AccountId: 011433970860
ContactId: f5598dc4-139a-4eef-b263-90124b367f43
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 451040 ms
Total Talk Time (AGENT): 130569 ms
Total Talk Time (CUSTOMER): 186821 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/f5598dc4-139a-4eef-b263-90124b367f43_20250424T20:03_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] I'm doing good. See, I have a question. Um, I have something that I paid for, um.
[CUSTOMER][NEUTRAL] Like an ultrasound thing and I would like to submit the receipt, right? to see if maybe.
[CUSTOMER][NEUTRAL] Insurance.
[AGENT][NEUTRAL] OK, uh, do you have your policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, I do, uh, it's the group number, right?
[AGENT][NEUTRAL] And it'd be your policy certificate number?
[CUSTOMER][NEUTRAL] That's so weird. The card that I have says APL insured coverage group, effective date and plan. There's no uh.
[CUSTOMER][NEUTRAL] Policy number
[AGENT][NEUTRAL] OK, um, I can look it up by your last name or your social.
[CUSTOMER][NEUTRAL] OK, uh, the last name is [PII]
[CUSTOMER][NEUTRAL] [PII] and the first name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Will you spell that one more time? You were cutting out some, so I think I missed some.
[CUSTOMER][POSITIVE] Yes, of course.
[CUSTOMER][NEUTRAL] Uh the last name is [PII] and then [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And if you need the social, I have it too.
[AGENT][NEUTRAL] OK, yeah, let's try with that. I'm for some reason I'm not able to pull it up.
[CUSTOMER][POSITIVE] You got it.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I thought it was weird that I didn't have a policy number on these cards cause I was telling like my doctors for some other bills and they it was confusing.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] What did you find?
[AGENT][NEGATIVE] All right, my system is running just a bit slow.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] After maybe you can tell me the policy number and all the info because I don't have it.
[AGENT][NEUTRAL] OK. And what was your name?
[CUSTOMER][NEUTRAL] Uh, I'm the spouse of [PII], and it's, it covers [PII] and, and me.
[AGENT][NEUTRAL] OK. And what was your name?
[CUSTOMER][NEUTRAL] Uh my name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then the.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is it a claim for yourself?
[CUSTOMER][NEUTRAL] Um, let me see what this thing. I have it upstairs, so, I'm walking my dog. Yes, because we're pregnant. So this is for, I believe, an ultrasound. If not, it could be for, um, they did a genetic testing on the baby.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let me give you, uh, can you confirm your address real quick?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Do you have an old address maybe, but I don't have that address on file.
[CUSTOMER][NEUTRAL] You have [PII]
[CUSTOMER][NEUTRAL] He never changed.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is that the one you have? Yeah, that's not the address. We don't live, we haven't lived there in 2 years.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, do you have access to our portal?
[CUSTOMER][NEUTRAL] No, but if you tell me how, I will do it.
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] Now, he'll have to set it up because it has to be his social.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then his information it's based on his birthday, social.
[AGENT][NEUTRAL] Um, but I probably need to have him call in though because we don't have an email address, and since you're not the insured.
[CUSTOMER][NEUTRAL] And probably.
[AGENT][NEUTRAL] I have to take the information from him.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Because you're gonna need an email address to set it up um but I can tell you what we need to.
[CUSTOMER][POSITIVE] OK, no worries.
[CUSTOMER][NEUTRAL] OK, I'm gonna go upstairs and let him know. Yeah, tell me.
[AGENT][NEUTRAL] OK, so you have to have an explanation of benefits from your primary insurance when you submit the claim. So do you have like United Healthcare or um Blue Cross Blue Shield?
[CUSTOMER][NEUTRAL] We have [PII] Blue.
[AGENT][NEUTRAL] OK, [PII] Blue. OK, so you'll need, yeah, you'll need the explanation of benefits from Florida Blue.
[CUSTOMER][NEUTRAL] Yeah, sort of blue, yeah.
[AGENT][NEUTRAL] And then you'll need to submit the claim that shows like what procedure was done, where it was done at, um, the diagnosis, and the build charges.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, and then, then you can submit that for.
[CUSTOMER][NEUTRAL] OK, so I have the bill charged. The, the, so is it like a paragraph that we need to write? Who needs to write this? Because I have the receipt of what we paid.
[AGENT][NEUTRAL] No, no, it has to
[AGENT][NEUTRAL] It has to be from the doctor's office or hospital cause there's, there's coding that we need. We need like the diagnosis.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Um, coding for the
[CUSTOMER][NEUTRAL] OK, diagnosis, and what else?
[AGENT][NEUTRAL] I'd be like the whatever the coding is for your procedure that was done.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So you had an ultrasound testing, diagnostic testing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's uh, it was, I mean, yeah, ultrasound was one of the things, but the main thing I think was the, uh, I can't think right now. I don't know, they put needles in my stomach basically to check the placenta of the baby. But OK, I'll write this down and I'll get to this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Anything else I can help with today?
[CUSTOMER][POSITIVE] That's all, thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK