AccountId: 011433970860
ContactId: b81e88ae-c46a-41a5-940a-8555864e9cee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451049 ms
Total Talk Time (AGENT): 252816 ms
Total Talk Time (CUSTOMER): 152699 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/b81e88ae-c46a-41a5-940a-8555864e9cee_20250220T18:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to see if um any of my, I forget what they're called, like if a bill that I had was sent to you guys.
[AGENT][NEUTRAL] Oh yeah, if we've received a claim.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure I can check that for you um what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then uh do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 02515497.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, I'm just gonna verify some information really quick, [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and can I get your mailing address please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. OK, thank you so much for verifying that information, [PII]. So I have here we have received one claim for you. This was from.
[AGENT][NEUTRAL] McBride Orthopedic Hospital, that date of service was [PII].
[CUSTOMER][NEUTRAL] OK. So you've not gotten any. Yeah, I'm supposed to have.
[AGENT][NEUTRAL] Was there another one we were needing to, no, this is the only claim we've got on file for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I will try to call them again and they like resubmitted the claims in November, but I guess.
[CUSTOMER][NEGATIVE] How does that work? Like if they're supposed to resubmit the claims, how come that doesn't go through?
[AGENT][NEUTRAL] You know if it's possible I would have them give us a call um that way we can verify do you have the correct information um or I could give that to you and you could pass it along if you'd like but um we do talk to providers all the time that way you're not stuck you know middlemanning the whole thing.
[CUSTOMER][NEUTRAL] OK, yeah, so I will ask if they'll give you guys a call. I feel like before they've told me they don't do that, um, what information should I give them?
[AGENT][NEUTRAL] Um, I mean they can call us on the same number that you did if they would give us a call, um, otherwise I can give you we've got, um, a mailing address, a fax number, and a payer ID so that if they were, uh, able to submit it to us electronically.
[CUSTOMER][NEUTRAL] OK. Um, I think the fax number and the mailing address I have, but what's the payer ID?
[AGENT][NEUTRAL] Yes, that is 60801.
[CUSTOMER][NEUTRAL] 60801
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Oh, actually I have that too.
[CUSTOMER][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] As they should be on your card, but never know.
[CUSTOMER][NEUTRAL] Yeah, I, I saw it. It's just up at the top. Um, and then if they don't end up sending you guys stuff or giving you the information, um, for me to submit it myself, what all do I need? Any diagnostic codes?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, OK, so I will say the quickest and easiest way to get claim information to us is going to be through our online portal, um, now, uh, to create that account, do you have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK perfect so it does have it doesn't really have mobile support is why I asked um and then we would have to have an email address on file for you that's what you would use to create the account um what would you like me to add for that email for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, I will go ahead and get that added um so you can I'll give you that web address too whenever you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, so it's the word [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] So secured. [PII].
[CUSTOMER][NEUTRAL] And name is
[CUSTOMER][NEUTRAL] Is all that
[CUSTOMER][NEUTRAL] Lowercase letters.
[AGENT][NEUTRAL] Yeah, that's just the web address that you would enter um on your computer and then uh you of course would go that you know creating a new account um and then all of this information that we verified including this email is what you're going to use to create the account there's a spot that would ask for a member ID or a social security number you would put in your social it is different than your policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then on that main page after you create the account you'll see a spot a button um that says you know upload uh documents or that's where you would upload the claim information and then whenever you're ready I will let you know what that information is that we need.
[AGENT][POSITIVE] I know this is quite a bit of information I apologize.
[CUSTOMER][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] Yeah, that's, it's OK. I'm writing it down. All right, OK.
[AGENT][NEUTRAL] OK good alright OK so yes it would be the itemized statement.
[AGENT][NEUTRAL] That shows diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then the only other thing we would need would be the explanation of benefits from your primary insurance and your provider wherever you went for treatment, they'll have all of this information and that essentially just shows us what your major medical did pay.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that is it. Aside from that, whenever you go to upload the information, um, you would of course fill out the correct claim form and this plan name is Medlink. You just fill out that form, upload this information, um, it can take about 7 to 10 business days for claim information to process. It doesn't generally take that long, but that's kind of a safe window and you could check on the status on the website, or of course you're more than welcome to give us a call as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. Um,
[AGENT][NEUTRAL] Alright, I know that was information overloaded. Did you have any questions for me?
[CUSTOMER][POSITIVE] No, no, you did a great job. Yeah, my only question, um, I think when I've gotten the bills before they'll show like either a, is a CPT code the same thing as a, OK, so I think sometimes they'll show procedure codes but not.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, it
[AGENT][NEUTRAL] It does pretend each provider is very different um sometimes they'll give all of that information to you all in one document um so they are all very different that's why I think you know best to just go ahead and ask for that, uh, just in case.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] Alright, you are very welcome. I hope you have a great rest of your day sir. Let us know if you have any other questions.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] OK, thank you so much. I appreciate it.
[AGENT][POSITIVE] Alright thank you of course alright bye bye.
[CUSTOMER][NEUTRAL] Bye.