AccountId: 011433970860
ContactId: 8601c333-43f7-4570-b76e-48e9fef05101
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248139 ms
Total Talk Time (AGENT): 126850 ms
Total Talk Time (CUSTOMER): 113197 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/8601c333-43f7-4570-b76e-48e9fef05101_20250107T15:27_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Thank you for calling.
[CUSTOMER][NEUTRAL] Hey Ms. [PII], my name is [PII]. I have a supplemental insurance through APL. I can give you my group number and policy number.
[AGENT][NEUTRAL] Yes sir, Mr. [PII], what's the policy certificate number?
[CUSTOMER][NEUTRAL] Um, 02521720.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um, [PII] current billing address is [PII].
[AGENT][POSITIVE] Perfect, thank you. And your email and phone number please, sir?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Email is [PII]. My phone number is [PII].
[AGENT][POSITIVE] All right, thank you, sir. And how can I help you today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes, ma'am. So yesterday I went, I had to go get my eyes looked at because I had what was called a, uh, stress-related, I had stress-related fluid under my retina.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Which is very interesting. Never had that happen before. Never knew that could happen.
[AGENT][NEUTRAL] I didn't either.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um, I had, uh, you know, I have the supplemental insurance, um, you know, I gave them my insurance card which they already had, and I gave them this when they said, hey, you know, according to them, they were like, you know, I was told by your rep when they came and sold us this insurance that if we, they, the company is supposed to just file it right alongside our, uh, primary insurance.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] They're telling me that um I need a bill and I would submit it so I'm just trying to figure out the best way to go.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I've never done this before and had this before.
[AGENT][POSITIVE] OK, well, that's not a problem. It would be my pleasure to assist you and I'm sorry they're not gonna file that for you um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] We just can't control if they file claims or not. So what we're gonna need and for reimbursement claim is of course the itemized bill.
[AGENT][NEUTRAL] With the diagnosis codes and procedure codes, and we'll also need a copy of the explanation of benefits from your primary insurance showing how they process the claim and what they applied to the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you have your online account.
[CUSTOMER][NEUTRAL] Yeah, that, that'll
[AGENT][NEUTRAL] With us
[CUSTOMER][NEUTRAL] I do not.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK, so we do have a portal that's secured.
[AGENT][NEUTRAL] [PII]. That should be listed on your card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think so let's see.
[CUSTOMER][NEUTRAL] Yep, secured at a [PII] hashtag login.
[AGENT][NEUTRAL] Mhm. That's right. You can create a login and password you can upload the documents directly online.
[AGENT][NEUTRAL] And we can process that. Now, make sure that you get the EOB from your primary that shows what they applied to your deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's fine. Yeah, none, none of that is has happened yet, so you know, once all that happens I'll, uh, I'll get it and submit it.
[AGENT][NEUTRAL] Absolutely and if you ever have any problems wherever you go, just ask them to call us we can verify that we do pay providers if the providers file the claims.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] And then hopefully you won't have to pay out of pocket. If you want to view your policy benefits, you can also click on your policy number on that website. It will download your policy and there's a page called the Schedule of benefits page inside the document, and that will give you your benefits and what's covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] Is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] That'll be all thank you so much.
[AGENT][POSITIVE] Well, it's been such a pleasure to assist you, Mr. [PII]. If you have any other questions or concerns, never hesitate to give us a call. And thank you for calling APLA. I hope you and your family have the happiest of [PII]'s.
[CUSTOMER][POSITIVE] Thank you so much you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.