AccountId: 011433970860
ContactId: 515bf96d-1695-47ea-9faa-ebf06963fa5e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 231130 ms
Total Talk Time (AGENT): 148200 ms
Total Talk Time (CUSTOMER): 74265 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/515bf96d-1695-47ea-9faa-ebf06963fa5e_20250211T16:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, my name is [PII]. Um, I had an outpatient surgery, and I would like to um process a claim for it. How do I go about doing that?
[AGENT][POSITIVE] OK, yeah, absolutely happy to help. So claims can be filed either online we have a service center um that you can do it through, or you can send them in the US postal mail or they can be faxed it's really whatever is more convenient for you.
[CUSTOMER][NEUTRAL] OK, and I had it in August of last year. Is that still applicable?
[AGENT][NEUTRAL] Yeah absolutely there's no sort of time frame as far as when you have to file it by so you could still file for last year.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And how, how does the um process go? Um, out of my pocket it was 3000, um, and how does that, um, APL reimburse that?
[CUSTOMER][NEUTRAL] Go about reimbursing the claim?
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, so you, I'm guessing have a secondary plan with us, so you would, uh, fill out the Medlink claim form. You would need your explanation of benefits from your primary insurance uh showing what they paid and then what the difference was as far as what you paid. Uh, you would need to submit all that with your claim form.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then when we reimburse, um, that's sent to you and you can do either direct deposit or it's sent in a paper check.
[CUSTOMER][NEUTRAL] OK, OK, great. OK, then I'll just go online and, and, and the website is, uh, what was the website again?
[AGENT][NEUTRAL] Uh, the website is [PII].
[AGENT][NEUTRAL] And when you get to our home page you'll see on the top right hand side of the page there is a link there for claims and forms that's where you're gonna get the med link claim form.
[AGENT][POSITIVE] And you can download it there and print it out.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And then in that same area on the website there is a link there that you can click to sign in and when you click that it takes you to a secure site uh then you'll need to of course create a log in if you've never logged in before.
[CUSTOMER][NEUTRAL] No, this is gonna be the first time. OK, so, uh, I just click on the right hand side regarding the claims and then once, once I'm in that portal, I would need to download the, the form and also create my um user ID and password.
[AGENT][NEUTRAL] Mhm when you click sign in uh you're gonna click new user yep, and then um it's gonna ask for like your social and your email and all of that um once you get logged in it's pretty easy you'll see it says my claims and then there's a green button that says upload forms that's where you would upload all of your supporting documentation for your claim, um.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When you're looking at
[CUSTOMER][NEUTRAL] Uh, as well as the, um, the, the form, OK.
[AGENT][NEUTRAL] Yeah and the EOB and everything and when you look at the claim form page one is just instructions it tells you exactly what is needed with your claims so.
[CUSTOMER][POSITIVE] OK. Awesome. Awesome, that's great. That sounds great. That sounds easy enough.
[AGENT][POSITIVE] All right. Yeah, if you have any other questions or concerns, feel free to call us. We're always happy to help, of course.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great, thank you so much for your help.
[AGENT][POSITIVE] You're welcome. I hope you have a nice rest of your day.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Mhm.