AccountId: 011433970860
ContactId: 788e1773-73de-48e3-96ba-38872d786f31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308119 ms
Total Talk Time (AGENT): 188575 ms
Total Talk Time (CUSTOMER): 79557 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/788e1773-73de-48e3-96ba-38872d786f31_20250321T15:50_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling about um.
[CUSTOMER][NEUTRAL] I guess a claim I'm not sure. I haven't.
[CUSTOMER][NEGATIVE] I'm new to this. Um, I went to the doctors and I paid my copay and they said they're gonna file a claim and then you guys reimburse me or something. I'm not sure exactly how this works.
[AGENT][NEUTRAL] OK, we can yes ma'am, we can definitely assist you on how to file a claim and how your plan works, but before we proceed, is it possible to get your name and a callback number please?
[CUSTOMER][NEUTRAL] You claim.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, it's [PII] [PII].
[AGENT][NEUTRAL] And Miss [PII], do you happen to have your policy number?
[CUSTOMER][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] 02516045
[AGENT][NEUTRAL] Thank you for that. I'm gonna need you to verify a couple things for me. Can you verify your date of birth and mailing address, please?
[CUSTOMER][NEUTRAL] Uh, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And my birthday? Oh.
[AGENT][NEUTRAL] Mailing address. Your mailing address.
[CUSTOMER][NEUTRAL] What else did you need?
[CUSTOMER][NEUTRAL] Uh, 6
[CUSTOMER][NEUTRAL] [PII] or [PII].
[AGENT][NEUTRAL] Thank you for that and that is what we have on file. I'm also showing that we have an email account can you verify that too, please?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, looks like it's your [PII].
[CUSTOMER][NEUTRAL] OK, so [PII].
[AGENT][NEUTRAL] Thank you for that, Ms. [PII]. All right. So it does look like you have an active gap policy. You've been with us since [PII]. And definitely, anytime you go to the doctor or hospital, you need to present your major medical card and our card. Most of the time when you present our card, provider does submit a claim on your behalf. Um.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see if we've got any claims on you, Ms. [PII].
[AGENT][NEUTRAL] When did you go to the doctor?
[CUSTOMER][NEUTRAL] Um, the last time I've gone twice, but the last time I went was [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, doesn't look like they're submitting your claims into our office we don't have any claims from the provider, um.
[AGENT][NEUTRAL] You can file the claims yourself directly, but we will need an itemized bill of the of what was done that day and it basically has procedure codes and charges. If you do get that, you can, you can um download it onto our online service center or you can fax it to us. Unfortunately we don't accept emails um I can give you our fax number and I can also email you the instructions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You have a, you said you have a website?
[AGENT][NEUTRAL] Yes ma'am, we have an online service center. I can email you the instructions on how to register onto the online service center if you'd like.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Yeah, and then I'll submit these.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, and just so you know for future you can always go back to to the provider and have them submit just ask them to resubmit that we didn't get them but again by you filing them once we review them and whatever is payable, we will definitely refund that back to you since you're filing them. So if the provider files them, they'll get payment.
[CUSTOMER][NEUTRAL] OK. Is that done?
[CUSTOMER][NEUTRAL] OK, is that done with a check or how is that reimbursed?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] We do have two options we can um do a check or we can do a direct deposit. We do have a direct deposit form I can attach that to the email as well um you can actually download that too and send it back to us as well.
[CUSTOMER][NEUTRAL] Back
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, yeah, if you could send that to my email, I'd greatly appreciate it.
[AGENT][NEUTRAL] Not a problem at all, Ms. [PII]. So just to make sure since I am sending you, I know you verified, but I just wanna make sure your email is your first name, [PII], and then your last name [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, alright, so you're gonna be getting an email from [PII]. Keep an eye out for it. You should have it in about 15 to 20 minutes, and it will include the information on how to register on the online service center and a direct authorization form as well. Is there anything else I can help you with, Ms. [PII], before you go?
[CUSTOMER][NEUTRAL] Uh, no, that is it.
[AGENT][POSITIVE] Alright, well thank you for calling APL and you have a wonderful day.
[CUSTOMER][POSITIVE] OK thank you bye.
[AGENT][POSITIVE] Thank you.