AccountId: 011433970860
ContactId: 8daec035-108e-48b0-bda7-a78675f3d127
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 234389 ms
Total Talk Time (AGENT): 113195 ms
Total Talk Time (CUSTOMER): 98309 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/8daec035-108e-48b0-bda7-a78675f3d127_20250602T13:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling EPL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, um, I received, um, two bills from two different, uh, our visits from the hospital. Um, I have given them the card for the, um.
[CUSTOMER][NEUTRAL] Gap insurance um Medlink or whatever it's called, um, but I assume it wasn't processed with that um so I wanted to know what I need to ask the hospital for in order to um put in the claim and get it paid for.
[AGENT][POSITIVE] Yes, ma'am. I can assist you with your benefits. Um, first, can I get your name and a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII], my number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Um, now, could I get your policy number? It'll be the outpatient certificate number on the card.
[CUSTOMER][POSITIVE] thank
[CUSTOMER][NEUTRAL] It'll be which number on the card?
[AGENT][NEUTRAL] The outpatient certificate number?
[CUSTOMER][NEUTRAL] 0, 022.
[CUSTOMER][NEUTRAL] 16473 ML8
[AGENT][NEUTRAL] Thank you. Now, please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] 092791 [PII].
[AGENT][NEUTRAL] And please verify your email address.
[CUSTOMER][NEUTRAL] The sil uh yeah, I think it's the [PII].
[AGENT][NEUTRAL] OK, I'm actually showing a different one.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. And what's the date of service for the claim?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That you're calling about.
[CUSTOMER][NEUTRAL] Um, one of them.
[CUSTOMER][NEUTRAL] Is um [PII] and the other one is [PII].
[AGENT][NEUTRAL] And are they for you or one of your dependents?
[CUSTOMER][NEUTRAL] For me.
[AGENT][NEUTRAL] OK, right. I'm not showing those claims on file. Um, in order for them to file the claim, um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They would need your policy number and our phone number and um normally they'll give us a call to verify your benefits. And once they verify your benefits, they can, if they're not familiar with us, um we can explain to them also how to submit a claim. What they would need to do is send us the claim form and the EOB from your primary insurance company. So when we process the claim, we'll know how much um to pay, what went towards your co-pay, co-insurance or deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and if I were to submit the claim.
[CUSTOMER][NEUTRAL] What would I need to submit?
[AGENT][NEUTRAL] If you were to submit to submit the claim, um, we would need, um, let's see, the explanation of benefits for the date of services that you're filing a claim for. And we would also need your diagnosis code. Um, you can get your diagnosis code from the provider's office. We would need a letter or a statement or something from the um provider's office with your diagnosis code on there. And the diagnosis code is the code for the illness, the reason why you're seeing the doctor.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can submit that information online. Um, you can fax it to us or you can mail it to us.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK, well, that's
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK. Well, I thank you again, [PII] for calling ATL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Mm. You're welcome.