AccountId: 011433970860
ContactId: 59c577e2-7016-4549-a47e-1163914a6fa1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 705219 ms
Total Talk Time (AGENT): 244266 ms
Total Talk Time (CUSTOMER): 308748 ms
Interruptions: 1
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/59c577e2-7016-4549-a47e-1163914a6fa1_20250306T21:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is, uh, Mrs. [PII], and the purpose I call is I have a gap insurance with you guys, and, um, it covered for MRI and I did an MRI and for some reason, um, I don't know how to claim it because this is the first time making a claim. Can you check? I don't even have my plan number.
[AGENT][NEUTRAL] OK, so you want to know how to make, how to file a claim?
[CUSTOMER][NEUTRAL] Yes, how to file a claim and what is my plan number?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All [PII]. Well, I can definitely help you with your policy number and how to file a claim. And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that, and I can look the policy up with your social if you like.
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here. Hold on one moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Here it is. And this is your secondary policy, correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, this is it. Hold on one moment.
[CUSTOMER][NEUTRAL] It's a gap, gap insurance.
[AGENT][NEUTRAL] All right, and I believe I have it here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure. My date of birth is [PII]. I just moved, so I'm not sure if the address is updated. I'll give you the old address, which is [PII].
[CUSTOMER][NEUTRAL] I don't know if you have the [PII]. OK, good. So it's updated. That's my updated address.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and all the information provided is a verification of benefits, not a guarantee of payment. So your policy number is um hold on one second, 240.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 658 7.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 658-7, yes.
[AGENT][NEUTRAL] And to file a claim, you have 3 options. You can mail it, you can fax it, or you can upload it to the online service center. Um, you also, depending on how long ago the service was, you can provide the um provider with your policy number, like give them your ID card, um, and they can bill us as well.
[CUSTOMER][NEUTRAL] 00, I did not know I have to pay. Um, I think I'll upload. How do I go about uploading? Do I just create an account?
[AGENT][NEUTRAL] Yes, um, so you'll go to our website [PII]. OK.
[CUSTOMER][NEUTRAL] Just one minute.
[CUSTOMER][NEUTRAL] OK. [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] A like apple, M like Mary.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Public.com.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yes, I got it. OK, let me write that. [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] To the top right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, uh, to the top, the top right claims or signing.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] To the top right corner, you'll see, you'll see where it says sign in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Go ahead and click that and you're gonna click on I'm a new user.
[CUSTOMER][NEUTRAL] New user, nice. I'm an individual policy, is it individual?
[AGENT][NEUTRAL] Yes, and then you'll you'll um follow the prompts when they ask for your social security number or member ID um put the full social in that field.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] R.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, my zip [PII] email. May I ask what email address you have? Is it the [PII] or the [PII]?
[AGENT][NEUTRAL] So we actually need to add an email, which email address would you like?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I'll wait till you add then I'll, I'll hit next.
[AGENT][NEUTRAL] OK, so, um, it should work for you.
[CUSTOMER][NEUTRAL] OK, I'll go do that right now. Next.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, good. Yes, I think that's it. um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, I think.
[CUSTOMER][NEUTRAL] Let me see, it's the password issue it's not taking it.
[CUSTOMER][POSITIVE] Sorry about that. OK.
[AGENT][POSITIVE] Oh, take your time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a waiting on submit.
[AGENT][POSITIVE] OK. Take your time. It's no problem.
[CUSTOMER][POSITIVE] Thank you, appreciate it. I know I have this such a long time and yeah yeah concrete success will create good. So I think now I have to log in.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm. So once you log in, let me know what you see.
[CUSTOMER][NEGATIVE] $30. So ma, oh, it's invalid password that's weird.
[CUSTOMER][POSITIVE] OK, perfect. Um, I am in now.
[CUSTOMER][NEUTRAL] Um, I think N6 will do that. So you receive a claim status. Let me see, 949558-1950.
[CUSTOMER][NEUTRAL] Um, verifying the the verification.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Confirm.
[CUSTOMER][NEUTRAL] OK. So, um, what do I see? I see my coverage. I see the, the number and everything.
[AGENT][NEUTRAL] Mhm. So you're going to, you're looking for um
[CUSTOMER][NEUTRAL] Upload
[AGENT][NEUTRAL] Yes, upload documents.
[CUSTOMER][NEUTRAL] Upload document. OK. I don't have the documents yet.
[AGENT][NEUTRAL] Oh, OK. Well, once you get them, that's where you'll go to upload them and then um it'll submit to us and you'll get a confirmation number to let you know it's been submitted.
[AGENT][NEUTRAL] And um we'll go ahead and process.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so what do I just take a picture of this um of this claims and then upload it, uh, I mean, of the, the receipt?
[AGENT][NEUTRAL] Well, it depends on what you, so anytime you file a claim, you're going to need your Medlink claim form, which on our website um [PII].
[AGENT][NEUTRAL] Instead of where you want to sign in, you'll click on claims and forms.
[CUSTOMER][NEUTRAL] Oh, OK, so I have to fill out the forms, a form.
[AGENT][NEUTRAL] Yes, you're looking for the Medli claim form. It goes with the policy type. Mhm.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] That's what I say.
[CUSTOMER][NEUTRAL] OK, so I click on it and then um which um I see accident cancer med link. OK, I think I saw it here there we go now. Oh boy, it's running. OK, Medlink.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] It doesn't say anything.
[AGENT][NEUTRAL] So once you see the meddling claim form, you'll download it.
[CUSTOMER][NEUTRAL] Mhm. Oh, download, download, you said download your ID card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but the forms.
[CUSTOMER][NEGATIVE] I don't see a form.
[AGENT][NEUTRAL] if you saw the Medli claim form, that is the form.
[CUSTOMER][NEUTRAL] Oh no, sorry. I saw download your ID card. No.
[CUSTOMER][NEUTRAL] Not the form. I'm not seeing the.
[AGENT][NEUTRAL] Are you in your portal or you're on the website under claims and forms?
[CUSTOMER][NEUTRAL] I'm on the claims and forms.
[AGENT][NEUTRAL] OK, so you might need
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] It's OK. You might need to scroll down to where you see like page 12 or 3. It may be on page 2 because they're in alphabetical order.
[CUSTOMER][NEUTRAL] OK, we get a final agreement.
[CUSTOMER][NEUTRAL] OK, let me see where it is. Claims and form policy change documents um.
[CUSTOMER][NEUTRAL] Download form, but I don't know which form they're talking about.
[AGENT][NEUTRAL] OK, so hold on, let me go to the
[CUSTOMER][NEUTRAL] Um, Medlink.
[AGENT][NEUTRAL] Website, hold on one second. OK, so you clicked on claims and forms and then.
[CUSTOMER][NEUTRAL] Mhm. Uh, I think I
[CUSTOMER][NEUTRAL] I got it. I think it it meddling forms, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK perfect yeah I think I just got it. I appreciate your help and I guess this with the um this with the receipt is what I'm submitting, right?
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] Right, so you'll be submitting the claim form, the explanation of benefits from your primary insurance?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Explanation of benefits, I don't have that.
[AGENT][NEUTRAL] So, depending on um when the service was, you may, um, it may not be populated yet, but that will come from your insurance company.
[AGENT][NEUTRAL] Your primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but this is something I pay on my own.
[AGENT][NEUTRAL] Alright, so you know how this is your secondary policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So we're 2nd to Aetna.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, Aetna will have because since Aetna's primary, they pay out or they give their decision first. So we would need it from we would need the explanation of benefits from Aetna, the itemized bill from the provider, which is the doctor or hospital, and then your claim form.
[CUSTOMER][NEUTRAL] Oh, got it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Informs and and and um bill. OK. Thank you so much. OK, bye-bye.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, that's all. I appreciate your help. Bye-bye.
[AGENT][POSITIVE] All right. You're welcome. Thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye.