AccountId: 011433970860
ContactId: 537a6e46-ebf5-449c-8449-c091f75fa895
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402200 ms
Total Talk Time (AGENT): 174825 ms
Total Talk Time (CUSTOMER): 105729 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/537a6e46-ebf5-449c-8449-c091f75fa895_20250623T15:41_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII]. I have a policy with ATL, um, and I wanted to see how I can go about, uh, putting in a claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sure. I can give you instructions for claims. Mr. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And may I have the policy number, Miss?
[CUSTOMER][NEUTRAL] Uh, yes, the policy number is um.
[CUSTOMER][NEUTRAL] So, OK, so I have a group number and then I have an in hospitals benefit or outpatient benefit.
[CUSTOMER][NEUTRAL] Certificate number.
[AGENT][NEUTRAL] Outpatient benefit certain number.
[CUSTOMER][NEUTRAL] Um 018.
[CUSTOMER][NEUTRAL] 458
[CUSTOMER][NEUTRAL] 44
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, and the number 8.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. For security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII].
[CUSTOMER][NEUTRAL] And the email address on file should be [PII].
[AGENT][POSITIVE] OK, perfect, thank you.
[AGENT][NEUTRAL] OK, it looks like we have your work email, OK? Um, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you have one of our secondary supplemental plans, um, so for this one, you're gonna need the claim form, um, the claim form you can find it on our website at [PII] and it's gonna be the Metlink claim form.
[AGENT][NEUTRAL] Together with the claim form, we need 2 documents and that's also on the claim form on the first page nurse instructions. Um, we're gonna need the first document which is an itemized bill with diagnosis codes and procedure codes and you can get that from the provider of service.
[CUSTOMER][NEUTRAL] OK, so
[AGENT][NEUTRAL] And the second document is the explanation of benefits from the primary insurance for that date of service showing the amount applied towards the deductible co-payment and co-insurance.
[CUSTOMER][NEUTRAL] OK, um, let me ask you a question because I used to be um able to log in and and view everything um but it's, it's like locked me out is there a way to like reset me up or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK. Um, yes, we have changed the website and so everybody needed to create the account again. If you have not created an account since [PII], you just need to go ahead and go and click on create your OSC account once you go in.
[CUSTOMER][NEUTRAL] OK, so I'm insured.
[CUSTOMER][NEUTRAL] OK, um, so I'll recreate it then um because I haven't, I haven't used it since last year.
[AGENT][NEUTRAL] Oh, OK, yes, then you have to recreate the account. Um, you're gonna need to use the email that is on file. Um, it's best if we change that to your personal email. If you have a personal email, I can go ahead and change that for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, please.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEGATIVE] It's [PII]
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] We just remove the [PII] and then it's gonna be [PII].
[CUSTOMER][NEUTRAL] Yes.net.
[AGENT][NEUTRAL] Done.
[AGENT][POSITIVE] OK, I went ahead and updated that information as well. Is there anything else I'm gonna help you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][NEUTRAL] OK. Um, and you can just register and once you register, you can upload the claim online, OK? Or you can check claim status and get your benefit information as well.
[CUSTOMER][NEGATIVE] OK, so it's telling me no user was found with this information.
[AGENT][NEUTRAL] Oh, you was doing it as you was giving me the information. Give me just a second, OK? Because I have not finalized everything. One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh OK, OK, no problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me make sure everything changed everywhere.
[AGENT][NEGATIVE] OK, go ahead and um just erase everything or just close that um page and open it again because sometimes it will just get stuck if you continue on the same page after you get that error.
[AGENT][POSITIVE] And you can try one more time.
[CUSTOMER][NEUTRAL] OK, let me just.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and let me, it's telling me now to complete my my set up and everything.
[AGENT][POSITIVE] OK, perfect. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, that's all. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Thank you, bye.
[AGENT][POSITIVE] You're welcome. Bye.