AccountId: 011433970860
ContactId: b6ab93fb-4b51-4ad0-9022-3f7d5c1a51d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 450809 ms
Total Talk Time (AGENT): 173083 ms
Total Talk Time (CUSTOMER): 157600 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/b6ab93fb-4b51-4ad0-9022-3f7d5c1a51d3_20250331T14:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII].
[CUSTOMER][NEUTRAL] And I have a question.
[AGENT][POSITIVE] Yes ma'am I can help you with questions.
[CUSTOMER][NEUTRAL] Um, my hus
[CUSTOMER][NEUTRAL] My husband was admitted twice into the hospital and I'm trying to file a claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now,
[CUSTOMER][NEGATIVE] The problem is, is that it's, I've been going through the claims that were paid by my insurance company.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] It seemed like the biggest claim. I have a, I have a receipt.
[CUSTOMER][NEUTRAL] For the time, the first time he was in there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then he got out, came home, and then he had to go back.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] The hospital kind of clumped it all together on their bills.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So I don't know what to prove proof.
[AGENT][NEUTRAL] OK, all right, Ms. [PII]. I can help you with, with, with your claim. Uh, can you please give me the policy number?
[CUSTOMER][NEUTRAL] Um, 204.
[CUSTOMER][NEUTRAL] 1957.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK. And I'm gonna need you for security reasons just to please verify your policy for me. Can you give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what's your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Um, address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Phone number. Let's try [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And the email address.
[CUSTOMER][NEUTRAL] Would that be [PII]?
[AGENT][NEUTRAL] It looks like it's a.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Miss [PII]?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, sorry about that we cut out. Yes, I can hear you. We cut out for just a moment. So it looks like you have a work email on file with us.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] Yes, that's it. I do find that email address. OK, so when you file your claim, what you're going to need is the explanation of benefits from your primary insurance. Any explanation of benefits that has those dates on it that he went to the hospital will need to be sent in.
[AGENT][NEUTRAL] And then you're also going to need an itemized statement from the facility. So the hospital that he was at, you'll have to ask them for the itemized statement for those dates of service.
[AGENT][NEUTRAL] And those two.
[AGENT][NEUTRAL] Documents along with the claim form will need to be sent in to file the claim.
[CUSTOMER][NEUTRAL] OK, I usually just upload the documents.
[AGENT][POSITIVE] OK, yes, you can do that.
[CUSTOMER][NEUTRAL] I don't see any uh.
[CUSTOMER][NEUTRAL] Claim form. I just saw it. I never did that before.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, on the in the online service centers where you're working from.
[CUSTOMER][NEUTRAL] I have the
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] You're working through the online service center, yes ma'am, so you just upload the documents to your Medlink policy.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And, um, but.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then go ahead and submit it with your EOB and your itemized statement.
[CUSTOMER][NEUTRAL] Now the itemized statement I have is like.
[CUSTOMER][NEUTRAL] Prescriptions that they sent him?
[AGENT][NEUTRAL] OK, so the one that you'll.
[CUSTOMER][NEUTRAL] That they gave him my pass.
[AGENT][NEUTRAL] The one that you'll need has the diagnosis codes and procedure codes on it for everything that they did while he was in the hospital.
[CUSTOMER][NEUTRAL] I know, I'll just upload everything. Here it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, wait a minute chest X-ray, this has got all prescriptions on it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I guess I'll upload everything I can and then you'll tell me what I need.
[AGENT][NEUTRAL] If, if you don't have everything, yes, ma'am, if you don't have everything that I'll send um through the online service center you'll, you'll get an alert through the online service center and if um.
[CUSTOMER][NEUTRAL] I have so much paperwork.
[AGENT][NEUTRAL] You need further help, you can always pick up the phone and call us and we'll tell you exactly what the remarks are.
[CUSTOMER][NEUTRAL] OK, no problem. Thank you. Uh, it won't let me get to.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're, you're so welcome.
[AGENT][NEUTRAL] Ma'am?
[CUSTOMER][NEUTRAL] Oh, hold on one second. It won't let me get the claim forms, claims and forms.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Yes, you click on claims and forms and then you're gonna click on your Medlink policy.
[CUSTOMER][NEUTRAL] File claims 24/7.
[CUSTOMER][NEUTRAL] Medin policy this is home.
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] I'm trying to look for it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I got a bunch of forms.
[AGENT][NEUTRAL] It's gonna say Medlink M E D L I N K.
[CUSTOMER][NEUTRAL] Medlink
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The bar to hotel.
[CUSTOMER][NEUTRAL] OK, I get that.
[CUSTOMER][POSITIVE] OK, I got it. Thank you very much.
[AGENT][POSITIVE] Oh, perfect. Awesome. You're very welcome. Anything else I can help you with Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's it at this time.
[AGENT][POSITIVE] OK, well, you have a great week and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. Bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] I can't do this now anyway because this one might have to have to.