AccountId: 011433970860
ContactId: b038263b-bf04-4855-b4db-6df6365ad0f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 350980 ms
Total Talk Time (AGENT): 141242 ms
Total Talk Time (CUSTOMER): 179354 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/b038263b-bf04-4855-b4db-6df6365ad0f2_20250430T20:57_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, what I was calling about is I have a, um, a paper that my wife just handed me to look into this. Um, it was, uh, for an explanation of benefits and then on the back of it, it, it asked for, um, please provide copies of your explanation of benefits and um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know
[CUSTOMER][NEUTRAL] I don't think you guys paid me for the last time I went in the hospital. I think that's what it was, but, uh, is there a way any numbers you need on here to bring up my, you want the policy number or reference number?
[AGENT][NEUTRAL] Mhm. Um, yes, I can definitely help you with the claim. Um, may I first have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, yes. Thanks for asking that. [PII]. Last name [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And then your policy number or the reference number if you have it.
[CUSTOMER][NEUTRAL] OK, policy number 02506865.
[AGENT][NEUTRAL] And that was 0256865?
[CUSTOMER][NEUTRAL] No, you forgot a 0.0250.
[CUSTOMER][NEUTRAL] 686 5
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] OK, thank you. Sorry about that. Hold on one moment.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] All right, now I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Mhm. OK. [PII] and you said uh after that, what? What do you mean?
[AGENT][NEUTRAL] Um, your mailing address?
[CUSTOMER][NEUTRAL] OK, uh [PII].
[AGENT][NEUTRAL] And your email.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, my first name, last name, so [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And this is for, um, on the explanation of benefits, does it have claim number 3589341?
[CUSTOMER][POSITIVE] Yes it does.
[AGENT][NEUTRAL] OK. So this is asking you for the explanation of benefits from your primary insurance. So we're your secondary insurance. We need the
[CUSTOMER][NEUTRAL] You, you're also, oh.
[CUSTOMER][NEUTRAL] I think you're my both, um, no, OK.
[AGENT][NEUTRAL] Mm. We need the explanation of benefits from Aetna.
[CUSTOMER][NEUTRAL] OK, not from the hospital that put in this claim then, right?
[AGENT][NEUTRAL] The explanation of benefits and the itemized billing are two different things. So, the explanation of benefits comes from Aetna.
[CUSTOMER][NEUTRAL] To me now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The itemized bill will come from the hospital.
[CUSTOMER][NEUTRAL] OK, I probably have that.
[CUSTOMER][NEUTRAL] OK, so, and then, um, I just have, where would I send this, uh, explanation of benefits to the telling here.
[CUSTOMER][NEUTRAL] Password if you just
[AGENT][NEUTRAL] Um, hold on one second.
[AGENT][NEUTRAL] So you can mail it in, you can fax it, or you can upload it to the online portal, whichever you prefer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, upline portal, how would I, do I have that, or do I just go to the website?
[AGENT][NEUTRAL] Um, let me see if you have a, um,
[CUSTOMER][NEUTRAL] A M P.
[AGENT][NEUTRAL] A profile on the online service center. Hold on one second.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Um, you do. So you'll go to our website, um, which is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][POSITIVE] [PII] OK.
[AGENT][NEUTRAL] And when it populates um to the top right corner, you'll see sign in. So you'll go ahead and click on that and then your username, let me know when you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] With a capital M.
[CUSTOMER][NEUTRAL] [PII]'s [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I didn't know if you said yes to [PII]. OK, OK, I, that's just a number. I, I mean, I remember that that's my old, uh, uh what do you call it email address. OK, now, OK, and um just uh pull that up and, and fill it out and and give you the uh um copies of the explanation of um of services or.
[AGENT][NEUTRAL] Right, so you'll, um, let me see if it's asking for the itemized bill or just the explanation of benefits. Yeah, this is just asking for the explanation of benefits from Aetna. So you would just, um, you can either call or see if if you
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, they send me a thing every time I go in for this.
[AGENT][NEUTRAL] Oh, you have it? OK.
[CUSTOMER][POSITIVE] Yeah, I'm sure I do, but I, I, I can definitely get it. So now that I know what we need and then I just send it to uh that I mean that email address and then we can get it handled. Cool.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, well, was there anything else I can assist you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No. No, you did great. Thank you.
[AGENT][POSITIVE] Well, thank you and thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too thanks bye.
[AGENT][POSITIVE] Thank you, bye bye.