AccountId: 011433970860
ContactId: e5a8acf4-48df-4d72-b3c6-4e77de7b4921
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396829 ms
Total Talk Time (AGENT): 186322 ms
Total Talk Time (CUSTOMER): 160423 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/e5a8acf4-48df-4d72-b3c6-4e77de7b4921_20250530T20:24_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] Hi, good afternoon. Um, I have two questions.
[CUSTOMER][NEUTRAL] Uh, first, I don't know if this gap works as well for vision care.
[AGENT][NEUTRAL] OK. Well, 1st may I have your name and are you the insured or you're calling with the provider's office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, my name is [PII].
[CUSTOMER][NEUTRAL] Um, and then should I give you my payer ID or group number or?
[AGENT][NEUTRAL] Um, do you see anywhere that says policy cert number?
[CUSTOMER][NEUTRAL] Um, no, I never find it.
[AGENT][NEUTRAL] OK, what's their group number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's 25921.
[AGENT][NEUTRAL] OK, can you spell your last name for me?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Your date of birth and your home address?
[CUSTOMER][NEUTRAL] [PII]. Home address is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] So, no, ma'am, this is not for vision insurance. This is for your medical insurance only. Um, it goes with your United Healthcare policy.
[CUSTOMER][NEUTRAL] OK. Now, um, how can I do if I wanna, I have a lab a laboratory bill.
[CUSTOMER][NEUTRAL] So, how do I
[CUSTOMER][NEUTRAL] Send that to you guys so you can review it.
[AGENT][NEUTRAL] So you can either let the lab know that you have a secondary insurance and give them your policy number and our phone number, um, so that they can bill us or you can file the claim on your own.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and if I file the claim on my own, where do I have to go?
[AGENT][NEUTRAL] Um, you can fax it to us, you can mail it to us, or you can upload it through the online service center. So you'll need the Medin claim form.
[AGENT][NEUTRAL] The explanation of benefits from your primary insurance?
[CUSTOMER][NEUTRAL] OK, I don't have anything of that. What is the easiest way?
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] The easiest way to get these, I'm giving you the documents that you need to file a claim. Are you asking for the easiest way to get the documents?
[CUSTOMER][NEUTRAL] No, because I don't have those documents. I just have my insurance card, this card, and the bill. I don't know how to get those documents that you're mentioning.
[AGENT][NEUTRAL] So to get the explanation of benefits, you can reach out to United Healthcare, either on their portal or the member services number on the back of your card and ask for the explanation of benefits for whatever day you're filing the claim for.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The item
[CUSTOMER][NEUTRAL] Well, it's basically the gap.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's basically it's a $63 bill and um my knowledge is that this gap covers at least $350 per day.
[CUSTOMER][NEUTRAL] So that's why I wanna ask.
[AGENT][NEUTRAL] Right, so I'm giving you the information that you're needing to file the claim. So the documents that I'm giving you are what you need to submit to us so that we can process the claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] dirty.
[CUSTOMER][NEUTRAL] OK, so you want me to send attachment of explanation benefits and what else?
[AGENT][NEUTRAL] So you'll need your explanation of benefits from United Healthcare.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You'll need the Medlink claim form from our website.
[CUSTOMER][NEUTRAL] And what to
[CUSTOMER][NEUTRAL] Your website [PII].
[AGENT][NEUTRAL] [PII] and it's [PII].
[CUSTOMER][NEUTRAL] OK, give me a moment, please.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It's [PII] I'm sorry, can you say it again? Please, [PII].
[AGENT][NEUTRAL] Yes. It's [PII].
[CUSTOMER][POSITIVE] Bless you.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you. um OK, where do I go here?
[AGENT][NEUTRAL] So once you get to the website, you're gonna click on claims and forms to the top right corner.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And once that, you're going to scroll down to the bottom to where you see policy documents and you're looking for the Medlink claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, OK, got it download them.
[CUSTOMER][NEUTRAL] OK, I have to fill out this data, OK.
[AGENT][NEUTRAL] Yes, so you'll send that form with the explanation of benefits and the itemized bill from the doctor's office or hospital.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is that?
[CUSTOMER][NEUTRAL] OK, got it. And which is the address that I have to send it over I'm, I'm sure it's here somewhere.
[AGENT][NEUTRAL] P
[AGENT][NEUTRAL] Yes, on the bottom of the claim form, that first page, you'll see the mailing address and the fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But I can give it to you as well if you need it.
[CUSTOMER][NEUTRAL] Um, no, it's fine. I have it. I see it here. It's OK. It has to be mail and if I wanna send it to the to an email all this attached.
[AGENT][NEUTRAL] Um, there's no, uh, we can accept claims documents through email. If you'd like to send it electronically, you can upload it to the online service center.
[CUSTOMER][NEUTRAL] Is there a way?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] So, on our website, we're
[CUSTOMER][POSITIVE] OK perfect so
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Yes, go ahead please.
[AGENT][NEUTRAL] So on our website where you click on claims and forms, that same page, um, to the right, you'll see where it says sign up or sign in. You can click on that and it'll take you straight to the portal.
[CUSTOMER][NEGATIVE] Well no
[CUSTOMER][POSITIVE] OK, thank you for everything. OK, thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that will be it. I'll follow up. Thank you so much. Have a good day.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Yeah