AccountId: 011433970860
ContactId: f091ce21-6d4b-467c-928d-b34852fbd5cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 648539 ms
Total Talk Time (AGENT): 417329 ms
Total Talk Time (CUSTOMER): 153161 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/f091ce21-6d4b-467c-928d-b34852fbd5cc_20250109T13:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and um this is the first time um I'm using you guys. I just realized that my account changed over to you and so my daughter gets medical supplies so I was trying to, I went online and created an account and it said upload files, but I'm not sure what files like what do you need from the medical supply company just to make sure I get it right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you're wanting.
[CUSTOMER][NEUTRAL] Like do you just need their bill?
[AGENT][NEUTRAL] OK, so you're wanting to verify what documents you need to submit for a claim for your daughter, is that correct? Yes, ma'am. I can help you with that. And um Ms. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number?
[CUSTOMER][NEUTRAL] Uh, my policy number is um.
[CUSTOMER][NEUTRAL] 02545333
[AGENT][NEUTRAL] OK, thank you. So give me a moment to get your information uh pulled up. Once I do, I will have to verify several things with you first for security, and then also any information that is provided will be a verification of benefits and not a guarantee of payment. So give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, Ms. [PII], if you, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And your child's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. Your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that is on file for you is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and lastly your email address please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] OK, so on the supplemental policy, do you know where to obtain the claim form?
[CUSTOMER][NEGATIVE] Uh, no.
[AGENT][NEUTRAL] OK, so you can.
[CUSTOMER][NEUTRAL] So I need it on the app you mean?
[AGENT][NEUTRAL] Well, there's, you see, you would go to our website, you're gonna go not to the portal, but to our website at secured. I'm sorry, that's, I was about to give you the portal's website [PII].
[CUSTOMER][NEUTRAL] Or like
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] When that page pulls up the signer at the top, you will see where it says claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You would click on that link.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Scroll down the page and you will see a box that says filter by product with a green drop down arrow in it.
[CUSTOMER][NEUTRAL] Filter by product.
[AGENT][NEUTRAL] Uh-huh. And there's a little green drop down arrow. Click on that little green arrow. It's going to give you a list.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're you're looking for the word medlink.
[AGENT][NEUTRAL] Like on your ID card, M E D L I N K.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You would click on that word.
[AGENT][NEUTRAL] Then you should see out to the right of your screen there should be a blue button that says download form.
[AGENT][NEUTRAL] And if you will click on that, it's going to open up your claim form and the top section on that claim form is donener has the instructions.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For the additional documentation that you will need to provide us.
[CUSTOMER][NEUTRAL] OK, so then I just print those out, oh, go ahead, I'm sorry.
[AGENT][NEUTRAL] Now, I
[AGENT][NEUTRAL] Mhm. No, no, no. So yes, ma'am, you just complete your claim form, attach the additional documentation.
[AGENT][NEUTRAL] That's required now I can tell you and there is a copy of your policy you said you had just set up your profile, but there is a copy of your policy certificate in your portal as well that you can download that has all of your benefit information.
[AGENT][NEUTRAL] Now, on durable medical equipment based benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I will tell you that you can see this in your policy, but disposable.
[AGENT][NEUTRAL] Or refillable.
[AGENT][NEGATIVE] Supplies would not be covered. It gives you a list.
[AGENT][NEUTRAL] And they
[CUSTOMER][NEUTRAL] Like Dexcoms because my daughter uses Dexcoms and omnipods.
[AGENT][NEUTRAL] If it's, I don't, I'm sorry, I don't know specifically what that is.
[CUSTOMER][NEUTRAL] Well,
[AGENT][NEUTRAL] But I'm just saying.
[CUSTOMER][NEUTRAL] They are disposable. I change them every 3 days.
[AGENT][NEUTRAL] Yes, ma'am. That would not be covered under this policy.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So disposable medical supplies.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so where I'm so sorry. I'm gonna look at this on the list it would tell me if it's covered or not, right?
[AGENT][NEUTRAL] No, no, you're fine.
[AGENT][NEUTRAL] Well, it tells you what the definition of durable medical equipment is, and then it lists out, let's see, 7, it's number 137.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So, uh, um, in the porthole, where do I, or like where to check that list?
[AGENT][NEUTRAL] OK, so you can click, you should have click on your policy number.
[CUSTOMER][NEUTRAL] OK, because I just went to I think it's.
[AGENT][NEUTRAL] And it has a PDF you should see a PDF icon. Now, let, let me ask you a question. Did has anyone emailed you the user guide for the portal?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK. Now, I will.
[CUSTOMER][NEUTRAL] I just kind of um went to your website or something and I just kind of I think built uh it said you know create an account so I created account so I'm not even sure if that's where I'm supposed to be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] No, yeah, you did. I can see that you've set up your profile, but I do have a user guide that gives you some more information on like the types of files that can be uploaded and step by step, you know, instructions of course I said you've already added in direct deposit information and opted in for text alerts and that information is included in this user guide as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But it's, it's just a helpful tool if you do have to file your own claim.
[CUSTOMER][POSITIVE] OK perfect.
[AGENT][NEUTRAL] As to the size of file and all that kind of thing.
[CUSTOMER][NEUTRAL] OK, and then
[CUSTOMER][NEUTRAL] Yeah and then on there would it be the when you send me that um will the list be on there too or I have to find the list on this thing?
[AGENT][NEUTRAL] OK, so when you go in, well, when you go to your portal, if you search the entire document, total pages, it's 28 total pages, OK?
[CUSTOMER][NEUTRAL] On the um portal.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The definition of what durable medical equipment is begins on page 12 of the, let's see, I think it's 12. Just one second. Let me make sure.
[CUSTOMER][NEGATIVE] So I don't see this. I don't know. I'm on my phone it's not working very well.
[AGENT][NEUTRAL] It starts on OK, and that's another thing you may not, I don't know, you may not be able to access it from your phone. You may have to do it from a computer because that is one of the things as well as far as uploading documents. You have to do that from a computer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But if again, if you search the total document, not just the page numbers that are on the lower right corner of your certificate, it starts, the definition of durable medical equipment starts on page 11 of 28 and then goes over to page 12.
[CUSTOMER][NEUTRAL] OK, and so when I go on there I just go, um, sorry, page 11.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And again, that's of the total document. Mhm.
[CUSTOMER][NEUTRAL] And so when I go, when I go on.
[CUSTOMER][NEUTRAL] So I go to total documents is the word I'm looking for.
[AGENT][NEUTRAL] No, you're looking, OK, if, do you know, OK, so.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, so your document is a total of 28 pages.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's actually starts on page 11.
[CUSTOMER][NEUTRAL] OK, but I'm just asking where do I find these documents? Sorry.
[AGENT][NEUTRAL] Of that total document.
[AGENT][NEUTRAL] Yeah, when you click go into your portal and click on your policy number.
[CUSTOMER][NEUTRAL] A policy number.
[AGENT][NEUTRAL] You should see a PDF icon that you can click on and it will download your policy information.
[CUSTOMER][NEUTRAL] You did say that sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great I'll look into that thank you.
[AGENT][NEUTRAL] And every, all of the definitions, yeah, all of the definitions are in alphabetical order, you know, like chiropractic, claims office. I mean, it, it goes in alphabetical order, so you're looking for durable medical equipment.
[CUSTOMER][POSITIVE] OK, durable medical equipment.
[AGENT][NEUTRAL] But if you
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][POSITIVE] Now I will be, I'm gonna send you this email in just a couple of minutes and um it will come from care team.
[AGENT][NEUTRAL] At a yes, [PII].
[AGENT][NEUTRAL] And I will put APL mhm care team, uh-huh, like a, yeah.
[CUSTOMER][NEUTRAL] What's that with a C Caine?
[CUSTOMER][NEUTRAL] OK, and
[AGENT][POSITIVE] Yes, like I care for you. Uh-huh, and I will put APL in your subject line so that that's easy to recognize.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] Awesome I appreciate that.
[AGENT][POSITIVE] And you'll get that in just a couple of minutes. Absolutely, you're very welcome.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And if you have any other questions when you get ready to submit a claim, you can call us back and we'd be more than happy to help you.
[CUSTOMER][NEUTRAL] I like
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Yes, ma'am. You're very welcome. So is there anything else, Miss [PII], I can help you with?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] OK. Well, thank you very much for calling APL and I hope that you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[AGENT][NEUTRAL] Bye-bye.