AccountId: 011433970860
ContactId: b3d3feb4-f301-4fd6-8b51-9616deb2bf29
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 588510 ms
Total Talk Time (AGENT): 258134 ms
Total Talk Time (CUSTOMER): 290576 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/b3d3feb4-f301-4fd6-8b51-9616deb2bf29_20250328T14:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning [PII]. My name is [PII]. I am a broker and I'm with Loving Associates. How are you today?
[AGENT][POSITIVE] I'm doing well, Ms. [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] I'm doing great. It's Friday. The only thing you would make it better if it was Friday payday and uh right before a long weekend, but I'll take what I got.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, exactly, me too.
[AGENT][NEUTRAL] Um, and you said that you were with which group please, Ms. [PII]?
[CUSTOMER][NEUTRAL] I'm actually um a broker and I am calling on behalf of one of our groups. The name of the group is Ium, I T E R U M Financial. Would you like the group number?
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] It's 258-82.
[AGENT][NEUTRAL] OK, let me look up that group real quick, Ms. [PII].
[AGENT][NEUTRAL] OK, I have the group pulled up. Um, can you just, uh, and you're with NAS?
[CUSTOMER][NEUTRAL] No, I'm with Levi and Associates.
[AGENT][NEUTRAL] The
[AGENT][POSITIVE] Love, oh, OK, thank you very much. I appreciate that.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] And how can I help you today?
[CUSTOMER][NEUTRAL] Um, one of the, uh, the, one of the benefits administrators reached out to me regarding one of the uh members. Uh, the member's name is [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You um want her individual policy number or do you, can you find her?
[AGENT][POSITIVE] Yes. Can I please get real quick your callback number, um, Ms. [PII], just in case our call gets disconnected, I'll be able to call you right back.
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII] and I'm at extension [PII].
[AGENT][POSITIVE] Thank you, ma'am. And then can you also give me the address of the group real quick?
[CUSTOMER][NEUTRAL] Um, the address of the group, I if we got changed for.
[AGENT][NEUTRAL] Or even the email address for your agency for your brokerage.
[CUSTOMER][NEUTRAL] Oh, well, my, my email is [PII].
[AGENT][NEUTRAL] OK. Thank you. I appreciate that. And you said it was for [PII]. And what is [PII]'s policy number?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It's 231-378-8.
[AGENT][NEUTRAL] OK, let me pull up his policy real quick.
[CUSTOMER][NEUTRAL] Actually it's a she.
[AGENT][POSITIVE] She, her, oh, I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. It's one of those names that uh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Here in [PII] we recognize that but it's a it's an unusual name otherwise so I I get it.
[AGENT][POSITIVE] It's, I like that though knowing now that it's a female, that's a cute name.
[CUSTOMER][NEUTRAL] Isn't it pretty?
[AGENT][NEUTRAL] Yes it is. OK, so you received information on LLC, is that correct?
[CUSTOMER][NEUTRAL] Actually, uh, they reached out to us and they're asking, they were asking me about uh filing a claim, so I want to start by asking if you show anything on file pending for Nelcy in terms of any claims outstanding for Nelcy.
[AGENT][NEUTRAL] No, ma'am. I do not see that any claims have been reported.
[CUSTOMER][NEUTRAL] OK, that's kind of what I thought because what they've done is they sent me a whole bunch of like stuff. I got pictures of stuff. I've got the sheets. I've got EOBs. I got all kinds of stuff and it just looked at me like, and they're asking me about. I was like, OK, are you asking me like to follow up on a claim or are you asking me about a claim? So my thought process.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This was they're just asking me perhaps maybe that they need assistance in filing a claim. So let's make the presumption that that's what they're asking me about because I'm literally on an email chain or that's I've gone back and forth my first thing was like I'm not sure what you're asking me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I didn't think they at first I thought they were asking me about claims. I was like, looks like these claims have been filed. So what, what exactly are you asking me? And then finally, after literally back and forth 4 times, they I, I got drilled down that they're asking about gap insurance. OK, good. Now we got that. So now I think what they're asking me about how to file on some of this, uh, to file with, uh, you all for, for gap instead of just, you know, being smart and handing the car to begin with, I evidently they did manage to do that so.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's say that that's what we're looking to do if they're looking to file, how should I instruct them to go about doing that, Tory?
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] If they can file themselves, the best way to do it is have them sign up for the online service center.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, that's the secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If they sign up for the online service center they can actually download their documents on their computer and upload them.
[AGENT][NEUTRAL] Um, through the online service center.
[AGENT][NEUTRAL] We also
[CUSTOMER][NEUTRAL] OK, and I know that they have that because they have emailed it to me, so they have that available to them so.
[AGENT][POSITIVE] Oh, good.
[AGENT][NEUTRAL] Good, so when they get into the online service center after they decide their user name and their password and all that and they actually get in, they're gonna click on uh claims and forms.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For their Medlink.
[AGENT][NEUTRAL] Policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And they'll just fill out the med link claim form. They'll need to have the explanation of benefits where they're primary paid, and they'll need their itemized statement with diagnosis codes and procedure codes. So those three documents, well, the claim form will actually be there already, but those 3 things need to be sent in to be able to file the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So they're gonna need the the invoice like where they paid right? the EOB.
[AGENT][NEGATIVE] The itemized
[AGENT][NEUTRAL] The EOB and the itemized statement which they get from the facility um the itemized statement is different than the invoice it has the diagnosis and procedure codes on it so they.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Diagnostic because it's, it's what you get when you go to the doctor and they hand it to you at the end and say here's what we did today, basically, right?
[AGENT][NEUTRAL] Yeah. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I actually am looking online and I see that there is a uh instruction on how to do it so I'm going to send this over to them and uh tell them that that's what it does and I'm trying to look and see and it tells them.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, on that, on that Medlink claim form that first page is like a cheat sheet that gives you step by step what you need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm gonna shoot this over to them and uh I'll let them know that that's the information that they're gonna need to gather, but tell them that that's and um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And that's, you know, the easiest and uh most secure way for them to do it as well as probably the fastest way for them to anticipate getting.
[AGENT][NEUTRAL] Right, yes, ma'am, it is, um, and they do that if the um facility itself will not file the claim form for them, um, they can do it through the online service and we also have a fax number let me give you the fax number if they get some people get tied up on the online service center and they just wanna fax it in so that's [PII].
[CUSTOMER][NEUTRAL] Paid I would imagine correct?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] OK, and is there a claim form that needs to go with that they're gonna fax things in Tory?
[AGENT][NEUTRAL] Yes, if they decide to fax it in, they will actually send the Medlink claim form that's on the [PII] website.
[AGENT][NEUTRAL] Not the secured the secured is the online service center, but it's a.m. public.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] It's in the same spot but they just need to download the form?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, I will give them all of this information and let them make up their mind if they would prefer to either fax it in or uh just go ahead and and uh.
[CUSTOMER][NEUTRAL] Uh, file it online.
[AGENT][NEUTRAL] And act and let them know um the online service center gives you updates on your claim where if she they were to fax it in they wouldn't know right.
[CUSTOMER][NEUTRAL] Yeah, that way, yeah, they can keep track of it.
[CUSTOMER][NEUTRAL] Mhm, yeah.
[CUSTOMER][POSITIVE] OK, sounds good to me. I appreciate your help and if I have any other questions, I'll give you a holler back.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, Ms. [PII]. Feel free to call anytime. Is that all I can help you with today?
[CUSTOMER][POSITIVE] Thanks to.
[CUSTOMER][POSITIVE] That's so far so much so I appreciate it. If I have anything else, I'll let you know you've been very helpful. I appreciate it have a great rest of your day and a good weekend.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're very welcome. Yes, you too. Thank you, Ms. [PII] and thanks for calling APL.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Mm. Bye-bye, ma'am.