AccountId: 011433970860
ContactId: a56457ae-6cd3-43f6-b0e2-3e6487c1c414
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 384839 ms
Total Talk Time (AGENT): 175221 ms
Total Talk Time (CUSTOMER): 162039 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/a56457ae-6cd3-43f6-b0e2-3e6487c1c414_20250421T19:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII].
[AGENT][NEUTRAL] May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. My husband's the insured on the, uh, on our American Public Life plan. I had gotten a bill for a biopsy from my, um, gynecologist, and when I asked them if they had, um, billed you guys, they told me that they don't do that and that I had to.
[CUSTOMER][NEUTRAL] File a claim with you guys directly that you guys would cut me a check and then I could submit that for payment to them which they're the first doctor's office to ever tell me that so I'm just going based on what they said to me, so I don't know how that process works.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, Ms. [PII]. I can um help you with filing a claim. Can you please give me your callback number, ma'am, just in case our call gets disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 01611.
[CUSTOMER][NEUTRAL] 843.
[CUSTOMER][NEUTRAL] M as in Mike, L as in Larry, and the number 8.
[AGENT][NEUTRAL] OK, thank you. Let me pull that policy up real quick.
[AGENT][NEUTRAL] OK, Miss [PII], can you please please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you ma'am and then for security reasons I'll need for you to give me your address, phone number and email address that's on the policy.
[CUSTOMER][NEUTRAL] Um, address is [PII]. Uh, phone number is.
[CUSTOMER][NEUTRAL] My husband's number is [PII]. Mine is [PII]. I'm not sure which one is on the account. And for email address, his email is [PII], and mine is [PII].
[AGENT][POSITIVE] OK, thank you Ms. [PII]. I appreciate you verifying the information for me.
[AGENT][NEUTRAL] All right let me look um.
[AGENT][NEUTRAL] So the facility that you went to would not file the claim for you and they told you to file the claim yourself. Is that correct? Wow, OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And I'm pretty sure, yes, and I'm pretty sure they've done it before, but I'm like, what do you mean you don't build the gap? I mean, I've, and I've had this policy for a few years already. I know they've billed you guys before. She must be new in the office or whatever, but I'm just going based on what she said so.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. All right, so, um.
[AGENT][NEUTRAL] Mm, what you'll
[AGENT][NEUTRAL] Need to do are you guys signed up online service center?
[CUSTOMER][NEUTRAL] Uh, I think I am.
[AGENT][NEUTRAL] OK, let me check real quick. Oh.
[CUSTOMER][NEUTRAL] I think
[AGENT][NEUTRAL] OK, I'm gonna check real quick and see uh if you guys have signed up for it because that's the easiest way to do it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is driving like that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You guys are signed up on the online service center. I can't give any information about it unless your husband's there for me to be able to verify with him that it's OK for me to get the information out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What do you mean? What information? The log in?
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Uh, like, like the username password, and all that stuff. I don't have the password, but I do have the username.
[CUSTOMER][POSITIVE] Oh, I, it, trust me.
[CUSTOMER][NEUTRAL] Yeah, it's gonna be me. He, he doesn't log into any of this stuff. I'm the one who deals with all. I'm the one who uses the policy the most. He doesn't even, he barely uses it. Yes, OK, I'm pretty sure I have to log in. Yes, thank you.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so once you log in and you get in there, you're gonna click on um claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna choose the, the Medlink M E D L I N K claim form?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll need to send in your explanation of benefits from your primary insurance carrier and also the itemized statement from the facility that has your diagnosis codes and procedure codes on it.
[CUSTOMER][NEUTRAL] See, I knew, I knew they were gonna, you were gonna ask for that, and they were like, no, just give them the invoice that you have, which has no quotes on it. OK, I'm gonna have to call these people back.
[AGENT][NEUTRAL] Those 3
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am, because it goes based on what your primary pays. So that's why we need the explanation, the benefits from them and then you have to have the diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Seedure codes so we know what was done to know what to pay.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and those 3 documents need to be sent in and you could just upload them from the online service center and send them all together.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then you would be sending me a check directly or or I'm sorry, go ahead.
[AGENT][NEUTRAL] And if you need
[AGENT][NEUTRAL] Right, you'll be the one filing the claim, so the claim will be paid to you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, OK, that's fine.
[AGENT][POSITIVE] Alright, and if there's anything else like if you get in there and you need help with anything, pick up the phone and call us and we'll walk you through it, OK?
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're very welcome. Can I help you with anything else today, Ms. [PII]?
[CUSTOMER][POSITIVE] No, that, no, that'll be all thank you.
[AGENT][POSITIVE] OK, you're very welcome you have a blessed day and thanks for calling on ATL.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][NEUTRAL] Mhm. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.