AccountId: 011433970860
ContactId: 6188fe09-fd04-49ab-bac6-bcb0919f2060
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 590159 ms
Total Talk Time (AGENT): 278046 ms
Total Talk Time (CUSTOMER): 267594 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/6188fe09-fd04-49ab-bac6-bcb0919f2060_20250416T20:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes ma'am, um, my name is [PII], um.
[CUSTOMER][NEUTRAL] I am.
[CUSTOMER][NEUTRAL] Uh, trying to get help on.
[CUSTOMER][NEUTRAL] I've, I've had, um, uh, I, I, um, I've had the secondary insurance for a little while now, but I've unfortunately, uh, never filed a claim, um, and that's unfortunate, um, um, but I, I, I need to go ahead and start doing that, um, and I need help, uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. I.
[CUSTOMER][NEUTRAL] Need to kind of find out uh where to begin.
[AGENT][POSITIVE] Yes, ma'am. I can help you with your claim.
[CUSTOMER][NEUTRAL] I, I've got a lot of paperwork in front of me and yes um I see uh like on my app uh I guess that I'm looking at in front of me where it shows uh status a lot of, a lot of things processed but it doesn't have confirmation numbers.
[CUSTOMER][NEUTRAL] Um, and I've never received any kind of check, um, from you all, but I, I mean, obviously because I've never, I've never filed a claim, but, um.
[CUSTOMER][NEUTRAL] Anyway, I, I'm sorry, I'm, I'm just a bit flustered I, I've got a lot going on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] That's OK. That's all right. I can help you through it, Ms. [PII]. Um, first, can I get your callback number, ma'am, just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes ma'am, uh [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your policy number?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 02446504
[AGENT][NEUTRAL] OK, let me look your policy up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Miss [PII], I'll need for you to verify your policy for security reasons. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um, you said address [PII].
[CUSTOMER][NEUTRAL] Uh, I'm sorry, what was the, the next thing I needed to verify?
[AGENT][NEUTRAL] Your
[AGENT][NEUTRAL] Email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And the number that you gave me to call you back on if we get disconnected, is that your cell phone, ma'am?
[CUSTOMER][NEUTRAL] It is.
[AGENT][POSITIVE] OK, thank you, Ms. [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So you have never filed a claim actually yourself and you're wanting to learn how to do that, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, first thing I'm gonna have you do because because it's just the easiest way to do it and you get confirmation numbers when you do it this way if you go into our um online service center.
[AGENT][NEUTRAL] If you sign up for it and let me uh let me just check real quick to see if you've ever signed up for it.
[AGENT][NEUTRAL] Yes ma'am, you have. OK, so if you go into the online service center.
[AGENT][NEUTRAL] You're going to click on claims and forms.
[AGENT][NEUTRAL] And you're going to choose the Medlink claim form which will be on page 2 and the 3rd 1 down on page 2.
[AGENT][NEUTRAL] You'll need to download that claim form and fill it out.
[AGENT][NEUTRAL] And then you'll be able to submit your claims by uploading them from your computer.
[AGENT][NEUTRAL] And what you'll need to send with your claim form.
[AGENT][NEUTRAL] Is the explanation of benefits from your primary insurance carrier.
[AGENT][NEUTRAL] And then you'll need one other document and that's the itemized statement with your procedure codes and diagnosis codes. And that comes from the office that you went to, either the office, the hospital, urgent care center, wherever you want to have service and treatment done, you'll need to send that in. You'll get that from them.
[AGENT][NEUTRAL] And the explanation of benefits comes from your your major medical insurance.
[CUSTOMER][NEUTRAL] All right, um.
[AGENT][NEUTRAL] And you'll need for them to match the date of service that you had your procedures done, your itemized statement, and your explanation of benefits will need to match on that date of service that you went to the doctor.
[CUSTOMER][NEUTRAL] OK, um, let's see, so itemized bill diagnosis from Friday after finished.
[AGENT][NEUTRAL] Yes, and once you get that information, you can upload the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] From right there from the online service center and it'll give you uh a confirmation number that we have received it.
[AGENT][NEUTRAL] It'll also if there's any other information they're needing or um any other documents it'll also at that time alert you and let you know where they are in the process of the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Once you receive the confirmation number and they've got everything that they need, which if you send those 3 documents they should have everything they need to process your claim. It'll take 7 to 15 business days to process the claim.
[AGENT][NEUTRAL] And it'll also alert you in the online service center that your claim is ready.
[CUSTOMER][NEUTRAL] OK. And then,
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Gates, so I don't, I don't have a computer at home. I, I just have my cell phone which is real, real annoying, unfortunately. So I, it's a little hard to, you know, it's a little hard to navigate on, on the phone. I'm hoping I can, I'm hoping I can get, you know, to an actual computer to be able to do this.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][MIXED] I was really, really hoping I could do it old school way and which I know would take forever and a day to try to go back and do it over the phone with someone. But anyway, it's, it's fine. I, I'll just hope, hope I can get to a computer and do this, but
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You can
[CUSTOMER][NEUTRAL] Um, I want, I wanna make sure, um, is, is [PII], is that what you're seeing as the, the oldest one that I'm eligible to be able to claim at this point?
[AGENT][NEUTRAL] Let me look and see, you can claim, um, so your effective date of your policy, your policy started on [PII]. So anything um after [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII], OK. I got you. OK.
[AGENT][NEUTRAL] And there's not a timely filing limit, so you can send it as long as your, your policy was active on the day you went to the doctor or the hospital or wherever you went to as long as your policy was active on that day, you can file it any time. Also, to answer your question about old school, let me give you our fax number in case you can't get it done. If you can't get it done online, that's OK.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I'm gonna give you our fax number and our mailing address if you decide to do it that way.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I, I actually, I, as old school as I am, I've got my paperwork. I'm looking at it right here. I, let me verify. I've got, I've got [PII] as the mailing address. I've got [PII] [PII].
[CUSTOMER][NEUTRAL] Let me get my magnify. No, I'm just kidding, not my magnifying glass. I'm not that old school, but I, let's see, I've got [PII] [PII] and then fax number [PII].
[AGENT][POSITIVE] Oh, that's all right.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, good. All right. Very good. All right. Well, thank you so much. I, I appreciate your help and uh hopefully I can, I can get all this information. Very good. Um.
[AGENT][NEUTRAL] Yes, Ms. [PII].
[CUSTOMER][POSITIVE] Yes, thank you so much. Well I, I can't wait to get started and and get these submitted. Um, if I have any questions, I will call you back. Thank you so much.
[AGENT][NEUTRAL] OK. All right.
[AGENT][POSITIVE] Yes, please do. Always feel free to pick up the telephone and we'll walk you through it, Miss [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK. All right. Thank you. You have a good evening.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You have a good evening too and a happy [PII]. Thank you for calling APL Miss [PII].
[CUSTOMER][POSITIVE] Yes ma'am, thank you.
[CUSTOMER][POSITIVE] Yes, thank you. Thank you. Happy [PII] to you and your family too. bye-bye.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[AGENT][POSITIVE] Thank you.