AccountId: 011433970860
ContactId: bfa44add-8470-4d48-a187-eb3abd3b339b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 414070 ms
Total Talk Time (AGENT): 188087 ms
Total Talk Time (CUSTOMER): 153902 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/bfa44add-8470-4d48-a187-eb3abd3b339b_20250407T20:29_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, ma'am. My name is [PII], and I just had a coverage about, uh, my gap insurance. I was just wanting to see what, uh,
[CUSTOMER][NEUTRAL] Well where it is in the claims process, ma'am?
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status, and Mr. [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] It is 806.
[CUSTOMER][NEUTRAL] 4011309
[AGENT][POSITIVE] Thank you for that.
[CUSTOMER][NEUTRAL] In a
[CUSTOMER][NEUTRAL] Your policy number that that'd be policy slash cert like cert number correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] It is 02.
[CUSTOMER][NEUTRAL] 581-933
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] Uh, my address is [PII].
[CUSTOMER][NEUTRAL] And I believe that the email that you have on might be mine is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So, um,
[AGENT][NEUTRAL] Well, there's two things. So, are you asking about the most recent claim that was received on [PII] or the previous claim on [PII]?
[CUSTOMER][NEUTRAL] On the [PII], ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think
[AGENT][NEUTRAL] Because it looks like the what came in on the [PII] is just like a the statement of insured. Were you trying to file another claim?
[CUSTOMER][NEUTRAL] I believe
[CUSTOMER][NEUTRAL] Uh, no, ma'am, we are, I, I believe, I guess we filed the claim on [PII] then.
[AGENT][NEUTRAL] OK, because that one has been paid. Hold on one second.
[AGENT][NEUTRAL] So the [PII]
[CUSTOMER][NEUTRAL] Uh, second one, we need to file a claim. We need to file a claim for the gap insurance because we pay all of the deductible to the
[CUSTOMER][NEUTRAL] Yes and you stayed over 24 hours.
[AGENT][NEUTRAL] Right, so I'm just trying to see, yes, of the two.
[CUSTOMER][NEUTRAL] Uh, did you catch that, ma'am?
[AGENT][NEUTRAL] So, are you looking for [PII] at Lubbock Hospital?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] We personally filed a claim. No, ma'am, we, uh, me and my wife personally filed a claim.
[CUSTOMER][NEUTRAL] Because we covered all the deductible and everything at the Lubbock Heart Hospital on [PII], and they told us to file our own claim with you guys for the, for the gap insurance.
[AGENT][NEUTRAL] OK, so then that, then yes, this is correct. So all we received though was the statement of insured. Um, let me pull up the documents that were received. Hold on one second.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So let's see.
[CUSTOMER][NEUTRAL] So let's follow.
[CUSTOMER][POSITIVE] I mean that'd be great cause I was wondering because normally they're fast on this.
[CUSTOMER][NEUTRAL] Because that's all the heart hospital thing open.
[CUSTOMER][NEUTRAL] So you still got all those receipts and stuff from the hospital?
[CUSTOMER][NEUTRAL] That that those itemized receipts and stuff.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] For
[AGENT][NEGATIVE] So from what was received, it looks like it's just the statement of insured and the second page is not signed. So, you can resubmit it, there's no timely filing or anything.
[AGENT][NEUTRAL] You, so we'll need the completed Medlink claim form, anytime you file a claim with us. You'll need the explanation of benefits from your primary insurance.
[AGENT][NEUTRAL] Because that's gonna show us everything that the hospital charged, everything primary paid, everything you paid, and then that way we know we can reimburse you or pay to the hospital or both, um, and then the itemized billing from the hospital.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] And ma'am, is there any way you can email me that stuff, please, in that list?
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] OK, yes, I can email you um and.
[CUSTOMER][NEUTRAL] It was, it was, it was, it was.
[CUSTOMER][NEUTRAL] I'm sorry, go ahead. I didn't mean to interrupt, ma'am.
[AGENT][NEUTRAL] Oh no, you're fine. I can email you and um attach a copy of the I'm sorry, a copy of the claim form and then list like the explanation of benefits and the itemized bill that's needed. You want to do that?
[CUSTOMER][POSITIVE] But yes, ma'am, that would be perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And we can get started on this this evening.
[AGENT][NEUTRAL] Uh-huh, and then you can just upload it to the online service and whenever you're done and then we'll go ahead and um continue processing. And you want it sent to the [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am, please.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So I am sending this to you now. So you should receive it in a few minutes. I'm just gonna type up the rest of the email, but everything's attached already.
[CUSTOMER][NEUTRAL] Yeah, yes, ma'am. I guess there's just some paperwork and stuff that we needed that I was unaware of.
[AGENT][NEUTRAL] Yes, and I'm going to list it and each time you, to be honest, the provider should be doing it, but anytime if you all do have to file a claim, just refer back to that list. As long as you have those three things, um, the claim will go ahead and be processed.
[CUSTOMER][POSITIVE] Yes, ma'am, that man, that's great. That's great. If you send all that stuff to me, we can go ahead and get this knocked out, man.
[AGENT][POSITIVE] Yes, sir. I am sending this um to you shortly. I am getting the email together now and um was there anything else I can help you out with today?
[CUSTOMER][POSITIVE] I did no, ma'am. I, is that, is that it babe? ma'am, that's it you've done, you've gone above, above and beyond. I wanna thank you very much.
[AGENT][NEUTRAL] Well, you're very welcome, Mr. [PII]. Um, so if, uh, did you want to wait for me to send it to you or while we're on the phone or you're OK?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yeah, no, I think we'll be all right, ma'am.
[AGENT][NEUTRAL] OK. Well, was there anything else I can help with you sure?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] But then no, ma'am, that's it.
[AGENT][POSITIVE] All right. Well, thanks for calling APL and I hope you all have a great evening.
[CUSTOMER][POSITIVE] I hope you do too, ma'am. Thank you very much.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] All right, bye-bye.
[CUSTOMER][NEUTRAL] Alright babe.