AccountId: 011433970860
ContactId: c2b43bb9-9553-4da9-814b-0548935e2f85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 432600 ms
Total Talk Time (AGENT): 186402 ms
Total Talk Time (CUSTOMER): 179509 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/c2b43bb9-9553-4da9-814b-0548935e2f85_20250620T14:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning. I'm calling because I have a claim.
[CUSTOMER][NEUTRAL] I went to have a, an ultrasound of the abdomen and um unfortunately they didn't take the APL and they just told me to send the, the receipt of what I paid to the, to the insurance. So I'm trying to see, I already have the.
[CUSTOMER][NEUTRAL] The receipt here and where do I need to send it?
[AGENT][NEUTRAL] OK. Yes, ma'am. I can assist you with filing a claim. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Sure. [PII] is [PII].
[CUSTOMER][NEUTRAL] S I
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. Now I need your policy number, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't have the um.
[CUSTOMER][NEUTRAL] It might be this one. if I'm in the same, we work together, my, my co-worker has that number because I don't have my card with me today. Would it be the same number?
[AGENT][NEUTRAL] OK, I can look it up by you. No, ma'am, it'll be a different number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It would be a different number.
[CUSTOMER][NEUTRAL] OK, no, I don't have it.
[AGENT][NEUTRAL] OK, I can look it up by your social.
[CUSTOMER][NEUTRAL] Do I can I give you the group number?
[CUSTOMER][NEUTRAL] Can I give you any other information besides that?
[AGENT][NEUTRAL] Um, I can look it up by your name and date of birth. What's your last name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Can you please spell that?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] And please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. I found you in our system. Um, please verify your mailing address and your email address.
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] OK, I'm showing that you don't have an email address on file. Would you like for me to add that one?
[CUSTOMER][NEUTRAL] Please
[AGENT][NEUTRAL] OK, and please repeat it.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] T U
[CUSTOMER][NEUTRAL] Y A
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Yes, ma'am. I've added your email address.
[AGENT][NEUTRAL] OK. And in order to, mm, no problem. And in order to file a claim, what we'll need is the explanation of benefits from your primary insurance company for the date of service that you're filing the claim for. Um, and we'll also need documentation from the doctor's office or where, wherever the place of service is, um, with your diagnosis code.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And once you get that information, um, you can file the claim online, you can fax it to us or you can mail it to us. Um, which way do you prefer?
[CUSTOMER][NEUTRAL] I can send it by email. Can I send it by email?
[AGENT][NEUTRAL] No, ma'am, we can't take it through email because of the HIPAA, but you can file a claim online or if you have access to a fax machine, you can fax it to us.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, um, I could, I would probably send, do it online. What, um, what's the, where do I need to go?
[AGENT][NEUTRAL] You will need to go to this website. Um, it's secured, that's [PII]
[AGENT][NEUTRAL] Do
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] And when you get there you should see a button that may say create account or.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Create new policy online. Do you see that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You'll click on that and you'll let.
[CUSTOMER][NEUTRAL] OK, when I do, I don't have, uh-huh.
[AGENT][NEUTRAL] Well, you'll click on that button.
[CUSTOMER][NEUTRAL] Go ahead, go ahead.
[AGENT][NEUTRAL] You'll click on that button to create an account online. Just let the system know that you're the insured and answer the questions to set your policy up online. And once you set your policy up online and you gather that documentation, you can log in to um um upload the documentation to file the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see. OK. And if I decided to do it by fax, what would be the fax number to do that?
[AGENT][NEUTRAL] Um, the fax number is [PII].
[CUSTOMER][POSITIVE] Good
[CUSTOMER][POSITIVE] OK, so my thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942 3.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am, and please attention it to the claims department.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Alright, I have the receipt from the um from the um from the person who performed the the the exam, um, they just haven't sent the, the claim to the insurance, so the EOB doesn't show on the insurance. I mean, how long do I have to be able to send this claim?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] There's no timely filing limit. So whenever you receive the EOB from your primary insurance, um, it'll be fine as long as you have coverage on the date of service.
[CUSTOMER][NEUTRAL] You don't.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Sounds good alright sounds good.
[AGENT][NEUTRAL] OK. And also, um,
[CUSTOMER][POSITIVE] All right. Thank you very much for your assistance. Mhm.
[AGENT][NEUTRAL] OK. There's also one more thing. Once you um set your policy up online, it's gonna ask for your policy number and I can give that to you if you don't have that information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh please.
[CUSTOMER][NEUTRAL] Um, sure, I, I should have a card in my house, but let me have it just in case.
[AGENT][NEUTRAL] OK, your policy number is 025.
[AGENT][NEUTRAL] 57865.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Got it. Alrighty.
[CUSTOMER][POSITIVE] All right, well thank you very much. You've been very helpful.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][POSITIVE] That will be all for today. Thank you so much. You have a wonderful day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] OK