AccountId: 011433970860
ContactId: 101628ae-1a9a-4c58-afcc-d610938b2e91
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 806859 ms
Total Talk Time (AGENT): 366164 ms
Total Talk Time (CUSTOMER): 392204 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/101628ae-1a9a-4c58-afcc-d610938b2e91_20250205T20:51_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], this is M40. I'm trying to make a submission for a claim on the website, and I keep getting a message that says oops, there's been an error. Looks like we're experiencing technical difficulties that if we continue to experience the difficulties to call the customer service option 4, and that's what I'm doing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're the insured and you're trying to submit a claim that it's giving you an error message?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Yes, ma'am. I can help you with that. And who am I speaking with again, please?
[CUSTOMER][NEUTRAL] You can unplug my
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Can you spell your last name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your policy number?
[CUSTOMER][NEUTRAL] The policy number will be 02458531 M as Mary L as in Larry the number 8.
[AGENT][NEUTRAL] Thank you. One moment while I pull up your information. I will need to verify several things with you first, [PII] for security purposes. So first off, if you could please verify your date of birth.
[CUSTOMER][POSITIVE] Not a problem.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, what is the street address again? I believe we have something different.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] [PII]. You're looking for my address, right? My home address.
[AGENT][NEUTRAL] OK, thank you. That's fine.
[AGENT][NEUTRAL] Yes, ma'am. And then your phone number that we have is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you and lastly your email address?
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK, so what is it again?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, Ms. [PII], are you trying to upload your information from a computer or from your cell phone?
[CUSTOMER][NEUTRAL] It's a Mac, it's a computer.
[AGENT][NEUTRAL] OK, so, and what do you use real detailed instructions on uploading information into the portal?
[CUSTOMER][NEUTRAL] I said it's a user yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Has anyone ever sent you our user guide for the portal on explaining how to not only set it up but then also the steps on uploading information?
[CUSTOMER][NEUTRAL] Yes, I've already submitted a claim, a claim before.
[AGENT][NEUTRAL] So anyone ever emailed you that from our company?
[AGENT][NEUTRAL] Miss [PII], can you still hear me?
[CUSTOMER][NEUTRAL] Yes, I can still hear you, um.
[CUSTOMER][NEUTRAL] I believe I did. There are instruction with the, yeah, I did, I did.
[AGENT][NEUTRAL] You do, OK.
[CUSTOMER][NEUTRAL] I did, yeah, I got an email with the form.
[CUSTOMER][POSITIVE] Yeah, I already have submit a claim and it was approved.
[AGENT][NEUTRAL] OK, so it may are you trying to upload different types of documents on your upload?
[CUSTOMER][NEGATIVE] I need to submit a claim, submit a claim. The requirement to submit a claim is the explanation of benefits, the form from APL and then the bill and the diagnosis. That's your procedure. I'm trying to upload those documents in order to submit a claim. I have already done that in the past as long as this you can see it was already approved, but every time I try to submit a claim, the website is giving me an error.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm not uh so have you tried to maybe submit instead of uploading it all together, all of your documents together to upload it with in multiple documents?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Thank.
[AGENT][NEGATIVE] I mean, multiple uploads sometimes.
[CUSTOMER][NEUTRAL] Yes, I did.
[AGENT][NEUTRAL] So you've tried to upload one page at a time and you're still getting that?
[CUSTOMER][NEUTRAL] But you mean like, let me see one second. Maybe you mean like um
[CUSTOMER][NEUTRAL] Um, complete the submission. I cannot upload the one page and complete the submission. It will take the whole claim, so I did submitted one at the time, but then I had to press at the end that it was completed and then send everything to the website.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Eli.
[AGENT][NEUTRAL] OK, so I'm not sure why you're receiving that error message, Ms. [PII], um, if you
[CUSTOMER][NEGATIVE] That's, that's concerning.
[AGENT][NEUTRAL] So try to just upload one of your, maybe just the claim form by itself.
[AGENT][NEUTRAL] Our system will know to tie them all together. I'm trying to find to determine if there could possibly be something wrong with one of your files and that's why it's not letting you upload it all together.
[CUSTOMER][POSITIVE] I'm gonna have a, I have, I'm gonna have someone that helps me talking to you. She, she's right. Uh, her name is [PII], she's gonna talk to you. Hi, how are you?
[AGENT][NEUTRAL] Hi [PII]. So Miss [PII] has given, Miss [PII], can you still hear me?
[CUSTOMER][NEUTRAL] Hello. Hi.
[CUSTOMER][NEUTRAL] I can hear you. You're on speakerphone.
[AGENT][NEUTRAL] OK. And, OK, and you are authorizing me to speak to [PII] to assist in helping to upload?
[CUSTOMER][NEUTRAL] Yes, I already stated that yes.
[AGENT][NEUTRAL] OK, so [PII], what I suggested was that she upload since it's not accepting all of the documents in one upload to break them up into multiple uploads so we can see if possibly there's.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, so what happens
[CUSTOMER][NEUTRAL] So we've done that. So we we're at the file the claim part and you hit your claimant you do next, you have the thing you read and then it's a select files and if we upload them one at a time, they all they all load and they show it uploaded and then there's the part uh the final part on the bottom where it says submit. We hit submit.
[CUSTOMER][NEGATIVE] And then it goes to an error message on the screen about that she told you and it says please contact if you continue to get that so we haven't been trying to upload them as one large document we have been doing them as four separate documents, um, and the thing is is we're not going to submit one document at a time for them to be told that our process is incomplete.
[CUSTOMER][NEUTRAL] Um, so, and we did this previously last week I believe, and everything was fine. It worked and everything was approved, so we're not new to this. We're just trying to figure out why it's not working and we're getting an error message because when we go, so we have.
[AGENT][NEUTRAL] OK, now on the policy, so on the policy number that we're looking at, there has not been anything uploaded to this policy since [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, she's not looking, she's not even looking at [PII]. She's looking at myself. This is for my daughter, [PII] who was you.
[AGENT][NEUTRAL] OK, so you had not indicated, Ms. [PII] that it was for another member you
[CUSTOMER][NEGATIVE] I'm sorry this is taking forever and we're talking about a lot of things and we're not on the, on the problem and you're not familiar with the error and that concerns me very much like what came for you, you said yourself you were not familiar with the error.
[AGENT][NEUTRAL] [PII], I'm very much.
[CUSTOMER][NEUTRAL] So if I, I, so now that we know it is for a.
[AGENT][NEUTRAL] Now, ma'am, I'm from
[AGENT][NEUTRAL] OK, I, I'm trying.
[CUSTOMER][NEUTRAL] So I see here we have confirmation number Oscar 9692652 service date [PII] [PII] Policy number is here date.
[AGENT][NEUTRAL] Yes, ma'am. I'm looking now at [PII], but it was not indicated initially that the claim was not for Miss [PII].
[AGENT][NEUTRAL] So on her profile that I was looking at there's not been anything updated since I I mean uploaded since October. I can see now that I'm looking at the correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And we know.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Now that I've been given the correct patient, I can see that.
[CUSTOMER][NEUTRAL] Yeah I'm gonna give you a pen. Yes, so we, um, so we did do an upload and like I said, the date was completed and not paid out. Everything is done properly on this one we're trying to do the exact same thing. We're getting the error.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so again, my concern is that there could possibly be something wrong with one of the documents that is included in your upload.
[AGENT][NEUTRAL] So the only way to really troubleshoot that would be to see if we could upload if it would let you go through the full step and submit.
[AGENT][NEUTRAL] By not submitting so many documents.
[CUSTOMER][NEUTRAL] Um, OK, my only concern is then, um, you guys are gonna say that the file is not complete because this happened last time.
[AGENT][NEGATIVE] That is not correct.
[AGENT][NEUTRAL] OK. Well, it should, because we, our system.
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEGATIVE] It should, but should it not, is not good because, yeah, so this happened last year and she's missing a couple 1000 because she was told that it should and then the time went to come and it didn't work out that way because here it even says.
[CUSTOMER][NEUTRAL] You know, verify date of service claims should be uploaded as separate claims, um, diagnosis code acceptable files. Please note missing documentation may delay the processing of your claim. So if it's not all in the same files that says submit, it's gonna be known as missing.
[AGENT][NEUTRAL] Yes, and
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Again, the system should be able to see that those because a lot of times people will not submit all of the required documentation that's necessary, so they have to resubmit anything that's missing and the system will know that that is all together. I'm just trying to determine if there's something wrong with one of the files and that's why it's not letting you do that one upload.
[CUSTOMER][NEUTRAL] Can we email um instead of uploading.
[AGENT][NEUTRAL] Cannot email claims now ma'am, for security purposes email we cannot receive emails via I mean excuse me claims information via email. Now there is a secure fax line on the bottom of the first page of the claim form.
[AGENT][NEUTRAL] That you can send it to?
[CUSTOMER][NEUTRAL] The first.
[AGENT][NEUTRAL] If you want to fax it. mhm on the bottom of page one, you should see where it says [PII].
[AGENT][NEUTRAL] You can put attention claims.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] Are you aware of any technical problems on the website or no?
[AGENT][NEUTRAL] No, ma'am. This is the first time I've talked to anyone that has experienced that.
[CUSTOMER][NEUTRAL] Do you know what's the maximum MB that can be um uploaded at one time?
[AGENT][NEUTRAL] I do and it's in that user guide that Ms. [PII] said she had received but the maximum size again would be 20 megabytes.
[CUSTOMER][NEUTRAL] We are under that, um, and that can be a PDF and a.
[AGENT][NEUTRAL] That's what I'm saying. I have had, I have had where people were not able to upload multiple different pages like that for whatever reason, but when they tried to break it out and submit it.
[AGENT][POSITIVE] Separately, then they did not have a problem.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] But if you don't want to do that, then the next quickest option to get it to us would be to fax it to that secured fax line.
[CUSTOMER][NEUTRAL] I can still try to change the format of the documents and see if they take it right.
[AGENT][NEUTRAL] I'm sorry, can you ask that again?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I can still try to change the format of the docs and try again, right? Of the PDF.
[AGENT][POSITIVE] You can. Yes, ma'am, you could.
[CUSTOMER][NEUTRAL] Can you remind me, can you remind me PDF are allowed and JPEG are allowed, right?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] That is correct. They are.
[AGENT][POSITIVE] And sometimes it may not, if you have multiple types of different files, that may be it. Again, I cannot say for sure. That's why I was recommending that.
[CUSTOMER][NEUTRAL] Alright, we're gonna play with a little bit, and then if it doesn't work, we're gonna fax. Do you have any suggestion for the faxing?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What do you mean suggesting you would send it to that you would fax it to that fax number and put attention claims.
[CUSTOMER][NEUTRAL] Yeah, that's what I meant.
[CUSTOMER][NEUTRAL] And then how long would we see that it was updated in the portal that you guys received it?
[AGENT][NEUTRAL] Updated in the portal, you would see it instantly. If you fax it in, it can take up to 24 hours for us to for it to be processed, you know, and placed on her profile where you would be able to see that.
[CUSTOMER][POSITIVE] Perfect. Alright, thank you very much for your patience. Have a wonderful day.
[AGENT][POSITIVE] You're very welcome and thank you both for calling APL. I hope you both have a very nice evening.