AccountId: 011433970860
ContactId: 89427eec-f02a-4f1d-bd21-75c237777d18
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 245039 ms
Total Talk Time (AGENT): 98750 ms
Total Talk Time (CUSTOMER): 124957 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/89427eec-f02a-4f1d-bd21-75c237777d18_20250506T16:57_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi. Um, I recently took my daughter for a uh medical visit, an ultrasound, and I did not give them my APL information and now I'm receiving a bill from them. So I wanna like retroactively apply my APL benefits towards that visit.
[AGENT][NEUTRAL] OK, are you submitting the claim yourself or will you give your provider the medical card information to submit it on your behalf?
[CUSTOMER][POSITIVE] OK. So I'm, I'm actually open to hearing which one would be more effective.
[AGENT][NEUTRAL] OK. All right. Let me get your name.
[CUSTOMER][NEUTRAL] Um, so I can give you my name although our APL is under my husband's name, so I'm assuming you would want my husband's name.
[AGENT][NEUTRAL] I, I need your name.
[CUSTOMER][NEUTRAL] My name, OK, my name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Our policy number, um, OK, so what would that be? I see coverage group number. Would that be group number? I don't know that.
[AGENT][NEUTRAL] Pa
[AGENT][NEUTRAL] It's gonna be the policy er number begins with a 0 maybe.
[CUSTOMER][NEUTRAL] Mm mm, I don't see that.
[AGENT][NEUTRAL] Kinda near the bottom.
[AGENT][NEUTRAL] It's an inpatient and outpatient policy certificate number.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, yes, it doesn't start with a 0 inpatient benefit certificate number outpatient benefit certificate number starts with a 14.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what am I giving inpatient in hospital or outpatient? I'm assuming outpatient.
[AGENT][NEUTRAL] OK, the number should be the same before the letter M, so just give me the number before the letter M.
[CUSTOMER][NEUTRAL] OK, that is correct, it is the same 142-0763.
[AGENT][NEUTRAL] OK, and what's a good phone number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And [PII], what's your date of birth?
[CUSTOMER][NEUTRAL] Mine is 1, OK, so um I'm this is all information on me although this is on behalf of my daughter and the insurance is under my husband, but my date of birth is [PII].
[AGENT][NEUTRAL] I'm
[AGENT][NEUTRAL] I'm verifying you because you're the one that's calling, so we have to verify that.
[CUSTOMER][NEUTRAL] Oh, OK, got it. That makes sense. OK, so mine is 11285.
[AGENT][NEUTRAL] And now if you, if you can give me the.
[AGENT][NEUTRAL] The dependent that had the diagnostic test, her name and date of birth, please?
[CUSTOMER][NEUTRAL] OK, so her name is [PII], same last name [PII], and her date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So it will be up to the policy holder which is your spouse's, um, whatever he chooses to do.
[AGENT][NEUTRAL] Um, it's a lot easier or you don't have to provide us information. It's about 3 documents if, if he submits it himself, uh, versus giving the provider the policy number on the card and the mailing address, and, um, once they submit it to the primary carrier they can then send it the claim to APL to process this um secondary so that's an easier process for for the family that way you.
[CUSTOMER][NEUTRAL] So just to, just to confirm for me to to call the clinic in which you had the diagnostics done with all our information. Got it. OK, and then they will, they will submit everything to you and then you, the, the next bill I receive should not, should be zero so to because typically a bill should cover it, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, we'll have to get the claim. We can't guarantee it until we get the claim.
[CUSTOMER][NEUTRAL] Right, no, we need to say, OK, and then I sort of, I, I submitted and then I sort of wait like meaning the bill that they sent me I put to the side and I wait for the next bill to arrive as an updated.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, so you would call the provider and just ask if they could if they could submit the claim on your behalf um to APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, got it. I'm gonna do that one. Got it. OK, thank you, ma'am. I'm gonna do that right now.
[AGENT][NEUTRAL] All right. Any other questions, [PII]?
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] That's all for now. Thank you.