AccountId: 011433970860
ContactId: e7398be9-b57d-4445-8c00-fbd527ea349d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 330950 ms
Total Talk Time (AGENT): 149934 ms
Total Talk Time (CUSTOMER): 111766 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/e7398be9-b57d-4445-8c00-fbd527ea349d_20250402T13:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I was trying to, um, I need to file a claim and I would like to register, um, online, but when I do that, it's not recognizing anything, so it gave me this number to call and says uh that you could be able to help me create an account.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with your online service and sign up. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][POSITIVE] [PII] Um I would be under [PII], he's my father, um and I can call you back if we get disconnected, so don't worry.
[AGENT][NEUTRAL] OK, and may I have your policy number?
[CUSTOMER][NEUTRAL] Um, I've got the group number. Is that OK?
[AGENT][NEUTRAL] Yes, that's fine.
[CUSTOMER][NEUTRAL] Yeah, it's 18158.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And you said it would be under [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What's the name of the employer?
[CUSTOMER][NEUTRAL] Future Energy Solutions FES.
[AGENT][NEUTRAL] OK, hold on one second.
[AGENT][NEUTRAL] I'm just looking for your dad's policy. Hold on one second.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] 25, here we go.
[AGENT][NEUTRAL] OK, so I just located the policy, um, and I just need you to verify your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] My date of birth is [PII]. Um, I don't know if this is the right mailing address that you have [PII], or do you have the [PII] address? I'm not sure.
[AGENT][NEUTRAL] Um, oh, it might be.
[CUSTOMER][NEUTRAL] So [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, and that's the address I have. Mhm.
[CUSTOMER][NEUTRAL] Is that the right one you have?
[CUSTOMER][POSITIVE] Yeah, OK, perfect.
[AGENT][NEUTRAL] And thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment. So it looks like it's not so.
[AGENT][NEUTRAL] The policies that you all have with us are no longer active as of [PII].
[AGENT][NEUTRAL] Um, the last
[CUSTOMER][NEUTRAL] OK, but this is a claim that I need to make for something that happened in January.
[AGENT][NEUTRAL] Right, so I'm trying to explain to you, so since the systems are connected, since it's lapsed in our system, it won't let you sign up for our online service center account. So you can, you can fax the claim or you can mail the claim to us.
[CUSTOMER][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] But can I email it to you because I'm not in the [PII] at the moment.
[AGENT][NEUTRAL] Um, we can't email claims because of HIPAA laws. Um, however, there is no timely filing limit. So if you needed to wait until you return, um, you can file a claim at any time as long as the policy was active when you on your data service, which it sounds like it was. So you, you can file it at any time.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So where do I get the form to complete?
[AGENT][NEUTRAL] So the claim form is on our website [PII].
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] And you'll click on claims and forms to the top right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then you just scroll down to where you see, I believe it says policy documents and forms. You're looking for the Medlink claim form, um, it's in alphabetical order down there.
[CUSTOMER][NEUTRAL] Medlink, yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Medlink claim form. OK, so download form.
[CUSTOMER][NEUTRAL] OK, so here I can submit the form and then I send it by mail.
[CUSTOMER][NEUTRAL] Is that right?
[AGENT][NEUTRAL] Yes, yes, ma'am, or you can fax it.
[CUSTOMER][POSITIVE] And nobody has facts around anymore. um, OK, fine, I will try to see what I can do. Thank you so much.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, in the meantime, if
[CUSTOMER][NEUTRAL] Um, because I, I basically wanted to find out, should I pay the, the bill and then I get reimbursed myself, or do you pay them directly?
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] if the bill has already come out, I would file it with insurance and let insurance handle it and then if something is left over, then see what the patient responsibility would be.
[CUSTOMER][NEUTRAL] I mean, is it worthwhile me contacting the hospital to give them the APL details and then they can reach out to you to settle the bill?
[AGENT][NEUTRAL] Yeah, you could do it that way too. I just let them know I have a secondary, I had a secondary insurance at the time. Here's the policy number. Go ahead and bill them and then they'll send us everything.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you don't have to do it.
[CUSTOMER][POSITIVE] OK, all right, perfect.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] No, that's perfect. Thank you.
[AGENT][POSITIVE] All right, you're welcome. Thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you bye bye.