AccountId: 011433970860
ContactId: f32c6203-ee90-4950-b975-339a9a8949c9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219970 ms
Total Talk Time (AGENT): 84626 ms
Total Talk Time (CUSTOMER): 115057 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/f32c6203-ee90-4950-b975-339a9a8949c9_20250325T21:57_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] To see if I can
[CUSTOMER][NEUTRAL] Hi, um, I am, I'm fairly new to um having the gap insurance, um, and I had a chiropractor appointment yesterday that included X-rays that apparently were not covered by my insurance. So I was wondering if I am able to submit that, and if so, how I go about doing that because they said they couldn't do it from their office, so.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I'd be happy to assist with um how to file a claim today. Um, may I have your policy number please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes, it is. I'm sorry. I put my card away, uh, policy number is that the payer ID?
[AGENT][NEUTRAL] Um, no, it would say inpatient or outpatient benefit certification number.
[CUSTOMER][NEGATIVE] Uh, that is, oh, no.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, OK, um, this would be outpatient then I guess, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it's 02506886.
[CUSTOMER][NEUTRAL] M L H
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] And if you can please verify your name, date of birth, and email address.
[CUSTOMER][NEUTRAL] Sure, her name is [PII]. Date of birth is [PII]. Uh, I don't know if you my Gmail or my work email. Uh, the work email is [PII] the [PII]. It's [PII].
[AGENT][NEUTRAL] It's a [PII].
[AGENT][POSITIVE] Thank you for that alright.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you said um.
[AGENT][NEUTRAL] So they're not willing to file the claim. OK, so you just um let them know that you'll need the um diagnosis code?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, for that visit. And then once, um, has your major medical filed the claim yet?
[CUSTOMER][NEUTRAL] Uh, yes, they have.
[AGENT][NEUTRAL] OK, so then we'll need the explanation of benefits from that data service along with that diagnosis and um if you're registered with the online service center you can upload it um those documents on there. If not, you would have to either fax it in or mail it in by paper mail.
[CUSTOMER][NEUTRAL] Um, OK, so can I, is that the, uh,
[CUSTOMER][NEUTRAL] How do I register for that if I'm not in it?
[AGENT][NEUTRAL] Um, it's the [PII].
[CUSTOMER][NEUTRAL] Yes, uh.
[AGENT][NEUTRAL] Website.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and you're gonna use that email that we have on file, the Gmail email, your social, your zip code, um, what else does it ask for?
[CUSTOMER][NEUTRAL] OK, second.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Birthday, I think maybe.
[CUSTOMER][NEUTRAL] OK, things I should know.
[AGENT][NEUTRAL] Yeah, right.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, OK, so I can register on there and then just get all the info from the provider and then upload it.
[AGENT][NEUTRAL] Right. So we just need the diagnosis and the explanation of benefits.
[CUSTOMER][NEUTRAL] That way, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and they should have the EOB if it's been.
[CUSTOMER][NEUTRAL] I mean I know they already got everything back from.
[CUSTOMER][NEUTRAL] The visit cause they got it while I was there.
[AGENT][NEUTRAL] Um, I don't know if they'll give you that, um, since you have access to it.
[CUSTOMER][NEUTRAL] OK, but it should be on file with the oh, I, I have it. OK, right, right.
[CUSTOMER][NEUTRAL] Um, OK, I will.
[CUSTOMER][NEUTRAL] Try to get all of that and file the claim.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK, uh, no, that should be all.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] All right thanks you too.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Alright bye.