AccountId: 011433970860
ContactId: c4be0a74-9825-4f55-9101-34a10c7b11a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 508679 ms
Total Talk Time (AGENT): 252939 ms
Total Talk Time (CUSTOMER): 171117 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/c4be0a74-9825-4f55-9101-34a10c7b11a8_20250402T16:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I was trying to schedule a, um, doctor's appointment for, um,
[CUSTOMER][NEUTRAL] Yeah, like a pediatric doctor's appointment, um, and they were asking if
[CUSTOMER][NEUTRAL] Um, my insurance would cover, um, and they were asking if this like, I guess this is my secondary insurance. I'm kind of confused at
[CUSTOMER][NEUTRAL] This APL insurance like I've given it to.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] A lot of different places and
[CUSTOMER][NEUTRAL] No, no one is taking it. I don't know. I, I guess I just need help understanding.
[AGENT][POSITIVE] OK, yes, ma'am. I can help you with your benefits. Can I please get your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. And then what is your policy number?
[CUSTOMER][NEUTRAL] 02586771
[AGENT][NEUTRAL] OK, let me pull up your policy real quick.
[AGENT][NEUTRAL] OK, [PII], for security reasons can you please verify your address and email address for me please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, um, I don't, it's through my school, um, so I don't know if it's.
[AGENT][NEUTRAL] It looks like
[AGENT][NEUTRAL] It looks like it's personal.
[CUSTOMER][NEUTRAL] My work address?
[CUSTOMER][NEUTRAL] Personal, OK. Um, then it's um [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then the phone number that you gave me to call you back on, is that your cell phone number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. I appreciate you verifying your policy for me. OK, so yes, you are correct. This is a supplemental insurance policy that's billed secondary to the primary. This policy only helps with deductible, co-pay, and co-insurance.
[AGENT][NEUTRAL] And this is to verify your benefits. It's not a guarantee of pay.
[AGENT][NEUTRAL] So if you go inpatient into the hospital.
[AGENT][NEUTRAL] Which is 18 hours or more.
[AGENT][POSITIVE] You have a benefit of $2100 that helps towards the deductible co-pay or co-insurance.
[AGENT][NEUTRAL] And then you also have the same benefit amount, $2100 to help with outpatient uh procedures. I'm going to check to see if you have office visits on your policy.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, um, so I actually.
[AGENT][NEUTRAL] That's on your policy.
[CUSTOMER][NEUTRAL] Um, I actually am currently in the hospital. Um, I just gave birth and so,
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, and so when I was checking in, I like tried to give them the this, um, and it like wasn't really coming up with anything, so how, how would I go about doing that 2000.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so, um,
[AGENT][NEUTRAL] And then the, the people at the hospital didn't call and verify your benefits to show that this will help?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I guess they didn't call though, um, they, they just said like that it wasn't coming up and like they couldn't list it as an option.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK, so you'll have to file the claim yourself. It it sounds like, um, we have an online service center.
[AGENT][NEUTRAL] I'm gonna give you that address so that you can go off and um sign up for the online service center. It's the easiest way for you to file a claim.
[AGENT][NEUTRAL] Are you, do you, do you have a pen and paper handy so you can write it down?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, are you able to get a pen and paper?
[CUSTOMER][NEUTRAL] And can you get a pen and paper?
[CUSTOMER][NEUTRAL] You have there or you can put it on your phone. Yeah, we, we can write it down.
[AGENT][NEUTRAL] OK, good. Um, just let me know when you're ready.
[CUSTOMER][POSITIVE] We're ready.
[AGENT][NEUTRAL] OK, so the website is secured [PII].
[AGENT][NEUTRAL] Dot A like Apple Michael.
[AGENT][NEUTRAL] Public
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] When you go in there for the first time you're gonna sign up as a new user.
[AGENT][NEUTRAL] And then that second option that you're gonna choose is I'm an individual with a policy.
[AGENT][NEUTRAL] You're going to put your username and password that you decide that you want to use.
[AGENT][NEUTRAL] When it's time to file your claim, you're gonna need your explanation of benefits from your primary insurance carrier.
[AGENT][NEUTRAL] And then you're also going to need your itemized statement from the hospital that has your procedure codes and diagnosis codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when you go into the website or this online service center for the first time to file your claim, you're gonna choose claims and forms.
[AGENT][NEUTRAL] You're going to click on the, your policy is called Medlik, M E D L I N K.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you're gonna click on med link and then you'll.
[AGENT][NEUTRAL] Uh, upload your explanation of benefits in your itemized statement.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Into the online service center and send it and it'll give you a confirmation that we've received it and it'll also give you updates as to where the claim is during the process.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] It's just that easy.
[CUSTOMER][NEUTRAL] Um, and then, so.
[CUSTOMER][NEUTRAL] So I'll, I can file it for that. So will it affect like my pediatrician at all?
[CUSTOMER][NEUTRAL] Or since those are office visits.
[CUSTOMER][NEGATIVE] For him, it wouldn't make any difference.
[AGENT][NEUTRAL] So what you'll need to do is um add your baby onto your policy and you'll need to do that through your employer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then he'll have, his effective date should go back to the date of birth.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And if you get stuck, you're very welcome and if you get stuck along the way and you need help, please call us and we'll help you through it, OK?
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][POSITIVE] OK, great, thank you.
[AGENT][POSITIVE] You're very welcome, [PII]. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, I think that should be good.
[AGENT][POSITIVE] OK, well, you have a blessed day and congratulations on your new baby.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL.
[CUSTOMER][POSITIVE] Uh huh bye have a good one.
[AGENT][NEUTRAL] Bye-bye.