AccountId: 011433970860
ContactId: 67e09c43-b0af-4f5e-9854-e2338ff7f20e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 747369 ms
Total Talk Time (AGENT): 306382 ms
Total Talk Time (CUSTOMER): 445878 ms
Interruptions: 7
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/67e09c43-b0af-4f5e-9854-e2338ff7f20e_20250318T20:24_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. Um, my name is, uh, [PII] and I have a couple of questions about, uh, claim.
[CUSTOMER][NEUTRAL] So, um, the, I have with my company, I have an accident policy and then I also have um um a um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, gap pay, uh, gap, uh, Chu gap. Do, do they all go through the APL?
[AGENT][NEUTRAL] I can check that for you, Mr. [PII]. First of all, what is a good callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK. Sure.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII]. And do you have one of your policy numbers available?
[CUSTOMER][NEUTRAL] I'm trying to figure out where I get that at. Let's see, policy contact info.
[AGENT][NEUTRAL] Do you happen to have a gap policy card?
[CUSTOMER][NEUTRAL] Uh, gap policy card. I don't know what they gave us. Let me look in my portal here.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Yeah, if you've got
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Are you on the APL policy portal?
[CUSTOMER][NEUTRAL] Uh, I, I was on there but I don't see anything, uh, I don't see anything that, that gives me any information about that, so I was looking in our, our, uh, customer portal.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and what it does when I go there, let me just look at in confirmations maybe.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] Mr. [PII], what state are you in?
[CUSTOMER][NEUTRAL] Uh, I am in uh [PII].
[AGENT][NEUTRAL] Are you in [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][POSITIVE] All right. I've got you. I found you.
[AGENT][NEUTRAL] I just need to verify some information.
[CUSTOMER][NEUTRAL] Oh, and I just found, I think the policies. I, I think I just found the policies, but of course.
[AGENT][NEUTRAL] Well I was trying to beat you. No, I'm just kidding.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I just need to verify your date of birth and current mailing address, please, sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And current mailing address?
[CUSTOMER][NEUTRAL] Uh, it is [PII].
[AGENT][NEUTRAL] All right, thank you. And you gave me that callback number. What's your email address, please?
[CUSTOMER][NEUTRAL] Um, you can, uh, uh, I think I have it through my email, uh my personal email which is [PII]. That's the number [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right. Thank you. I appreciate that verification. Now, Mr. [PII] with APL you only have the
[AGENT][NEUTRAL] GA policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I can provide your policy number. Do you have the APL policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let's see, gap, I have, uh, AP, uh, oh wait, it doesn't give me the number.
[CUSTOMER][NEUTRAL] All it says is APL got 5000 option one, but it doesn't tell me the number.
[AGENT][NEUTRAL] So if you um on your APL if you've got that account.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then you can print a card from there or I can email you a card if you would like.
[CUSTOMER][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Checking to see if you have.
[CUSTOMER][NEUTRAL] I'm on there.
[CUSTOMER][NEUTRAL] Let's see, let me go in here.
[AGENT][NEUTRAL] Let me check one other thing. Let's see.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 00, no, I see it. I see it right there. It, it was, it's a little PDF icon Medli WF benefit ass assignment.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so this is for the gap, this is for the gap. OK, I wasn't for sure exactly. I've got, I just, I just bought all that stuff, um, the different policies, so I have an accident and whatever. So a question that I have, so I do have it. I have the policy. I have everything I need. So I saw on the, the, on one of the forms, uh, it said to fill out a claim form.
[CUSTOMER][NEUTRAL] Uh, CH form and it says uh to have the physician uh fill out section C.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And so I'm not sure how I can do that. I actually uh fell down the steps and broke a couple of ribs and had like, uh, you know, I had to go in an ambulance, I had to be overnight and all that stuff, so I don't know how to get some of that information.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] OK, so on your Medlik policy, did you, have you paid for any of those services because the provider can file claims for you and we can pay them direct.
[CUSTOMER][NEUTRAL] No, I've already paid them, yeah.
[AGENT][NEUTRAL] OK, so with your gap policy,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] On the APL portal, there is a claim form under the claims and form section, and the Medli claim form is what we will need.
[AGENT][NEUTRAL] M E D L I N K claim form.
[AGENT][NEUTRAL] If you want to look at that real quick, we can take a look at that together to make sure you provide the information needed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, um, I had pulled it up I think is this.
[CUSTOMER][NEUTRAL] Is it uh fillable claim form?
[AGENT][NEUTRAL] Yeah, for Medlink claim form.
[CUSTOMER][NEUTRAL] Is that in its 12?
[CUSTOMER][NEUTRAL] Um, I don't see Medlik.
[AGENT][NEUTRAL] Now this is on the APL portal.
[CUSTOMER][NEUTRAL] Now this is workplace benefits.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's in the APL portal?
[AGENT][POSITIVE] Yeah, that's right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claims and forms.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me go down here, sign in and register.
[AGENT][NEUTRAL] It's on page 2.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, let me
[CUSTOMER][NEUTRAL] Oh, OK, wait. Uh oh, I see.
[AGENT][NEUTRAL] I see you have an active account.
[CUSTOMER][NEUTRAL] What's that?
[AGENT][NEUTRAL] You do have an active account on the APL portal.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So if you just sign in with your username.
[AGENT][NEUTRAL] And then your password.
[CUSTOMER][NEUTRAL] Yeah, so when I sign in, OK, so I sign in, oh, I see claim forms at the top. It takes me back to another page that shows the claims where uh I see an accident claim form, authorization disclosed, cancer change request, continuing benefits, critical claim, dental.
[CUSTOMER][NEGATIVE] Direct, I don't see, oh wait, there's more than one page. Oh, it's page 2, page 2. OK. So oh mid link there it is right there. I'm so sorry. I did not realize there were 2 pages. I mean there were multiple pages.
[AGENT][NEUTRAL] So you're gonna go page 2, yeah.
[AGENT][NEUTRAL] Not a problem. So this is a claim form that you will need to complete. Your doctor does not need to complete any portion of this claim form for APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you. OK.
[AGENT][NEUTRAL] And then above the segment of insurance, it has the documents needed to file a claim.
[CUSTOMER][NEUTRAL] And then all I do is
[CUSTOMER][NEUTRAL] OK, I see A, B, C, yeah, it's not really much to fill out there, uh, other than, uh, OK, and then I just attach all the bills that I paid. Now, um, part of it is, um, go ahead.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] We will also need an explanation of benefits from your primary insurance carrier showing the amounts that were applied to your deductible, co-pay or co-insurance for the charges listed on the itemized bill.
[CUSTOMER][NEUTRAL] Yeah, yeah, no, yeah, I, I, I, I did put, um, I do have those for I just went to explanation of benefits, but um it is, it's kind of, um, so what I've had to do, so this is why it's confusing a little bit and I wanna make sure I'm doing it right and, and how much I need to fill out, do I fill out one form and file everything?
[CUSTOMER][NEUTRAL] So what happened is, so I broke, I broke two ribs, um, but then uh uh then I, I was knocked down at the bottom, so I slid down on my left side and I hurt my knee in the process. So I broke ribs and, and so I had to go get an MRI and an X-ray and all that. Do I include that as part of this?
[AGENT][NEUTRAL] That's right, cause it's for the same injury.
[CUSTOMER][NEUTRAL] It's the same incident.
[AGENT][NEUTRAL] Incident, right.
[CUSTOMER][NEUTRAL] OK, OK, OK, yeah, and we're still in that.
[AGENT][NEUTRAL] Yeah, you can just do one thing.
[AGENT][NEUTRAL] Form
[CUSTOMER][NEUTRAL] OK, OK, and, and I'm, and then as I go and go see a specialist, we'll determine what we did. I the MRI did show some damage on the knee, but I don't know what that means, so, um, but yeah, it was, uh, crazy, crazy, crazy and people ask me, uh, you know, uh, you know, what happened? and I said, well, uh, how did it happen? I said, I didn't listen to my wife. So uh I went I I I yeah, we have wooden stairs and.
[AGENT][NEUTRAL] So.
[AGENT][NEGATIVE] That's dangerous.
[CUSTOMER][NEGATIVE] I was, I was going down the steps with socks on, and she has told me repeatedly, do not go down the steps with socks, and I had two boxes in my hand, so I didn't have my hands free, and boy, I slipped and went down about 7 or 8 stairs, slid down. It was not fun.
[AGENT][NEUTRAL] It's the long day.
[AGENT][NEUTRAL] I hope you listen to your wife now.
[CUSTOMER][NEUTRAL] So I wear, I wear shoes.
[CUSTOMER][POSITIVE] I tell you, I will, uh, I wear shoes now every time. OK, so that's pretty easy cause I, I was looking at the wrong form and it was like all sorts of stuff and I'm like I can't get any of this information. So, so that makes it easier.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, no, no, it's just because you have that Medlink policy, you need the Medlink claim form, and if you ever want to see what's covered on your policy on that portal under my coverage, you can click on the policy number and it will download your policy documents. And then there, there's a page called the Schedule of benefits page in your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Oh, OK, cool.
[AGENT][NEUTRAL] And it's gonna be about halfway through and it'll have your inpatient benefits and your outpatient benefits and you can see what types of services are covered that way you know what to file for.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then, uh, so this does not, so the, the accident um is paid out, it's a different cause, cause I also had uh because this was an accident, so, uh, that would be a different different site that I do that in, yeah.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Right. That's gonna be through a different company. I don't see you have an active um accident policy with us.
[CUSTOMER][NEUTRAL] OK, uh, yeah, I, I, I get confused cause I mean, I bought like all the different stuff. I always just rather be safe than sorry.
[AGENT][NEGATIVE] Right. Exactly. You never know when you're gonna not listen to your wife again.
[CUSTOMER][NEUTRAL] You know, and then I'm then I'm covered in.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][POSITIVE] Exactly, absolutely. So, OK, well, you've been, um, [PII], you've been absolutely incredible. Thank you so much.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well it's been such a pleasure now you can also, once you have those claim documents, you can upload that claim directly online on the portal as well, and you'll get a confirmation if you sign up for the text messaging, which is an option, it will notify you when we receive a claim and once it's processed. If you do sign up for that for and you receive a text message stating the claim was processed, it could take up to 48 hours to view online.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's perfect.
[AGENT][NEUTRAL] And then there's a direct deposit option if you would prefer benefits go directly to your bank account.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I think I have that already set up in there.
[AGENT][NEUTRAL] So that's about
[AGENT][NEUTRAL] You do. And for the future, just keep your APL ID card with your primary insurance card and
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] You know, show that APL card when you show your primary insurance card and let the providers file things for you, so you don't have to pay out of pocket.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh, OK, yeah, that makes that absolutely makes sense. I never thought about that, so.
[AGENT][POSITIVE] Yeah, providers normally file claims and they'll do that for you and then that way you're clear, you can just sit back and let the magic happen.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] And recover.
[CUSTOMER][POSITIVE] All right. Well, thank you so much.
[AGENT][POSITIVE] It's been such a pleasure, Mr. [PII]. I hope you do get to feeling better soon. And you call us if we can be of further assistance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I will.
[CUSTOMER][POSITIVE] I will do that. Thank you. OK. All right, bye. Yeah. All right. You too. Bye.
[AGENT][POSITIVE] Thank you, sir. You have a lovely afternoon. Bye-bye.