AccountId: 011433970860
ContactId: dab62e6d-1edc-4f57-8a78-efec2991e46b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 351000 ms
Total Talk Time (AGENT): 147272 ms
Total Talk Time (CUSTOMER): 148776 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/dab62e6d-1edc-4f57-8a78-efec2991e46b_20250327T18:12_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] Yeah, hi, I have, uh, I'm gonna be filing a claim, um.
[CUSTOMER][NEUTRAL] For, uh, for a service that I had, um, about a month ago and um I just wanted to, what I I last time I did, I know I need explanation of benefits I believe it was what was there anything else that I need to do um to attach with that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, maybe, let me see what type of policy you have and then I'll know what forms you need. Um, may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your name and your policy number?
[CUSTOMER][NEUTRAL] Uh, my name is [PII] Um, I gotta see if I have my policy number on, on me. I think I have a.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second
[CUSTOMER][NEGATIVE] Oh fuck.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Trying to think when I went to the doctor. Hold on one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] 00 crap uh.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I can also search it with your social if you like.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][POSITIVE] Yeah, let me get water one second holy shit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah fine.
[CUSTOMER][NEGATIVE] No, I'm dying, holy crap. Um, uh, excuse me.
[CUSTOMER][NEUTRAL] So yeah my uh social is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] You OK?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I don't know what's going on.
[CUSTOMER][NEUTRAL] I just came out of nowhere.
[AGENT][NEUTRAL] Yeah, that was very random.
[AGENT][NEGATIVE] It scared me.
[CUSTOMER][POSITIVE] Oh my goodness. That was wild. That was wild.
[CUSTOMER][POSITIVE] I think we're good now.
[AGENT][NEUTRAL] Anyway
[AGENT][NEUTRAL] OK, good. I just found your policy as well. Um, it's coming up now. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII] um address is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and then just your email.
[CUSTOMER][NEUTRAL] Is uh [PII] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Um, so for your policy, you're going to need um the explanation of benefits from your primary insurance. You'll need the itemized bill or the universal bill.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] From the provider?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] When you say that, when you say universal bill, that's kind of oh my god.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] What is going on? Universal bill you mean like when when I pay check out?
[AGENT][NEUTRAL] Um, I'm getting ready to explain it to you. So the universal bill or the itemized bill is the is the provider like the doctor or the hospital's version of the billing. It's gonna have the diagnosis code which tells us why, so make sure you stress because they might try to send you your patient copy, but it has to be the provider's copy. Um, the
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] ICD like igloo, Charlie, David, and then the number 10.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] ICD 10 codes, which is the diagnosis codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] CTT codes like Charles, Paul, Tango.
[AGENT][NEUTRAL] That's the
[CUSTOMER][NEUTRAL] That's on, that's on the universal, that's on the universal bill or I need to get that?
[AGENT][NEUTRAL] What, so the, so the things that I'm, I'm saying is on the itemized bill or the universal bill, depending on the first, yeah, the itemized bill and universal bill is the same thing, different locations call it one or the other.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] I got you I got you, OK.
[AGENT][NEUTRAL] And um OK, so it has the diagnosis codes, the procedure codes, which is CPT.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And then all the charges.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then as long
[CUSTOMER][NEUTRAL] So I just need those two things.
[AGENT][NEUTRAL] Mhm. And your Medlink claim form.
[CUSTOMER][NEUTRAL] Meddling claim form. What's where do I get that?
[AGENT][NEUTRAL] And that claim form can be found on our website?
[AGENT][NEUTRAL] Which is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, yeah, I think I filled it out last time online.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] You got it? OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, I think I just did this online and uh clicked on forms or submit a claim. I think I did after I logged in.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK, yeah, and then, and then I think I just uploaded everything I needed.
[AGENT][POSITIVE] Uploaded it. Yes, you're in the right place.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK, alright, I'll give them a call and then uh I'll go ahead and and start the bill.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK. Was there any
[CUSTOMER][NEUTRAL] Or start the start the claim.
[AGENT][NEUTRAL] All right, was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, I'm all set thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and I hope you have a good day.
[CUSTOMER][POSITIVE] Alright thanks you too.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye.