AccountId: 011433970860
ContactId: c299612b-8b20-4990-ae09-dcd12a9ebd22
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 640190 ms
Total Talk Time (AGENT): 185915 ms
Total Talk Time (CUSTOMER): 224068 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/c299612b-8b20-4990-ae09-dcd12a9ebd22_20250604T20:29_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Mm doesn't mind.
[AGENT][NEUTRAL] Hello, thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, yes, um, I was calling because I was trying to submit a claim, uh,
[AGENT][NEUTRAL] I could barely hear you.
[CUSTOMER][NEUTRAL] Uh, OK.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEGATIVE] So you're, you're very low.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Can you hear me now?
[AGENT][POSITIVE] I can. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, I was trying to process a claim. Um, however, I was trying to see if I can get into the, uh, I'm not, I don't recall if I ended up signing in or registering online before. I think I have, I just don't recall what maybe the username or something that I must have used. I, I tried, you know, using the, the stuff online that it tells me, but.
[CUSTOMER][NEGATIVE] It doesn't seem like it's working.
[AGENT][NEUTRAL] Well, we have a new website.
[AGENT][NEUTRAL] So let me see.
[CUSTOMER][NEUTRAL] Uh, let me see if if I'm probably the wrong one then.
[AGENT][NEUTRAL] Are you the provider or the insured?
[CUSTOMER][NEUTRAL] Um, I'm the insured, so.
[AGENT][NEUTRAL] So let me see.
[AGENT][NEUTRAL] So are you at the [PII] website?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Say that again, I'm sorry.
[AGENT][NEUTRAL] Can I have your name and the policy number to pull up your policy?
[CUSTOMER][NEUTRAL] Yes, um, give me one. [PII].
[CUSTOMER][NEUTRAL] And the
[CUSTOMER][NEUTRAL] I have here, is it the group number?
[AGENT][NEUTRAL] No, it should say policy assert number on your card.
[CUSTOMER][NEUTRAL] On my card, it says in hospital benefits cert number.
[AGENT][NEUTRAL] Yes, that number, one of those numbers, either one of them, it doesn't matter just as long as you just provide me with one of them to pull up the policy.
[CUSTOMER][NEUTRAL] Or out
[CUSTOMER][NEUTRAL] OK. 02291428.
[CUSTOMER][NEUTRAL] M as in Mary. L as in Larry. 7.
[AGENT][NEUTRAL] Thank you, [PII], could you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] What, what else did you want me to verify?
[AGENT][NEUTRAL] Your date of birth?
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] Thank you, you and my daughter share the same birthday, and what is the email address that we have on file for you?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It is, um, I believe I'm, I'm thinking if you could either be [PII].
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, that is what we have and what is the call back number for you? Just in case the call is disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So, are you online at
[CUSTOMER][NEUTRAL] I was, if there's a way that can
[AGENT][NEUTRAL] Go ahead, what were you about to say?
[CUSTOMER][NEUTRAL] Say that again I'm sorry.
[AGENT][NEUTRAL] So I was gonna walk you through setting up your online account.
[CUSTOMER][NEUTRAL] No, if I, if I can
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] That's the reason for your call, correct?
[CUSTOMER][NEUTRAL] Uh, yes. Um, but can I change the email address? Because I, I no longer use that email address?
[AGENT][NEUTRAL] OK, so what is the email address that you would like to update it to?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] 1832.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I got [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so, um, go to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Once you're there then you're gonna choose that you're the insured.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then you're gonna hit next.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then you're gonna provide the following information that's been requested. It's gonna say it's gonna request your last name, your social, social security number, your member's ID, whichever one you prefer, but let me know if um.
[AGENT][NEUTRAL] You use your member's ID and I'm gonna give you that.
[CUSTOMER][NEUTRAL] Um, no, I just use the social.
[AGENT][NEUTRAL] OK, and then you're gonna put your residential zip code and your email address and your date of birth. Well, everything that is asking you for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mm, OK. So now it says uh.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Did you put your date of birth and everything and then hit next.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So now I'm gonna send you.
[CUSTOMER][NEUTRAL] I, I actually went next.
[AGENT][NEUTRAL] Something about a verification of your gonna send you a verification to your email.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Have you seen that yet?
[CUSTOMER][POSITIVE] OK, yeah, it actually, yeah, it finally proceeds a little bit for now.
[CUSTOMER][NEUTRAL] OK, so finally I went to this like dashboard.
[CUSTOMER][NEUTRAL] And then if I want to start a team.
[AGENT][NEUTRAL] And what did you say?
[CUSTOMER][NEUTRAL] I would then um yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I didn't hear you if you ask me something, could you repeat it?
[CUSTOMER][NEUTRAL] Um, no, I was just saying that it's, um, I guess if I want to
[CUSTOMER][NEUTRAL] Um, file a claim, I would then just click on, I would just click on start your claim, right? Or?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Start your pain.
[CUSTOMER][NEUTRAL] Um, next.
[CUSTOMER][POSITIVE] I love.
[CUSTOMER][NEUTRAL] OK. So this would be the number, the, the, the Medlink form or I guess that number is the one that I have.
[AGENT][NEUTRAL] Mhm, yes, it'll be the main link.
[AGENT][NEUTRAL] Yes, it'll be Metlink.
[CUSTOMER][NEUTRAL] OK, and then I would have to, it would have to be like the explanation of benefits that for each claim for you guys to.
[AGENT][NEUTRAL] Process the claim, yes, so you need your itemized bill with your your itemized bill list in the diagnosis codes for those services and your EOB from your primary insurance company.
[CUSTOMER][NEUTRAL] Like what I have to
[CUSTOMER][NEUTRAL] Uh, let me see, so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] you mentioned.
[CUSTOMER][NEUTRAL] Because I see here only explanation of benefits PDF on the actual portal.
[CUSTOMER][NEUTRAL] And then let me see, hold up.
[CUSTOMER][NEUTRAL] I think I had previously sent 2 of them and then they asked for something else, but I'm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, because you probably did send the EOBs, but you were, you didn't send the diagnosis codes, the itemized bill with the diagnosis codes, and we may have been requesting that information because we're gonna need it to process the claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Is there anything else that you need from me today?
[CUSTOMER][NEUTRAL] Um, I mean, I'm just trying to figure out, so, OK, let me write this down before you said it would need because I see here I'm trying to like see if in the if in the actual explanation of benefits those codes that you're asking for, but I don't really see.
[AGENT][NEUTRAL] No, it's not gonna be listed on your explanation of benefits. It's gonna you're gonna need to request the itemized bill from the facility where you receive your services.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] The explanation benefit is only going, we need that for the, see what was what went towards your deductible copay and co-insurance, however, we're gonna still need your itemized bill from your, from the facility where you receive those medical services listing the ICD codes, your diagnosis codes.
[CUSTOMER][NEUTRAL] So I need to ask them for the item.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Um, no, that's it. Thank you so much.
[AGENT][POSITIVE] You're welcome thanks for calling APL and have a great day. Goodbye.
[CUSTOMER][POSITIVE] Thank you. Bye.