AccountId: 011433970860
ContactId: 6f2d6a4a-b0ff-4ee0-9a7d-ff5bc7588770
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 529700 ms
Total Talk Time (AGENT): 342102 ms
Total Talk Time (CUSTOMER): 99006 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/6f2d6a4a-b0ff-4ee0-9a7d-ff5bc7588770_20250218T14:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], I'm trying to get a new card.
[AGENT][NEUTRAL] OK, you're needing a new ID card, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, sir. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And [PII], can you spell your last name for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you know your policy number, [PII]?
[CUSTOMER][NEUTRAL] Uh, I could give, uh, let me, let me see if it's the same one. It's, it's through my job, but that everybody have the same one?
[AGENT][NEUTRAL] It's not
[AGENT][NEGATIVE] I can look it up with your social. No, sir, they do not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, one moment please.
[AGENT][NEUTRAL] OK, so Mr. [PII], I will need to verify several things with you first for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Also your home mailing address?
[CUSTOMER][NEUTRAL] [PII], uh, should it be [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number that we should have, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. And lastly, your email address, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Just one moment.
[AGENT][NEUTRAL] OK, Mr. [PII], I'll be happy to order new ID cards to be mailed to you. Have you ever set up your profile in our portal here at APL, our online service center?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't think I have.
[AGENT][NEUTRAL] OK, well then what I'm going to do is I'm going to also email you the user guide with the instructions of how to set that up because once you set that up you will have access to your ID cards, your policy information you will also be able to see claims that we have received.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And process on your policy and should you have to ever file your own claim with us, you can actually do that through this portal. So give me just one moment and I'm gonna, go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so like.
[CUSTOMER][NEUTRAL] Oh, so like if I had a my wife had a procedure done, she's under my insurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I, and we had to pay a deductible. Would I be able to file for reimbursement on that, or?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh yes, so give me just a moment to pull up your let me get this email sent to you and I'll look at your benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is like the first time I've had this so I don't know how it works.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] And just so that you know, the email that I am sending to you will come from [PII] and I will and I have put APL in your subject line so that that's easy for you to recognize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So give me just a moment, Mr. [PII]. I'm having to pull up uh some additional information.
[AGENT][NEUTRAL] And was this, you said this was an outpatient procedure that was done at a facility or outpatient hospital?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It was done at the hospital, yeah.
[AGENT][NEUTRAL] Hm. So yes, so this is something that you could file a claim for um.
[AGENT][NEUTRAL] I can also give you the website for where you would get the claim form that has all of the instructions.
[AGENT][NEUTRAL] For the for excuse me, for completing your claim form and the additional documentation that is required for us to review this type of claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, you can go to our website by going to [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When that page pulls up at the top, Mr. [PII], at the top you're gonna see where it says claims and forms.
[AGENT][NEUTRAL] You would click on that link.
[AGENT][NEUTRAL] And then scroll down the page.
[AGENT][NEUTRAL] There will be a small box that says filter by product.
[AGENT][NEUTRAL] And it has a green drop down arrow in it.
[AGENT][NEUTRAL] Click on the green arrow and it will give you a list of forms and you are looking for the word Medlink, M E D L I N K.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You would click on the word med link.
[AGENT][NEUTRAL] And then out to the right of your screen you should see a blue button that says download form.
[AGENT][NEUTRAL] Click that and that will be the claim form. And again, the instructions are at the top section of that form. But yes, sir, on your outpatient, you have an outpatient calendar year benefit maximum of $1500 per covered insured for covered outpatient services with no outpatient deductibles.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Per person per calendar year. So in the future, I always recommend that you present your APL card along with your primary insurance card when you go for medical services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, I can let you know and you may already be aware of this, but on your policy, office visits are not covered under this supplemental policy.
[AGENT][NEUTRAL] But if you were to receive some type of treatment in the doctor's office, then we could review the treatment portion for benefits, but not the office visit charge itself. And again, in this portal, it has a copy of your policy and your ID card and your ID cards as well so you could go ahead and print those out cause it takes about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 10 business days for you to receive those in the mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so I'll get as soon as I get to the house, I'll punch that in.
[AGENT][NEUTRAL] OK. Well, is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] OK, well then, thank you so much.
[CUSTOMER][NEUTRAL] So pretty much I'll go.
[AGENT][NEUTRAL] Uh-huh. Go ahead.
[CUSTOMER][NEUTRAL] I'll put the claim in with the documents and see if you guys approve it for the reimbursement.
[AGENT][NEUTRAL] Yes, sir. So you would just complete the claim form. Again, you will need to include the itemized bill from the provider along with the diagnosis code.
[AGENT][NEUTRAL] That informa and the primary insurance explanation of benefits that information though is on those instructions that I have sent you to the well, or they're on the top section of the claim form and then when you upload your information, you will have to do that from a computer because it doesn't currently support mobile uploads.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, are you where you can write down your policy number? If not, you will be able to see it in your portal.
[CUSTOMER][NEUTRAL] OK, no I'll do it from the portal.
[AGENT][NEUTRAL] OK. Well, again, oh yes, then we don't want you, no, we definitely do not want you riding while you're driving, so.
[CUSTOMER][NEUTRAL] So I'm driving right now.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK. Well, can I help you with anything else this morning?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, no, that was it.
[AGENT][POSITIVE] OK, well then, thank you so much for calling APA APL today. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye-bye.