AccountId: 011433970860
ContactId: d16472c5-677a-4eb4-9f09-47ba96de3f98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369190 ms
Total Talk Time (AGENT): 125838 ms
Total Talk Time (CUSTOMER): 173431 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/d16472c5-677a-4eb4-9f09-47ba96de3f98_20250331T15:42_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey sir, I just wanted to check on a couple of things. Um, so, um, is today the last date? Can I still file for [PII] claims if I get it in today?
[AGENT][POSITIVE] Mhm, yeah, absolutely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is today the last day though?
[AGENT][NEUTRAL] Let me look and see if there, I'm not sure what type of plan you have, if there's a time frame on it. Do you have your policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Actually, where would I find that? Hang on, I think I've got on this document.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] And they just locked me out.
[CUSTOMER][NEUTRAL] Here we go, policy number is 2506531.
[AGENT][POSITIVE] Thank you, let me pull this up here.
[AGENT][NEUTRAL] And then if I can get your name and date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][POSITIVE] Thank you so much. And then I just need to verify your address and email for security, please.
[CUSTOMER][NEUTRAL] Uh, it's [PII]. I think the email is [PII].
[AGENT][NEUTRAL] All right, so with your particular policy that you have, it's a secondary policy, and there's no sort of um timely filing limit, so it doesn't have to be filed within a certain time frame. So if you still have claims from [PII], you have plenty of time to still get those submitted for payment.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then just, just so I'm aware, because I don't see, I'm, I'm in the portal. I don't, I don't seem to have a way to submit the claims via the portal, so I'm gonna have to upload the physical, like I'm gonna have to download the file and then complete that and then upload it, that
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, that's the process that you had the steps that you have to take. It's through that green upload button. That's how you would do that through the portal, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then I'm trying to, when I click on product claim form, like I, I'm in, you know, I'm in step two for upload documents.
[CUSTOMER][NEUTRAL] It's not, it's
[CUSTOMER][NEUTRAL] I don't know which form do I need to file.
[AGENT][NEUTRAL] OK, yeah, you need the you need the med link claim form.
[CUSTOMER][NEUTRAL] Is it, yeah.
[CUSTOMER][NEUTRAL] Meddling claim form I meddling claim form. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. I'm just gonna download the form if you have any questions. OK. So, all right. So now, I've got physical therapy things I need to submit. Do I submit one form per um per like visit, or can I combine all the physical therapy visits into one claim?
[AGENT][POSITIVE] You can do them all in one claim absolutely you don't need to do one for each visit, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. And then there was also, I think I also had the ability, I just wanna verify this for you. I wasn't sure. So in terms of what is covered, um.
[CUSTOMER][NEUTRAL] I seem to recall.
[CUSTOMER][NEUTRAL] That diagnostics are covered under my plan. Is that correct?
[AGENT][NEUTRAL] Uh, let me pull that up here. I'm pulling your policy here.
[AGENT][NEUTRAL] Yeah, so it looks like that would fall under your outpatient cover charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But if, if I get if I have a diagnostic at my healthcare provider, that doesn't count. It has to be at a hospital outpatient facility, right?
[AGENT][NEUTRAL] Um, it looks like it has to be.
[AGENT][NEUTRAL] Covered outpatient facility.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Incurred in a physician's office.
[AGENT][NEUTRAL] So, I mean, if it incurs, if the treatment occurs in a physician's office, it's still applicable under outpatient. It doesn't have to be a hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and it, OK, got it. So um I'll submit and see if that takes, um.
[AGENT][NEUTRAL] Yeah, no, absolutely. I mean, I usually tell people, um, go ahead and submit it, you know, worst case scenario, if it's not covered, you know, then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, and like an endoscopy, for example, I'm getting an endoscopy at, at, you know, in a coup in like 3 weeks, like that that's tech that's covered as a diagnostic, right? cause it's an endoscopy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, mhm, mhm.
[CUSTOMER][NEUTRAL] OK, so I would submit that, OK.
[AGENT][POSITIVE] Yeah, absolutely.
[CUSTOMER][POSITIVE] OK, uh great, this is helpful. OK, it's, uh, um, I appreciate you walking me through the process. This is my first time having this type of gap insurance. I've never, I've never used it before, but it's uh, it's, I'm grateful that I don't have to do it today because I was like, oh, I gotta, I gotta try to get my taxes done first and then I'll do this.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] No worries, no worries. If you run into any questions or concerns, feel free to give us a call, OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you so much. Take care.
[AGENT][POSITIVE] You're welcome. You too. Bye-bye.