AccountId: 011433970860
ContactId: aa8373eb-5133-4e8d-b797-c39feaaa6353
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 504339 ms
Total Talk Time (AGENT): 126798 ms
Total Talk Time (CUSTOMER): 305532 ms
Interruptions: 3
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/aa8373eb-5133-4e8d-b797-c39feaaa6353_20250416T17:27_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yeah, [PII], how are you?
[AGENT][POSITIVE] I'm doing good. How are you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Good. I don't know how to go about this, but I, I have a, a gap plan through my employer. Um, I can give you a group number. I don't know what you need or pay ID number.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Sure, this is [PII]
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, I have a group number or a pay ID number. Is it either of those?
[AGENT][NEUTRAL] Do you have, does it say outpatient inpatient certificate number or something like that?
[CUSTOMER][NEUTRAL] But a group number?
[CUSTOMER][NEUTRAL] Mm, no, I don't have anything. I just took a picture of the card. I don't even have a card in my possession. I took a picture from our HR girl.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says group number um and the payer ID is the two things.
[AGENT][NEUTRAL] It should say inpatient outpatient certificate number, something like that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or if you have your social, I can look it up by your social.
[CUSTOMER][NEUTRAL] Well, let me see, I took a picture of the back side of it. I don't think I took a picture of the front side.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] You have your social security number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I don't, I don't I need to go back down there and see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I have a question. So basically if we, we had an in an incident and basically there's uh do I submit the claim?
[CUSTOMER][NEUTRAL] To the number on the back of the card via mail?
[AGENT][NEUTRAL] Well, I have to have your policy number or something to look, look up the policy first of all.
[CUSTOMER][NEUTRAL] How do we get reimbursed?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And your name is [PII], your last name?
[CUSTOMER][NEUTRAL] Coming back. That's why I got a question here I go.
[CUSTOMER][NEUTRAL] Alright, may you there.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Thanks bye.
[CUSTOMER][NEUTRAL] Yeah, get you on speaker. So policy number I gave her those two numbers I don't wanna. For what? for um this one yeah EPL I guess I see I see oh it says in hospital benefit certain number and outpatient benefits cert numbers so it says inpatient and an outpatient.
[AGENT][NEUTRAL] Yes, that's it.
[AGENT][NEUTRAL] Either one.
[CUSTOMER][NEUTRAL] OK, uh, 02317308 ML 7.
[CUSTOMER][NEUTRAL] And that's, I don't know if that's for everybody in the group or not that's someone else's card that I'm looking at so I don't know where mine is.
[AGENT][NEUTRAL] OK. It will be each individual person will have a different number. What's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII] and then it's probably [PII].
[AGENT][NEUTRAL] That's not the one we have.
[CUSTOMER][NEUTRAL] OK, like
[CUSTOMER][NEUTRAL] Probably wouldn't have be [PII] Well, what would they have uh Ere try [PII].
[AGENT][NEUTRAL] That's the one we have. Thank you, Mr. [PII]. And you had a question about the policy and how to file a claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] OK, um, [PII], yeah, well, while you're there, is there a way to look up? Oh, that's fine. Oh, cool, I found it. Thank you.
[CUSTOMER][POSITIVE] Perfect. Alright, um, yeah, so I have a question on um how to, how to 22 things.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I had a visit, I don't know, probably a few weeks ago.
[CUSTOMER][NEUTRAL] And there was uh there was a $1000 1000 dollars um deductible or something, it was a um emergency visit.
[CUSTOMER][NEUTRAL] There was a $1000 obviously that, that we got a bill for, for the visit.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] How was that, you know, so that would be one I would think we get something on it and then.
[CUSTOMER][NEUTRAL] I had another one where my daughter [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What, you know, she had an appendicitis, appendectomy or whatever emergency appendectomy back in uh
[CUSTOMER][NEUTRAL] Oh, mid January, I wanna say.
[CUSTOMER][NEUTRAL] And then recently she got a, we got a bill from the anesthesiologist portion which they said is outside of any other normal billings God knows why, but.
[CUSTOMER][NEUTRAL] Um, I guess that's the way they said they set it up. They go we we're a separate entity that bills outside of the hospital and da da da and for $1900.
[CUSTOMER][NEUTRAL] So I wanted to see, you know, obviously, go to the gap plan and we don't use it. I don't think I've ever used it.
[CUSTOMER][NEUTRAL] Um, what it, what it covers and doesn't cover and how to submit.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] We, uh, I can help you with that. We need the itemized bills.
[AGENT][NEUTRAL] That has procedure codes and diagnosis codes on it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on, I, I'm writing some my my bill.
[CUSTOMER][NEUTRAL] Procedure.
[AGENT][NEUTRAL] Codes, procedure codes.
[CUSTOMER][NEUTRAL] Procedure, what? I'm sorry?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Diagnosis codes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And charges.
[AGENT][NEUTRAL] And we also need your explanation of benefits from your primary insurance, so we can see that that money went towards the deductible.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield Insurance.
[AGENT][NEUTRAL] And that would be for you and [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can mail it, fax it or upload it to our online service center.
[CUSTOMER][NEUTRAL] Uh, or upload.
[CUSTOMER][NEUTRAL] To service.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And our online service center is.
[CUSTOMER][NEUTRAL] OK, uh
[AGENT][POSITIVE] [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK. All right. We will start getting this stuff together.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Great. Thanks.
[CUSTOMER][POSITIVE] That should do it. Thank you so much. Appreciate it. Oh, you've been great. And, and what, what's your name?
[AGENT][NEUTRAL] Would you like me to give you?
[AGENT][NEUTRAL] My name is [PII]. Would you like me to give you your policy number?
[CUSTOMER][NEUTRAL] [PII], I think I just got it because she printed it out if it's uh in 023173319 ML 7 is the inhospital.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That's yeah, that's correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, yeah, I got it now. OK, great.
[CUSTOMER][POSITIVE] Awesome. I appreciate it. You've been great help, [PII]. All right. Bye-bye.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Thank you. You have, thank you for calling AP.