AccountId: 011433970860
ContactId: 14f12b8e-07a7-4298-a60a-f2093790d0ee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 380140 ms
Total Talk Time (AGENT): 229173 ms
Total Talk Time (CUSTOMER): 140597 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/14f12b8e-07a7-4298-a60a-f2093790d0ee_20250303T14:27_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Um, I have a question about, I was uploading a file for um medical claims for GAP.
[CUSTOMER][NEUTRAL] And it's the first time I've done it, OK, so I uploaded, I uploaded, um, you know, the, the, uh, UB from my primary insurance and the statement from the doctor's office that shows the diagnosis code, but I did not upload anything like there's a med claim form. I'm doing this online, do I need to, um, there was like a med claim form that I have to fill out this is who I am and who am I.
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The insured it like my husband's the prime the insurance who's the insurance is through, do I have to fill that out for each one of these I process if I do it online is that automatic?
[AGENT][NEUTRAL] Well, it's, you need to fill one out for one of them. Um, [PII], what is your policy number? I could look it up, I just wanna make sure that everything's going through properly.
[CUSTOMER][NEUTRAL] Sure, it's 025.
[CUSTOMER][NEUTRAL] 72506
[AGENT][NEUTRAL] Thank you. And uh if I could just verify your date of birth and the phone number, please? I wanna make sure I get the right file.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] Yeah, [PII] [PII] and my uh phone number [PII].
[AGENT][POSITIVE] Perfect, thank you. And we're doing this, uh,
[AGENT][NEUTRAL] Let's see. These are files that you're putting in for yourself, is that correct? I see that you've got several of them here. OK, yes, so, um, so you just need to do one of them, OK? You, you, there is a, there is a file that we do ask you to fill out that that Medin, um, file, but you just need to file it out for one of them. You don't, uh, you don't need to do it for all. uh, so if you don't mind doing it just for one of them, it doesn't, it doesn't uh populate automatically. So if you don't mind, uh, just doing it for one.
[CUSTOMER][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, then we will attach it to all the other files, um, and then we would be good from there, but just, just one, yeah.
[CUSTOMER][NEUTRAL] OK, so I'll, I'll do it for the, the one that was dated earliest maybe and um but I don't know how to, I, it's gonna be a separate file upload it's not gonna be um.
[AGENT][NEUTRAL] No, that's fine. Yeah, we do understand that.
[CUSTOMER][NEUTRAL] I, because I don't know how to attend.
[CUSTOMER][NEUTRAL] I don't know how to append to something that's already there.
[AGENT][NEUTRAL] Right, absolutely, no, you don't have to. If you, if you will just go ahead and, and, uh, send it, um, just send it through separately, that will be fine. Um, we just need to, you know, we'll we'll just look and find it whichever whichever submission it is, and then we'll just put it in with the rest of the files, um, but you do not need to fill out, uh, one for each, uh, claim. You can do 11 claim form and then submit um a dozen different dates if if you wanted to do that.
[AGENT][NEUTRAL] Does that make sense? I mean, you don't have to do, you, you, you have to fill out once per per submission. I mean, uh per um uh a group of of claims that you're filing.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK, but when I file the claims, like I had 6 different dates, can I put those all up in one file upload?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, yes, absolutely, yes.
[CUSTOMER][NEUTRAL] OK, so if I have because I have a statement which covers like all of my.
[CUSTOMER][NEUTRAL] Um, appointments and then I have, so I would do, I would send a statement, then I would send, let's say 10 EOBs and one of these claim forms this uh.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, it says the signature, it can be an electronic signature or do I have to, um, do I have to print it, we sign it and we.
[CUSTOMER][NEUTRAL] Scan it back in.
[AGENT][NEUTRAL] There should be a way to do the electronic signature. I think it actually will, will um give you that option. So the electronic signature is fine.
[CUSTOMER][POSITIVE] Fantastic. OK, how will this know it doesn't say like the dates that I'm submitting these for.
[CUSTOMER][NEUTRAL] This claim form that's got my, you know, that doesn't have, it's not tied to a claim of ser uh a data services med claim form me link claim form.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see, because there's usually um.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] There should be one, that, OK, so what we're doing is we're just doing the med link one. Let me just check it because I thought there's a place on there you could fill out that, let me see. I'm just gonna download the form really quickly here and see. OK, so, um.
[AGENT][NEUTRAL] I'll ask you about the patient and there should be.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, if you don't, uh, normally what people will do, um, on these forms, uh, where, you know, where it has the place about the, about the insured, the statement of insured, and then in section B it says about the patient, um, and then, uh, there's a place for your electronic uh signature, um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, that should be fine because I think these new claim forms, uh, the old ones that, uh, that I'm really used to seeing more often, uh, do have a, a, a list of dates. These, these don't. And so you don't have to worry about that. Uh, what we're doing, what you're doing is that you're giving us, uh, authority to look at your, um, uh, medical records simply for the purpose of, um, that you're acknowledging that you're, that you're sending a claim to us and uh that you are giving us the, um, uh.
[AGENT][NEUTRAL] Authority, so to speak, uh, to look at your um your claim forms and your ELBs for the purpose of paying a claim. So that's what these new forms are, yeah, and, and I think it, I think they took that section out where they had a list of of the dates and things like that because we usually will find that on the EOB anyway, um, so that's, so these new forms, it looks like they have taken that out so you should be fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, what we will do is we will find, we're gonna look for the dates of service going by your EOBs.
[AGENT][NEUTRAL] And um any EOB that you send to us we will acknowledge uh and put onto the the claim form and then process so that should be uh that should be no problem.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, wonderful. I appreciate it you're fantastic. Thank you so much.
[AGENT][NEUTRAL] Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Not yet, not yet. Probably once I find out if these all get processed, I'll let you know, but.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely. OK, well, [PII], thanks for contacting ATO. You have a good
[CUSTOMER][NEUTRAL] OK.