AccountId: 011433970860
ContactId: bd35cdbb-4bfd-45dc-8d40-1056f6f45099
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 539979 ms
Total Talk Time (AGENT): 224501 ms
Total Talk Time (CUSTOMER): 300108 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/bd35cdbb-4bfd-45dc-8d40-1056f6f45099_20250425T12:23_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's [PII], and I actually, I'm calling because I never activated my card and, um, or just registered it, and I am gonna get a procedure done. So I was just wondering how to go about like, do I have to place like a claim and then um you know, provide uh receipts and stuff because I'm not too familiar with that.
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Spell your first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][NEUTRAL] I have the group number. I have, oh, the policy is 02.
[AGENT][NEUTRAL] It's gonna be the policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's um 02447037.
[AGENT][NEUTRAL] OK, thank you. What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Oh, it's [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Can you verify your date of birth, your mailing address and email for me?
[CUSTOMER][NEUTRAL] Yes, [PII]. Uh, my address is [PII]. My email address is my first name [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it looks like we have your work email address. Do you want your personal on file or your work?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it doesn't matter. You can leave the, I mean, I have access to both of them, so it's fine.
[AGENT][NEUTRAL] What's your work? OK. What's your work email?
[CUSTOMER][NEUTRAL] Oh, my work one is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that for me, [PII], and you said that you're seeking a service did you say it's in a doctor's office or is it an outpatient facility?
[CUSTOMER][NEUTRAL] It's an outpatient facility.
[AGENT][NEUTRAL] OK. Now, did you
[CUSTOMER][NEUTRAL] I'm getting like the a lumbar shot.
[AGENT][NEUTRAL] OK, now did you want benefits or you're just asking how do you go about submitting a claim?
[CUSTOMER][NEUTRAL] Yeah, that, um, cause I, I know I, I, I pay for it. I just don't know how to, like, what should I do to put in a claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, the uh
[CUSTOMER][NEUTRAL] Like, is there a reimbursement if I do so is the thing because if I pay, right?
[AGENT][NEUTRAL] So the policy that you have is a supplemental gap plan, which means that it's secondary to your major medical coverage. Who is your major medical carrier?
[CUSTOMER][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, Cigna.
[AGENT][NEUTRAL] OK, and with that being said, when you report to the doctor, you wanna provide both of your cards, your, your Aetna card and your APL card, generally, your uh healthcare providers will submit the claim to APL on your behalf so you don't have to do anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I know I because this is my 3rd shot, and I know I've done it like I provided them both before. I just like what I it dawned on me yesterday that I'm like, but I've never registered that card, so like I'm not sure how to go about.
[CUSTOMER][NEUTRAL] If there is any, you know, that I need to provide any um like receipts or anything is all I don't know.
[AGENT][NEUTRAL] OK, so you do not have to register the.
[CUSTOMER][NEUTRAL] Because I, I've always had like an FSA, oh, OK.
[AGENT][NEUTRAL] You do not have to register the APL card. You, it's just a matter of you presenting both of the cards to your provider. Now if, if you're wanting to send the claim in yourself.
[CUSTOMER][NEUTRAL] So I don't have to um.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, and I have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then there are 3 documents that are required for you to send.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] We do not process from a.
[CUSTOMER][POSITIVE] And can I get that just call me you guys I'm sorry.
[AGENT][NEUTRAL] I think there's a lapse in our conversation. We do not process off of a receipt or a balance due statement, so you'll need the uh met the APL met link claim form completed.
[CUSTOMER][NEUTRAL] It just.
[CUSTOMER][NEUTRAL] OK, she doesn't know I'm not in.
[CUSTOMER][NEUTRAL] He probably doesn't know I'm not.
[AGENT][NEUTRAL] And that form can be downloaded from our website.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, well can you anything I mean I mean that's that's a simple, OK, OK. OK, is that the secured is that the um, OK, go ahead.
[AGENT][NEUTRAL] I'll give you that in a minute.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Uh-huh, the secured. [PII]?
[CUSTOMER][POSITIVE] Yeah, I got that thank you.
[AGENT][NEUTRAL] It is and when you get to that side you'll click on the claims and forms link it's in the upper right corner.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then the claim forms will populate um they are alphabetized so you would just scroll down until you see the met link claim form and download it fully complete.
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Date and sign. Mhm.
[AGENT][NEUTRAL] Are you on the website now?
[CUSTOMER][NEUTRAL] OK. So I mean, no, I'm writing it down cause I'm heading to the hospital, so I, I, I'm not gonna have time to do it, but I will do that today just to, to get familiar with it. Um, so it's the claims form link and then I'll go to where it says [PII], you said?
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's the first document.
[AGENT][NEUTRAL] Yes, it'll, it's the Medin claim form.
[CUSTOMER][NEUTRAL] 34.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then there's 3 you said though, right?
[AGENT][NEUTRAL] OK, so that's the first document. The 2nd document required is an itemized bill.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so if you're having the service done in a hospital, you would reach out to the hospital billing department and just request the itemized bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I'll ask that when I get there today because I'm not sure where to go for that billing itemized.
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I had gone to, um, cause I'm, I'm going today, so I would ask the hospital where I could go cause I don't know where to go for the bill, the item I like billing documents.
[AGENT][NEUTRAL] Right, you'll just ask.
[CUSTOMER][NEUTRAL] So sometimes they were having issues providing me a receipt, so it's like I was in, in and out. I felt like a little cow, but yeah.
[AGENT][NEUTRAL] OK, right, and so we would not be able to process just with a receipt we'll need the actual itemized bill?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] That's fine, yeah, I will get it. I'll get it. The billing itemized from the hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh. And then the third document would be um your primary insurance explanation of benefits or it's referred to also as EOB.
[CUSTOMER][NEUTRAL] From hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] E L B.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, [PII] 4.
[AGENT][NEUTRAL] Explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I wrote that down. Thank you.
[CUSTOMER][NEUTRAL] So it's the, the, the med link um claims form. It will be the itemized billing document from the hospital and then the um EOB form.
[AGENT][NEUTRAL] From Edna.
[CUSTOMER][NEUTRAL] Oh, from Cigna, right? From Cigna?
[AGENT][NEUTRAL] Oh, I thought I heard you say Aetna. Yeah, Cigna is your primary insurance. That EOB will come from Cigna.
[CUSTOMER][NEUTRAL] Now, yeah, the thing is, yeah, I've had, I know before with the comp the company changes insurances all the time, so I think we did have I you know, when I did register for the ALP insurance first.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so I think I heard you say this is your 3rd injection.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the other two injections, if your coverage was with Aetna at the time, then you would need to get Aetna's EOB for those.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, it was all done, um.
[CUSTOMER][NEUTRAL] Yeah, no, it was all done this year.
[AGENT][NEUTRAL] OK. So then those 3 explanation of benefits should be on Aetna's website.
[CUSTOMER][NEUTRAL] So yeah it'll be with signal.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect I'll, I'll get it from the signal website.
[AGENT][NEUTRAL] I mean Cigna. I keep saying Aetna. I meant Cigna.
[CUSTOMER][POSITIVE] No, no worries, no worries, I understand you, I understand, no worries. OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Anything else, [PII]?
[CUSTOMER][POSITIVE] No, that was it. Thank you so much. At least you've been helpful on on trying to get the, the this started because I know I was like at work it's hard. I, I, I'm working, working, working, so I really don't ever have anybody explaining any of this stuff for me. So thank you so much.
[AGENT][POSITIVE] Right. OK. All [PII]. If no other questions, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You too have a wonderful day.
[AGENT][POSITIVE] OK, thank