AccountId: 011433970860
ContactId: 73ac87ab-587c-47f7-8a5d-06e2231d5bec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254179 ms
Total Talk Time (AGENT): 84132 ms
Total Talk Time (CUSTOMER): 126160 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/73ac87ab-587c-47f7-8a5d-06e2231d5bec_20250521T13:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I have gap insurance with APL, and I had gone to my dermatologist last week and um they told me I needed to submit my deductible to APL directly.
[CUSTOMER][NEUTRAL] So I need to figure out how to file a claim form for the $60 deductible that the gap should have picked up, but.
[CUSTOMER][NEUTRAL] I guess they said that they have issues receiving payments from APL so they wouldn't do it for me.
[AGENT][NEUTRAL] OK, uh, what is that policy number, please?
[CUSTOMER][NEUTRAL] 02620113
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have a callback number, Miss [PII] in case the call drops?
[CUSTOMER][NEUTRAL] I do. Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And verify your date of birth, mailing address, and email address for me, please.
[CUSTOMER][NEUTRAL] [PII] and um what was the last thing?
[AGENT][NEUTRAL] Uh, email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that [PII]?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] Oh, [PII]. Thank you. Hold on one moment.
[CUSTOMER][POSITIVE] Mhm you're welcome.
[AGENT][POSITIVE] Thank you so much. And what was, uh, was it for an office visit?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, it was an office visit and they, uh, it was a dermatologist, so they had frozen, you know, they did some freezing on my skin.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I mean I'm looking they had given me a copy of the claim form that they submitted to United Healthcare um I don't know if there's codes or something on here that.
[CUSTOMER][NEUTRAL] I mean I can send a copy of this over.
[AGENT][NEUTRAL] Uh, we will need the billing and the primary explanation of benefits for that data service.
[CUSTOMER][NEUTRAL] So I have the claim the United Healthcare health insurance claim form that they filled out to submit to them. Would that be sufficient with a copy of the bill, you know, a copy of the.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Invoice showing the co-pay and the deductible paid with my receipt.
[AGENT][NEUTRAL] You said a claim form, like a claim form from your primary insurance carrier?
[CUSTOMER][NEUTRAL] No, no, no, it's a claim form from the doctor's office that I guess they submit to United Healthcare showing the procedure, you know, the the, the, I guess the diagnosed agnostic codes or something that they.
[AGENT][NEUTRAL] Um, I would say to submit that to us. If it has the diagnosis and procedure codes, we definitely need that in order to process and then your UnitedHealthcare EOB for that data service showing what was applied towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, so I have to first wait to get the EOB before I submit this.
[AGENT][NEUTRAL] Uh yes ma'am, since we are secondary, that EOB is needed and once you receive everything, you can fax it, mail it, or if you set up on our online service center, we do have it to where you can upload the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, so I have to really wait until I get the EOB, which will be.
[CUSTOMER][NEUTRAL] Probably another month.
[AGENT][NEUTRAL] Uh, uh, yes, ma'am.
[CUSTOMER][NEUTRAL] OK all right no problem I just didn't know the procedure it's the first time I've ever had to submit.
[AGENT][NEUTRAL] I understand, yes, ma'am. um, and is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] No that should do it thank you.
[AGENT][POSITIVE] Yes ma'am, thank you for calling APL and you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye bye.