AccountId: 011433970860
ContactId: 9a302646-b857-42aa-a6e0-b8e7e4e89764
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 325320 ms
Total Talk Time (AGENT): 129637 ms
Total Talk Time (CUSTOMER): 146600 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9a302646-b857-42aa-a6e0-b8e7e4e89764_20250527T15:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] Good morning. Thanks for calling APO speaking. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII] in [PII]. I'm inquiring to see how to file a uh accident claim and and emergency room visit.
[AGENT][NEUTRAL] OK. And Mr. [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] OK, and it's today do you have your policy number?
[CUSTOMER][NEUTRAL] Is that a certificate number?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yes sir. 02044607
[AGENT][NEUTRAL] Thank you, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, let's see.
[AGENT][NEUTRAL] And verify your date of birth, mailing address and email address for me.
[CUSTOMER][NEUTRAL] Uh [PII] email is [PII] and you might have an old address for me. Um, I'm looking at the policy it says [PII], but I have a new address.
[AGENT][NEUTRAL] OK, what's that new address so I can change it in our system?
[CUSTOMER][NEUTRAL] Since then.
[CUSTOMER][POSITIVE] Thank you very much, uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and what was that email address again because I don't show one in the system.
[CUSTOMER][NEUTRAL] Oh, OK. Uh last name [PII].
[AGENT][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Give me one quick moment.
[AGENT][NEUTRAL] OK, uh, what we will need is the claim form which is available on our website.
[AGENT][NEUTRAL] And along with the claim form, we need any itemized billing showing diagnosis and procedure codes for your accident.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me verify your mailing address again, make sure I have it correct. And you said [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] OK, good deal.
[CUSTOMER][NEUTRAL] Uh, and what, what is the web address?
[AGENT][NEUTRAL] Uh, is that [PII]?
[CUSTOMER][NEUTRAL] on this letter here.
[CUSTOMER][NEUTRAL] Am
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Workforce benefits that work for you, OK, uh, claims and forms I'm guessing.
[AGENT][NEUTRAL] Yes sir, and under claims and forms, uh, if you scroll down you'll see the first one it shows accident claim form.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][POSITIVE] Accident claim form. OK, very good.
[AGENT][NEUTRAL] Yes, sir. And on the.
[CUSTOMER][NEUTRAL] Um, OK, and, uh, what was, uh, I'm sorry, go ahead.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] No, I'm sorry. I was gonna let you know on the claim form that first page does have instructions for the insured or patient, let you know just kinda uh what information we would need in order to file um along with the claim form when you file a claim.
[CUSTOMER][NEUTRAL] OK, so, um, uh, and what is the time frame to be properly filed because if I don't know how long I'll see any bills or anything was emergency room, you know that that takes a while.
[AGENT][NEUTRAL] Uh yes, sir. Uh, we don't have a time limit, so there's no timely filing.
[CUSTOMER][NEUTRAL] Oh really, huh, I'll be a son of a gun. I, I thought there was, uh, I have this on an employee and, uh, we forgot all about it. Had an ER visit, jeez, it's been a couple of years ago now, and I said oh it's out of the time frame, so we never did file the dumb thing.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, no, no, no, sir. There is no time limit. So, uh, once you receive that information, you can submit to us by mail or fax and um we do have an online service center that they are updating um to where you can set up an account um to view your policy, check claim status and also uh submit claims.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, super, thank you for your help. I have one last question, uh, if, if you can help me and I'll, I'll start working on that, um, uh, so, um, and I'm not trying to pin you on benefits, but it's got an emergency room benefit which I wrote in an ambulance to the emergency room and it says ambulance benefit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Does does that depend on how much my insurance did or didn't pay or does it just pay an ambulance benefit?
[AGENT][NEUTRAL] I just pay the ambulance benefit. Um, this policy is not contingent on any other, uh, insurance information.
[CUSTOMER][NEUTRAL] I couldn't
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, so long as long as I can document that then so good.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] All right, you're welcome and thank you for calling APL. You have a great day, Mr. [PII]. Oh, you're welcome.
[CUSTOMER][POSITIVE] Appreciate all your help.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Bye.