRAL] Yeah, we just have regular facts at this time.
[CUSTOMER][NEUTRAL] OK, um, and once we either fax it or mail it, how would he get um an update that you guys have received it or the next steps? How would we know?
[AGENT][NEUTRAL] Um, if unfortunately if there's no access into the portal or anything like that you can't check on it that way. There are email sent emails sent out for updates, um, and you can also call us and double check on them at any time, obviously we're here Monday through Friday so we can always check on it once it's been submitted.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, give it usually about 5 to 7 days to process on our side.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So we're obviously will include, do you need a copy of the card, of the, the person's card so that you, you can use it as a reference or any anything else that we need to send in?
[AGENT][NEUTRAL] Um, let's see, do you know what type of plan, uh, it looks like you guys had, uh, secondary plans with us, so, uh, the insured will need to make sure to submit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One, the claim form that's the med link claim form which can be obtained from our website.
[CUSTOMER][NEUTRAL] OK. I'm in there now. Um, so let's see.
[AGENT][NEUTRAL] If you're on [PII].
[CUSTOMER][NEUTRAL] So if I'm in
[CUSTOMER][NEUTRAL] I, yes, I'm at the page of the login page.
[AGENT][NEUTRAL] OK, so you should see a link there that says claims and forms.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me try again.
[AGENT][NEUTRAL] It's like to the left of the sign in link there.
[CUSTOMER][NEUTRAL] OK, so I have to log in um.
[AGENT][NEUTRAL] No, let me see.
[AGENT][NEUTRAL] Um, OK, you're still on the, you're on the online service portal page, the secured. Am public.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, to get the claim, let me see, I don't think there's a link there, no, so go to just [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII] probably.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Cleansing forms. OK.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And they're all in medical orders you should see I believe on the 2nd page for Medin.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK. So I see.
[CUSTOMER][NEUTRAL] So I see, let's see. So I see, um, other ways to submit your claim. There's a fax document it's download and complete the appropriate form. So I have to select like um meddling you said?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah Medlink is the form that you need and you can download and print it or or you can save it to your computer, whatever is easiest for you.
[CUSTOMER][NEUTRAL] Middle. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um going back if we were to fax it, it'll be the same correct that link.
[AGENT][NEUTRAL] Yeah yeah yeah so the fax number and the way you're gonna deliver the claim is gonna be the same so um they'll need the claim form and then we need the explanation of benefits also from their primary what they paid and what the.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Differences.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you download the form, page one should be when you look at it it's complete instructions as far as like what's needed and needs to be filled out the claim form.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, perfect. OK.
[CUSTOMER][POSITIVE] I think we have what we need for now. Thanks, [PII].
[AGENT][POSITIVE] You're welcome. If there's any other questions or concerns, feel free to give us a call.
[CUSTOMER][POSITIVE] We will. Thank you for your help. Have a good day.
[AGENT][POSITIVE] You're welcome you too bye bye.