AccountId: 011433970860
ContactId: 749ef9e7-09f6-43a6-a0aa-eaf2b9d28398
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358209 ms
Total Talk Time (AGENT): 180275 ms
Total Talk Time (CUSTOMER): 135430 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/749ef9e7-09f6-43a6-a0aa-eaf2b9d28398_20241231T16:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes, ma'am. My name is [PII]. Um,
[CUSTOMER][NEUTRAL] I have gap insurance provided to my employer [PII].
[CUSTOMER][NEUTRAL] Um, and I had, uh, I was hospitalized and had some outpatient, uh, care earlier this year.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'd like to start a claim on that please.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you, Mr. [PII]. Do you have your policy number available?
[CUSTOMER][NEUTRAL] Um, I do not, ma'am.
[AGENT][NEUTRAL] Uh it's all right. I can look it up by your social if that's OK with you.
[CUSTOMER][POSITIVE] That's great.
[AGENT][NEUTRAL] And that number.
[CUSTOMER][NEUTRAL] It's 972.
[CUSTOMER][NEUTRAL] 72
[CUSTOMER][NEUTRAL] 0096
[CUSTOMER][NEUTRAL] I'm sorry, uh, it's, it's, it's 27272.
[CUSTOMER][NEUTRAL] 0096
[AGENT][NEUTRAL] 27202.
[CUSTOMER][NEUTRAL] 227272.
[CUSTOMER][NEUTRAL] 00
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] 96.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And Mr. [PII], do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And my mailing address is [PII]. That's [PII]
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you, sir. And do you mind verifying your email and phone number as well?
[CUSTOMER][NEUTRAL] It's um [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you, sir. And it would be my pleasure to assist you regarding starting a claim.
[AGENT][POSITIVE] Now, I can give you your, it's my pleasure. I can give you your policy number if you'd like.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] Uh, that'd be great, thank you.
[AGENT][NEUTRAL] Yes, sir. Your policy number is 244.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 97
[AGENT][NEUTRAL] 41.
[CUSTOMER][NEUTRAL] OK, 244-9741.
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can file, there's two ways to file a claim. You can either file it yourself for reimbursement, or you can contact the facility.
[AGENT][NEUTRAL] Where those services were rendered, and they can file a claim for you as well.
[AGENT][NEUTRAL] Have you paid anything to those services?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, I have.
[AGENT][NEUTRAL] OK, so you don't owe anything to the facility?
[CUSTOMER][NEUTRAL] No, I, I do still owe, um, I'm trying to make payments.
[AGENT][NEUTRAL] OK, so there's two options. You can contact them and give them your policy information.
[AGENT][NEUTRAL] And then they can file the claim for you. They're gonna have all the documents needed to file a claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or if you would prefer to file a claim for reimbursement.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then you can submit an itemized bill with diagnosis codes and procedure codes.
[AGENT][NEUTRAL] As well as a copy of the explanation of benefits from your primary insurance showing what they applied to your deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I'll try to go ahead and have them um.
[CUSTOMER][NEUTRAL] I'll I'll contact them. I think that'd be better.
[AGENT][POSITIVE] It is easier because they've already got the documents needed to file a claim, and that way you don't have to try to secure those documents.
[CUSTOMER][NEUTRAL] OK, now I have I procrastinated so long that I, I won't be able to file this claim for uh [PII]?
[AGENT][NEUTRAL] No, sir, you have not. There's no time frame to submit a claim, as long as your policy was active for the data service and your policy has been active since [PII], so there shouldn't be any problems with that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's great news, ma'am. I really appreciate it.
[AGENT][POSITIVE] Well, it's been my pleasure to assist you, Mr. [PII]. Now, I also see that you have an active online account on the APL portal.
[CUSTOMER][NEUTRAL] Uh yes, I just signed into that, uh, this morning.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, and if you ever want to view your policy benefits, all you have to do is click on the policy number, and it will download your policy documents. And in those documents, there's a page called a schedule of benefits page.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And it on that page you can view the benefits payable on your policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, that's great.
[CUSTOMER][POSITIVE] Alright well thank you so much, ma'am. I really appreciate your time.
[AGENT][POSITIVE] Well, it's been such a pleasure to assist you, Mr. [PII]. Is there anything else you can think of that I could help you with today?
[CUSTOMER][NEUTRAL] Um, no, I think I just need to get my documents and, uh, contact some, uh, the hospital and the outpatient providers, so, um.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Well, if you need
[CUSTOMER][POSITIVE] Uh, thank you so much
[AGENT][POSITIVE] It's been a pleasure and if you need any further assistance whatsoever, you don't hesitate to give us a call, OK?
[CUSTOMER][POSITIVE] OK, thank you, ma'am and have a great uh New Year's.
[AGENT][POSITIVE] You too, Mr. [PII]. I hope you and your family have a safe and happy New Year, and thank you for calling APL.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Thank you. You've been a pleasure, man. Thank you.
[AGENT][POSITIVE] Thank you. Take care.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.