AccountId: 011433970860
ContactId: a3b26fcf-3089-4e08-ac65-db3b34690ab9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 467260 ms
Total Talk Time (AGENT): 193240 ms
Total Talk Time (CUSTOMER): 208072 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/a3b26fcf-3089-4e08-ac65-db3b34690ab9_20250115T17:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you doing?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] Doing great. Um, look, the reason why I'm calling is, um, I'm having a surgery in, in a couple of months. Um, I know that I have gap insurance with you guys. I, I am logged into the account. I was calling, um, UM, the hospital, and they said that they couldn't find my insurance in there to, to, uh, to add it to my profile, um.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The thing is, uh, how, uh, will, will I be able to use uh the gap insurance, your gap insurance, and how will I be able to do so?
[AGENT][NEUTRAL] Yeah, so, um, you should be able to use it as your secondary, and if they need to verify like your eligibility or benefits, um, they can definitely call us, um, and we can verify that. All they would need is your policy number.
[CUSTOMER][NEUTRAL] OK, and that's the thing, the policy number on my card is the one that goes in the bottom uh as uh hospital inhospital number, something like that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah, the thing is, I, I just called them and I gave them that number and they said that they couldn't find it in the system to add me, so they couldn't add that insurance profile.
[CUSTOMER][NEUTRAL] To their system.
[AGENT][NEUTRAL] What number? OK, what number do you have?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Give me, give me one second, let me go to my computer and see it. The thing is,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, they, they couldn't find American Public Life or APL as an insurance company. They were asking me if it was an HMO or a PPO, uh, I said that I didn't know. Um, the number that it says here is 02301155 ML7.
[AGENT][NEUTRAL] OK, let me take a look.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Let me just, I need to verify please your first and last name and your date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you. And then if you could verify with me the address on file and the email address.
[CUSTOMER][NEUTRAL] OK, the address on file I just updated, uh, with you guys, so it should reflect is [PII], uh, zip code [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, I mean, looking at your plan, [PII], I mean, everything is active and effective and
[AGENT][NEUTRAL] Um, you can tell them that, I mean, when they're entering the number, they don't need to enter in the ML 7.
[AGENT][NEUTRAL] Or the MLA, like you can, as far as your policy number, um, it's just 02301155.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, when it says, um, when they ask me HMO or PPO is neither, right?
[AGENT][NEUTRAL] The num
[AGENT][NEUTRAL] It's neither because it's your supplemental insurance. So explain to them that it's like a gap plan.
[CUSTOMER][NEUTRAL] Believe me, I tried. The thing is, I'm an insurance agent. I have the [PII] license. I was trying to explain to them that it was a gap, a supplement for insurance. I tried to explain everything to the receptionist, the one that that was adding my, my account, and she said that this was an insurance that she will try to put on the system, but it wasn't an insurance and that it has to be either HMO or PPO.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, it was complicated.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, I mean, they can always call that number that's on your card, the [PII] number you called [PII]. We'll verify your eligibility and benefits, but we can't unfortunately, you know, make them accept the insurance, you know, um, we can verify like our claims, mailing information, payer ID, all that information with them.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is there any way that I can do that for them just in case? Um, is there any way that if they give me the billing and I pay out of my pocket, you guys reimburse me for the amount that is covered on the insurance?
[AGENT][NEUTRAL] Yeah, I mean, you can just have them file with your major medical and then anything remaining um you could uh then submit the claim to us yourself and then we would reimburse you. absolutely you can do that online. We have a service center online, you can do it.
[CUSTOMER][NEUTRAL] OK, let me, let me double check real quick because I'm in the, the online account, uh, where it says, uh, my claim upload documents. I just upload documents and that's it.
[AGENT][NEUTRAL] Right, you would upload your documents there and you're gonna need um a claim form. The claim form that you would need is a Medlink claim form for your secondary insurance.
[AGENT][NEUTRAL] So you have to fill that out.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] How, how can I fill that out? Where, where I can see that form?
[AGENT][NEUTRAL] So the page that you're on right now is the secure login portal um if you it opened a new page when you clicked to log in from AMPublic if you go back to the home page of our website, there's a link there that says claims and forms.
[CUSTOMER][NEUTRAL] Uh, let me see if I can, OK, clean the form, OK, got it.
[AGENT][NEUTRAL] And it's gonna be on the 2nd page because it's a med link form and it's an alphabetical order and you can either print it out or you can download it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, on the 2nd page, that link claim form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And it will tell you on the very first page when you download that, it'll tell you everything needed with the claim, so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] OK, thank you. Thank you so much for your time and and effort.
[AGENT][NEUTRAL] You're welcome. Anything?
[AGENT][POSITIVE] Yeah, absolutely. Is there anything else?
[CUSTOMER][NEUTRAL] No, the
[CUSTOMER][POSITIVE] No, that will be all. Thank you. Have a nice one, OK?
[AGENT][POSITIVE] You too. Take care, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] OK, bye bye.