AccountId: 011433970860
ContactId: 4be0b189-097d-4ef5-8fc6-626ba83db6ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482160 ms
Total Talk Time (AGENT): 183075 ms
Total Talk Time (CUSTOMER): 214737 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/4be0b189-097d-4ef5-8fc6-626ba83db6ab_20250207T16:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I mean, good morning. Um, yeah, so good morning. Um, actually, I'm, uh, I wanted to file a claim with um, uh, doctor's claim, and, um, and I thought I had signed in, so maybe I wasn't, and I went to the online service center to sign in and it says that uh no user found with the information that was entered. So, can we confirm?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That I am a user of APL.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm, yes, I can. Um, may I have your uh last name, please?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] All right. And what is a good callback number in case our call gets disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you very much, Miss [PII]. Um, do you happen to have your policy number on hand?
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have the um.
[CUSTOMER][NEUTRAL] Publish individual group number.
[CUSTOMER][NEUTRAL] Inhospital benefit or outpatient benefit? Huh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I believe they should be the same. It is um 7 digit number starting with a 0, then a 1 or 2.
[CUSTOMER][NEUTRAL] OK. 02.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] 777
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] And then I have, I have 556 M.
[CUSTOMER][NEUTRAL] And then L7 or L8.
[AGENT][NEUTRAL] OK, just we will use just the numbers. uh, let's see.
[AGENT][NEUTRAL] I'm not sure if I got it.
[CUSTOMER][NEUTRAL] So 022.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So 0022777.
[CUSTOMER][NEUTRAL] 56
[AGENT][NEUTRAL] 56. All right. I got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] All right. And just for verification steps, do you mind um telling me your date of birth and address, please?
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And the address, um, and home address?
[AGENT][NEUTRAL] Mhm. Yes, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Let me just a second so I can look into the online service center and see what is going on with your account. Just a second.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, I do see your account and it says and it says it is active. Um, would you like me to provide your username?
[CUSTOMER][POSITIVE] Oh yes, please.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Let me know whenever you're ready.
[CUSTOMER][NEUTRAL] And then I can just say forgot my, yeah, I can just say forgot my password. OK, go ahead.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, um, that will be [PII].
[AGENT][NEUTRAL] [PII], your last name.
[AGENT][NEUTRAL] All lowercase.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, that's what I used. OK, so let me do forgot my password.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I'm on the website.
[CUSTOMER][NEUTRAL] Um, primary phone, send, uh, a method of verification.
[CUSTOMER][NEUTRAL] I got the method of verification. OK, perfect. OK. So, I need to put in a claim for um
[CUSTOMER][NEUTRAL] Services that my insurance did not cover?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And it's, it's, um, it's, it's blood work um that I used, um, I guess they are, they want me to do like a participant um laboratory, which is quest, and the, the, the test was performed at LabCorp.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, um, so how do I, how do I, um,
[AGENT][NEUTRAL] Submit the claim for it, yes, let's see.
[CUSTOMER][NEUTRAL] How do I go about this?
[CUSTOMER][NEUTRAL] Yeah, is there a form that has to go with the claim?
[AGENT][NEUTRAL] Um, give me just a second so I can look in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To the online service center.
[AGENT][NEUTRAL] Have you already submitted a claim through our website?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't think so. The first, um, no, it was down to the hospital. I think I gave my hospital the two, the two cards at Cleveland Clinic, and then they um they submitted whatever was not um participant, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They, they did it for you. OK, alright. If you were able to log in, there was um there is gonna be a section that is um called um my claims where you can upload the document you receive or that you have for that lab work.
[AGENT][NEUTRAL] And um depending on the type of coverage you have, I guess, let's see real quick if you have any more than the med link. OK, you only have the med link, so you would just select that med link um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Coverage that you have and it will just um request um your information, name, date of birth, um the
[AGENT][NEUTRAL] Pretty much all your information in that.
[CUSTOMER][NEUTRAL] OK, hold on, so I'm sorry to, to stop you because I'm already here in claims, and then there's a list of all the claims that I have here.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I have, which one is it that I um I do upload files or?
[AGENT][NEUTRAL] Yes, you can uh check up, yes, select upload files.
[AGENT][NEUTRAL] And you can go from there. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see. OK.
[CUSTOMER][NEUTRAL] Will do.
[CUSTOMER][NEUTRAL] OK, I'll do that. And how long does it leave? Once you receive it, you, you process it, how, what is the time frame?
[AGENT][NEUTRAL] Um, I'm not quite sure. I'm sorry, I can't really provide a date because um that will be more for the claims department question and I would say, yes, um, if you don't like me to, I can transfer you to do um to for them to give you quite estimate.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] For the claims department, OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, yeah.
[CUSTOMER][POSITIVE] No, I'll just upload it and then once I have it up there, I'll call them. I think it's better.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. Yes. All right. Is there anything else that I can help you with, Miss [PII]?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] You're very welcome and I hope you have a nice day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.