AccountId: 011433970860
ContactId: 5cf5be2d-99f2-4281-ba90-65f9d9766dea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407779 ms
Total Talk Time (AGENT): 151844 ms
Total Talk Time (CUSTOMER): 201392 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/5cf5be2d-99f2-4281-ba90-65f9d9766dea_20250107T18:14_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, my name's [PII]. I'm calling. I'm trying to file a claim. I just wanted to make sure I've done it before, but, but things change over over periods of time, so I wanna make sure that I have everything that I need, uh, before I fax it over.
[AGENT][NEUTRAL] And let me get your
[AGENT][NEUTRAL] OK, let me get your policy number, [PII], so I can get you verified.
[CUSTOMER][NEUTRAL] OK, 18193.
[AGENT][NEUTRAL] OK, that's a group number. Do you have your card in front of you? It's gonna be the policy er number that begins with a 0.
[CUSTOMER][NEUTRAL] Uh, you, uh, you need my actual card. Let me get my card out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Give me just a minute.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] What's your last name, [PII]?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] OK, and my.
[CUSTOMER][NEUTRAL] Group number is.
[CUSTOMER][NEUTRAL] Well, you need my group number or the policy number because because the group number I already gave you.
[AGENT][NEUTRAL] Yeah, you gave me the group number. What's your policy number?
[CUSTOMER][NEUTRAL] OK, it's 1178851.
[AGENT][NEUTRAL] OK, what's a good phone number, [PII] in case we're disconnected?
[CUSTOMER][NEUTRAL] It's gonna be uh area code [PII].
[CUSTOMER][NEUTRAL] [PII], that's my work number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or you can call, yeah, just call that number.
[AGENT][POSITIVE] Yeah, we get disconnected, this is the number I can call to get a hold of you.
[CUSTOMER][NEUTRAL] OK, and I'm the receptionist so sometimes I have to answer the phone or if somebody comes up to my window.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can you verify your date of birth and your mailing address for me?
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII]. My mailing address is [PII].
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] It would be I don't really have a personal one it would be my work email.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] And what is your work? Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] At [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you, [PII] for verifying that information for me and you're wanting to file a claim and need to make sure that you're submitting all of the correct documents needed?
[CUSTOMER][NEUTRAL] Right, yeah, it's a hospital claim. I was in the hospital back the end of uh.
[CUSTOMER][NEUTRAL] November
[AGENT][NEUTRAL] OK. And what documents do you have currently?
[CUSTOMER][NEUTRAL] Well, I don't, you know, you so I just had kind of fill it out, but call send me let me see, tell you what you got I got. Let's see.
[AGENT][NEUTRAL] So we'll need the APL um hospital indemnity claim form.
[CUSTOMER][NEUTRAL] Yeah, I have that and then I have um.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] The ED provider's notes updated on the notes from uh Doctor [PII] when I was admitted.
[CUSTOMER][NEUTRAL] That's that's from him there's there's piles and piles of notes from all different kind of.
[AGENT][NEUTRAL] OK, so we, if it's an inpatient claim we'll actually need the itemized bill with the diagnosis.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Um, the documentation that you have in your hand, I think you said it's like notes or is it records? Medical records?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Does it have your diagnosis in there and the admission and discharge date?
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It has the well the the first one is when the first was admitted through the ER which was the chief complaint but then the second one is um.
[CUSTOMER][NEUTRAL] Uh let me see.
[AGENT][NEUTRAL] So you were admitted through the emergency room?
[CUSTOMER][NEUTRAL] He it just has his notes from.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. [PII], let me give you a form name to request from the uh billing department at the hospital.
[CUSTOMER][NEUTRAL] Mayo Clinic.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's an acronym
[CUSTOMER][NEUTRAL] It's called now it's what now?
[AGENT][NEUTRAL] It's gonna be an acronym so it's short.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's the U as in UVO4 form that's U as in university, B as in Bob 04.
[CUSTOMER][NEUTRAL] That's UB 04.
[AGENT][NEUTRAL] Mhm, that's the automized bill for the hospital.
[AGENT][NEUTRAL] So if you get
[CUSTOMER][NEUTRAL] That's the form that I need.
[AGENT][NEUTRAL] Yes, if you can get that form and send it along with the HI claim form or the hospital indemnity claim form.
[CUSTOMER][NEUTRAL] OK, so I need to get a UB04 form.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] From the Mayo Clinic.
[AGENT][NEUTRAL] Yeah, that's considered, well, if it's inpatient, it would be the hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I don't know how I go about getting that but uh.
[CUSTOMER][NEUTRAL] I guess I'll just have to contact them that I said UB04 form from Mayo Clinic.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Number 04 mhm that's considered that's the hospital's itemized bill that's what the form name is.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, alright, that's all I need right now then.
[AGENT][NEUTRAL] OK. Anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well, no, no, I just was filling it out and I was trying to think what all do I need to send it because uh the very first time I had this is real simple. You didn't have to do as much stuff now it's more a little bit more complicated.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Do you need help filling out the claim form?
[CUSTOMER][POSITIVE] No, I've got the claim form and I just wanna make sure I have everything that y'all need.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] When I send in the claim form because I've I've done that.
[AGENT][NEUTRAL] Yeah, so that UVL4 form will have everything that we need on there, you know, your diagnosis codes and itemization of what was done, your admission and discharge dates, uh, when you report it to the ER it'll have all that information on there.
[CUSTOMER][NEUTRAL] And it's, it's a, it's a UB one I'm sorry, say it again.
[AGENT][NEUTRAL] UB 04.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, that's what I had, but I thought you said 1 or something like that. UB 04. OK, that's what I have. It'll have a diagnosis codes and.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, everything else.
[AGENT][NEUTRAL] Yeah, just they they know what that form is. It's an itemized bill, but if you give them that specific form name, they'll be sure to get you the correct itemized bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much I appreciate your help and I'll try to hop on it.
[AGENT][POSITIVE] You're welcome, [PII]. Anything else I can help out with today?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's all I think right now, but you have a blessing and a happy new year.
[AGENT][POSITIVE] OK [PII], thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.