AccountId: 011433970860
ContactId: 7c0a4964-bf37-429b-9890-ffd5f5aff31e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 353390 ms
Total Talk Time (AGENT): 209362 ms
Total Talk Time (CUSTOMER): 97489 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/7c0a4964-bf37-429b-9890-ffd5f5aff31e_20250217T18:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm a uh.
[CUSTOMER][NEUTRAL] A subscriber of yours and I got a bill from the uh.
[CUSTOMER][NEUTRAL] From a doctor and they
[CUSTOMER][NEGATIVE] Said that they don't they didn't accept any of the uh numbers I gave them from my card.
[CUSTOMER][NEUTRAL] I guess I have to be billed by you or do I bill you? How, how does this work?
[AGENT][NEUTRAL] OK, so you gave them this insurance information and they said that they just wouldn't accept it?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, OK, so in that case, um, you can absolutely file those claims yourself, we get your policy pulled up and I can help you out with that. um, what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes I do. I've got my card I guess it has the number on it, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it should say member ID or um in hospital or outpatient certification number.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, I've got outpatient certification number benefits er number 02492038ML8.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Got it thank you and then just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that is not the address we have on file for you.
[CUSTOMER][NEUTRAL] Do you have [PII]?
[AGENT][NEUTRAL] Yes, OK, so I do need to go ahead and get that changed, got it. OK, um, sure, what was that new address for you? I'm sorry.
[CUSTOMER][NEUTRAL] OK, I, I, I moved.
[CUSTOMER][POSITIVE] OK, I appreciate it.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Got it. OK, I will go ahead and get that updated. OK, so I appreciate you verifying that information, [PII]. So you've got a few different options as far as filing claims. Um, I will say the quickest and easiest way to get claim information to us is going to be through our online portal. Uh, do you have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Yes, I do, uh, probably tomorrow.
[AGENT][NEUTRAL] OK perfect um there's no timely filing limit so just whenever is easiest for you you can get that to us um I can give you that web address and then you'll simply create the account using this information that we just verified. We do have to have an email address for you on our system for you to do that though. What would you like that email to me?
[CUSTOMER][NEUTRAL] When I'm at work
[CUSTOMER][NEUTRAL] That's fine
[CUSTOMER][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I will go ahead and get that added so that's the email you would put in it does have to match what we have in our system, um, and then once you create that account, you could there's gonna be a spot where you can upload claim information and whenever you're ready I'll let you know exactly what it is what we need.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, I've got a pen.
[AGENT][NEUTRAL] OK, all right, so it's going to be the itemized statement.
[AGENT][NEUTRAL] That shows diagnosis, I'm sorry?
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] It has to be itemized.
[AGENT][NEUTRAL] Yes, itemized statement that shows diagnosis and procedure codes.
[CUSTOMER][POSITIVE] Wow, how do I get all that?
[AGENT][NEUTRAL] The provider will be able to give that to you they have that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So wherever you went for treatment they'll have that information.
[CUSTOMER][NEUTRAL] Diagnostic uh code you said?
[AGENT][NEUTRAL] Yes, diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then the other thing that we would need is going to be the explanation of benefits from your primary insurance and again the provider will have that information essentially that's just going to be showing what your primary uh contributed to the procedure treatment.
[CUSTOMER][NEUTRAL] OK, well that's on the bill.
[AGENT][NEUTRAL] OK, yeah, that's sure as long as that that information is there, um, that should be fine.
[CUSTOMER][NEUTRAL] That they sent me.
[AGENT][NEUTRAL] So once you have all of that you can just upload it through our online portal and then we'll get it pretty quick um it can take about 7 to 10 business days for claim information to complete processing. You can view the status on the website or you can give us a call and check on it.
[CUSTOMER][NEUTRAL] OK, uh, what is that website?
[AGENT][NEUTRAL] OK, so it's the word [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Secured
[AGENT][NEUTRAL] The word [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] So secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and then again it does have to be accessed through a desktop or a laptop um as it doesn't really have support for mobile devices you would just create the account using this information and then again you'll see that spot uh where you can upload claim information.
[CUSTOMER][NEUTRAL] And just
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Alright, did you have any other questions for me?
[CUSTOMER][NEUTRAL] Can I just send that in?
[CUSTOMER][POSITIVE] Uh, no, I don't. I appreciate you.
[AGENT][POSITIVE] Alright, of course, yeah, if you need any help or have any additional questions feel free to give us a call back. I hope you have a great rest of your day, [PII]. Thank you.
[CUSTOMER][POSITIVE] Thank you too. Bye-bye.
[AGENT][POSITIVE] Thank you bye bye.