AccountId: 011433970860
ContactId: 9b4209f1-6d5d-403e-84cb-281ac6651fd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311279 ms
Total Talk Time (AGENT): 172488 ms
Total Talk Time (CUSTOMER): 90752 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/9b4209f1-6d5d-403e-84cb-281ac6651fd7_20250422T15:14_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling PL. This is [PII]. May I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. Um, I was calling because I wanted to put in um a claim. I had to pay, uh, a lab fee and they were unable to process it through my secondary insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] So I'm not sure how to go about doing this.
[AGENT][NEUTRAL] OK. Well, go ahead and give me your name and your policy number.
[CUSTOMER][NEUTRAL] Sure. My name is [PII]. The last name is [PII], [PII]
[CUSTOMER][NEUTRAL] And by policy number do you mean the group number?
[AGENT][NEUTRAL] Now, ma'am, your certificate number please, ma'am.
[CUSTOMER][NEUTRAL] Um, that's for the outpatient.
[AGENT][POSITIVE] Yes, ma'am. Correct.
[CUSTOMER][NEUTRAL] That's 0203.
[CUSTOMER][NEUTRAL] 0186
[CUSTOMER][NEUTRAL] M as in Mary, L as in little, and the number 8.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for all that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Sure, it's area code [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alrighty, thank you so much, [PII]. Go ahead and verify your date of birth and your address for me, please, ma'am.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And the address is [PII].
[CUSTOMER][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] Alrighty, [PII], thank you so much for all of that information. OK, excuse me. OK, so your question is you have a bill that you want to submit um because your provider's not, um, going to submit. OK, all you need to do is go to our um website, I mean [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna go to where it says Medlink claim form.
[CUSTOMER][NEUTRAL] Um, I see, hold on, I see claims and forms.
[AGENT][NEUTRAL] Yes, you're gonna look for Medlink.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Do I need to have like a log in?
[AGENT][NEUTRAL] Yes, ma'am. You have, you, you have to set up your, your own.
[AGENT][NEUTRAL] Your own password and all that, but all you generally would need to do is go to the OSC website. Do you know how to upload it or do you just want to mail your stuff in? Which way are you wanting to do this?
[CUSTOMER][POSITIVE] I can upload it.
[AGENT][NEUTRAL] You can upload, OK, yeah, then you have to, you could go to the OSC website, set your account up, then like I said, choose the Medlink claim form.
[AGENT][NEUTRAL] And then you will have to attach the original copy of your bill. We are your supplemental plans, so we need your primary EOB.
[AGENT][NEUTRAL] And we also need the medical diagnosis from the provider's office in writing from them.
[CUSTOMER][NEUTRAL] What's what's the, what's the primary AOB?
[AGENT][NEUTRAL] Primary, your primary insurance company, we are just your medical supplemental plan [PII]. So we have to have that EOB right from your primary insurance carrier that you have to submit along with that claim.
[CUSTOMER][NEUTRAL] OK, so you're
[CUSTOMER][NEUTRAL] So the, the.
[CUSTOMER][NEUTRAL] The bill, my primary insurance card, and what else?
[AGENT][NEUTRAL] We need a diagnosis from the provider's office.
[AGENT][NEUTRAL] The reason why you went to the doctor's office. The easiest way to do that, did you say this was a lab bill, [PII]?
[CUSTOMER][NEUTRAL] It it is.
[AGENT][NEUTRAL] Yeah, OK, yeah, easiest way to do that is call that lab company and tell them to, uh, send you over a copy of that lab bill because it and tell them you know that you need that to send into your your uh supplemental plan because we have to have that diagnosis on that lab bill.
[CUSTOMER][NEUTRAL] I have the lab bill in front of me.
[AGENT][NEUTRAL] That's OK. Well, as long as it's got a diagnosis on it in writing from that provider's office, then that is what we would need, yes.
[AGENT][NEUTRAL] So it sounds like you have.
[CUSTOMER][NEUTRAL] I don't see a diagnosis. I, I just, I just see a service code.
[AGENT][NEUTRAL] Tell me what, tell me what the code you're saying.
[CUSTOMER][NEUTRAL] 82,670
[AGENT][NEUTRAL] Yeah, that's the lab code. Yes, ma'am. You need to call them back and tell them you need something with a diagnosis on it.
[CUSTOMER][POSITIVE] OK, OK, great. All right, thank you so much.
[AGENT][POSITIVE] Yes, ma'am. Well, yes, ma'am, [PII], is that all I can help answer for you today?
[CUSTOMER][POSITIVE] Yes, thanks so much I appreciate your help.
[AGENT][POSITIVE] OK. Yes, ma'am, anytime, and thanks for calling APL [PII]. Have a great day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][POSITIVE] Thank you. Bye bye.