AccountId: 011433970860
ContactId: a760275c-f1ee-4792-910f-a96b85e5fbd8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 802000 ms
Total Talk Time (AGENT): 279524 ms
Total Talk Time (CUSTOMER): 295183 ms
Interruptions: 6
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/a760275c-f1ee-4792-910f-a96b85e5fbd8_20250214T21:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes good afternoon um I'm trying to get some information about um putting a claim.
[AGENT][NEUTRAL] OK, I can help you with the claim. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure. First name is [PII] Last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much. And then what is your policy number?
[CUSTOMER][NEUTRAL] Uh, I do not have my policy number.
[AGENT][NEUTRAL] OK, let me try to.
[AGENT][NEUTRAL] Look it up with your name or if you wanna.
[CUSTOMER][NEUTRAL] Try to get another way? Sure.
[AGENT][NEUTRAL] Yes ma'am, do you have your social security number that'll pull it in for us.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, sure, and then I can actually write it down. uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Yeah, and then I'll, I'll write it down because I don't see that anymore.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, for security reasons can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then I also need you to verify your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] [PII] phone number [PII] as for email, I'm not sure if you have word, but I'll give you the [PII] [PII] or is that what you have?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, ma'am. Thank you so much.
[AGENT][NEUTRAL] OK, so you're wanting to file a claim on this policy. Let me give you the policy number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] Yes, ma'am. It's 2361521.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 236
[CUSTOMER][NEUTRAL] 121236121.
[AGENT][NEUTRAL] No, 2361521.
[CUSTOMER][NEUTRAL] Uh, 1, OK. 2361521. Thank you.
[AGENT][NEUTRAL] Yes, that's correct. OK, so I'm gonna um refer you to our website.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have a pen ready where you can write it down? It's uh A like [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and for, for some reason you're breaking, we're breaking up. So, I'm sorry about that.
[AGENT][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When you get on that website at the top right hand corner you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna choose the Medin claim form. It's M E D L I N K.
[CUSTOMER][NEUTRAL] Medlink form, OK.
[AGENT][NEUTRAL] At the first page of that claim form is is a little cheat sheet that tells you what you need to send in with your claim if you need to refer back to it, but what you'll need is the explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you'll need your itemized statement with your procedure codes and diagnosis codes.
[CUSTOMER][NEUTRAL] OK, now let me ask you um one more thing, um.
[CUSTOMER][NEUTRAL] Can a provider um send in the the claim themselves?
[AGENT][POSITIVE] Absolutely, absolutely.
[CUSTOMER][POSITIVE] Yes, OK, perfect. OK, perfect.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, um, when you give them your card.
[AGENT][NEUTRAL] The um payer.
[CUSTOMER][NEGATIVE] Uh-huh, which I don't have my card. I, I don't, I, they've never sent me a card.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I'll order one for you.
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] And then so the payer ID number on the card is what you're going to need to give to them and let me give you the payer ID number.
[CUSTOMER][NEUTRAL] Please, OK.
[AGENT][NEUTRAL] It's 60801.
[CUSTOMER][NEUTRAL] 60801. OK, [PII].
[CUSTOMER][NEUTRAL] That's gonna be for our dentist, OK, um, 60801. Are you able to send me uh.
[CUSTOMER][NEUTRAL] A copy of the, the insurance code via email. Well, you know what? I'm not at work today.
[AGENT][NEUTRAL] I can, um, I'm gonna
[CUSTOMER][NEUTRAL] I'm not at work. I'm not.
[AGENT][NEUTRAL] Oh, OK. I can order your card for you.
[CUSTOMER][NEUTRAL] I, I remem I remember requesting to, to change the email for some reason that's why I gave you the other one because I, I, I mean they don't need to have my uh my work one if I'm not at work all the time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me um go back to your policy and I can change it to the email that you want it to be. What email address would you like for us to use?
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] OK, I can send you a card uh by email, I mean sorry, yes, by email, and then we also have an online service center that you can sign up for and you can see your cards and your policy you can file claims on it, you can see um the status of claims that have been sent in from the providers for you. Let me give you that site. It's secured S E C U R E D.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, so
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, and if you sign up as a new user in there and I'm gonna fix your email address right now while we're on the phone together.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] Um, and then I'm also gonna order that I ordered a card already to be mailed to your home address.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And if you could send me through mail through my email if possible.
[AGENT][NEUTRAL] Yes ma'am, I'm going to send another card through your email um I'm gonna put you on a brief hold while I get that together for you. I'll be right back.
[CUSTOMER][NEUTRAL] Thank you. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Like.
[AGENT][NEUTRAL] OK, Miss [PII], this is [PII] back with you. I've got that card copy on its way by email to you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][POSITIVE] Perfect, perfect, um, yeah, let me see if I was, what was the other thing I was gonna ask you, um.
[CUSTOMER][NEUTRAL] It's uh on the gap, is it just myself and uh [PII] that's on it? Can you confirm? I can't remember.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so the card is, does he have one card for him or we on one card?
[AGENT][NEUTRAL] You guys can use the same card and I've got.
[CUSTOMER][NEUTRAL] Is it just one
[CUSTOMER][NEUTRAL] OK, that's
[AGENT][NEUTRAL] Yes, um, I emailed it to you so you can make as many copies as you want to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect, perfect. OK, so I'll, I'll give them the pay. I give him whatever, whatever other appointment that he's already we already been to we'll just, I'll just call in myself.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that sounds fine or if you wanna call the facility and give them the secondary in.
[AGENT][POSITIVE] and see if they'll do it for you sometimes they will.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Which one to call who? I'm sorry.
[AGENT][NEUTRAL] The facility that you went to before the other um.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, OK, no, because I know that we've already been, no, that, that's what you already told me, but the, the, uh, because we've, we've been to, uh, two appointments, so I didn't provide that.
[AGENT][NEUTRAL] The other ones, they got some.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I wanted to, but for future ones, uh, I'm just saying for the ones that already passed like about a month ago so that we can just send them in or I can go up and and uh and that one yes.
[AGENT][NEUTRAL] Oh, OK. I see what you're saying.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And, and I did
[AGENT][NEUTRAL] I did notice when
[AGENT][NEUTRAL] When I was doing your card copy, I did notice that that policy number I gave you lapsed on [PII]. Let me give you the active policy number, which is also the card I sent you.
[CUSTOMER][NEUTRAL] OK, please.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] It's 23.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It's 253-816-9.
[CUSTOMER][NEUTRAL] OK, hold on 253.
[AGENT][NEUTRAL] 8169.
[CUSTOMER][NEUTRAL] OK, I'm gonna repeat it back to you. I said it 253-816-9 you OK, active one, OK.
[AGENT][NEUTRAL] Yes, yes, that's active effective [PII].
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, perfect. I see. All right, perfect. OK, alrighty. I thank you so very much for all your help and you have a wonderful um rest of your day.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][POSITIVE] Thank you. Happy [PII]. Thank you.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Happy Valentine's to you too, Miss [PII]. You guys enjoy yourself tonight. Thank you for calling APL. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you so much. Thank you.
[CUSTOMER][NEUTRAL] Bye bye.