AccountId: 011433970860
ContactId: 5449470e-806c-4acc-b495-269ea8e3e3de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330000 ms
Total Talk Time (AGENT): 114421 ms
Total Talk Time (CUSTOMER): 98282 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/5449470e-806c-4acc-b495-269ea8e3e3de_20250416T13:07_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII]. How are you?
[AGENT][POSITIVE] Hey [PII], I'm good. How are you?
[CUSTOMER][POSITIVE] I'm good. I have Mr. [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] His policy number is 251.
[CUSTOMER][NEUTRAL] 1325.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] and he has the benefits question.
[AGENT][POSITIVE] OK, alrighty, send him through.
[CUSTOMER][POSITIVE] Alright, OK, thank you, bye.
[AGENT][POSITIVE] All righty.
[AGENT][NEUTRAL] Hi, Mr. [PII], this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, ma'am. I was trying to call about my benefits because I can't.
[CUSTOMER][NEUTRAL] To the doctor and I was trying to, they charged me $80 in copay.
[AGENT][NEUTRAL] And so was it for an office visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's your date of birth?
[CUSTOMER][NEUTRAL] [PII] so.
[AGENT][NEUTRAL] All right. And did the previous rep verify your mailing address and email address?
[CUSTOMER][NEUTRAL] Yeah, I already did.
[AGENT][NEUTRAL] OK. OK, just verifying.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Are you saying that they charged you before the visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so are you wanting to submit the claim yourself to seek reimbursement for that visit?
[CUSTOMER][POSITIVE] Oh yeah, that's how I go, yeah.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Yes, I, I thought that y'all pay. I, I didn't use y'all before. I never had to pay out of pocket, so.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Right, you do have an office visit benefit that covers up to $75 per visit.
[AGENT][NEUTRAL] So either the your provider can submit the claim to us on your behalf or you could submit it yourself if you've already paid out of pocket, it's up to you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I already paid. They said that it was uh $20. They said that they wanted $80 because I, I, I'm out of state. I don't know, some, she said, something to that nature.
[AGENT][NEUTRAL] OK, so do you want us to send you a claim form? Um, if you send it in yourself, uh, we'll need the APL claim form fully completed and signed, and then you would have to obtain the itemized bill from your doctor and send those documents to us.
[CUSTOMER][NEUTRAL] OK, and if they do it, how does that work?
[CUSTOMER][NEUTRAL] The same thing.
[AGENT][NEUTRAL] Uh, you could just
[AGENT][NEUTRAL] Well, they do not have to fill out our form they can just submit the itemized bill to APL.
[AGENT][NEUTRAL] Now if if your provider submits it to us, the reimbursement is gonna go to them and then they would owe you the 75 since you've already paid out of pocket.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I, OK, so, uh, I'll submit it then you send me that email.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you want me to send you the claim form?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I'm gonna go ahead and re-verify your email. Um, I'm showing [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] I wanna make sure that you received the form.
[AGENT][POSITIVE] So I'm gonna send it to you now.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] It's right.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] That negative.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, I just emailed it over to you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Mm, OK. That's [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. I've just received it. Thank you.
[AGENT][POSITIVE] All [PII]. Anything else, Mr. [PII], I can help out with today?
[CUSTOMER][NEUTRAL] Yes, ma'am. Yes, I'm fine.
[AGENT][POSITIVE] OK, thank you for calling ATL. Have a good day.
[CUSTOMER][POSITIVE] Fine thank you like.
[AGENT][NEUTRAL] Bye bye.