AccountId: 011433970860
ContactId: 41c6759c-c3b7-48ca-a8e1-2c5c2fe740df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 489010 ms
Total Talk Time (AGENT): 254425 ms
Total Talk Time (CUSTOMER): 227628 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/41c6759c-c3b7-48ca-a8e1-2c5c2fe740df_20250122T16:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, hi, um, I just want to make sure because I'm just confused, uh, the APL is GA Insurance, correct?
[AGENT][NEUTRAL] Uh, we offer a bunch of different insurance policies. I would be able to know when, if I can pull up your policy number.
[CUSTOMER][NEUTRAL] 00, would that, oh, would that be the policy num uh certificate number?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] 002583032
[AGENT][POSITIVE] Perfect. Let me pull that up real quick for you.
[AGENT][NEUTRAL] And would you just be able to verify for me please your first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] Last name is [PII], [PII]
[AGENT][POSITIVE] Thank you, Miss.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Wonderful. And I do just have to verify a couple other pieces of information before I can go into detail on your policy. If you could verify for me your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then the other two things, Ms. [PII], it's just the email and phone number on file.
[CUSTOMER][NEUTRAL] [PII] and then [PII].
[AGENT][POSITIVE] Perfect. I really appreciate that. And yes, this coverage on your policy is a gap insurance.
[CUSTOMER][NEUTRAL] OK, and I can go back and submit anything from when I first started the insurance that's what someone there told me. I just wanna confirm.
[AGENT][NEUTRAL] Uh, yes, we do not have a timely filing limit, so you're welcome to submit claims. It looks like you've had continuous coverage with us since [PII]. So as long as the date of services while you were, um, covered with us, we'll be able to process claims for you.
[CUSTOMER][NEGATIVE] OK, and then my, I asked my um insurance company for explanation of benefits and they sent me every single thing I've ever put in a claim for or I guess you guys or or my.
[CUSTOMER][NEUTRAL] Provider, so I have like a book that they sent me in the mail. So should I just send you all of that in the mail because that's gonna take forever to upload or just go through everything and just get what pertains to the gap insurance. What do you suggest?
[AGENT][NEUTRAL] Um, I would suggest like sending it all out, um, along with the explanation of benefits, you are gonna need itemized bills from your provider's office and your.
[CUSTOMER][NEGATIVE] Uh, yeah, I have all that. Well, I don't have everything, but I have, everything is now, uh, it's like such a mess because I asked them to mail it and then some of them sent it by email, so I have to like get everything together. Um, but what do I do with the card, the APL card? Like I have to go for a biopsy today. So, and I just happened to to receive in the mail you guys sent me, um, I guess my ID cards. So I have to, I give that to them at the doctor's office.
[AGENT][NEUTRAL] Together.
[AGENT][POSITIVE] I would give it out like [PII] anytime you go anywhere that they're going to bill your major medical insurance, I'd make sure they have your APL card because it's a lot easier for them to like handle filing claims on your behalf than it is for you to have to like track down all the documents. um, so yeah, I'd give it out anywhere.
[CUSTOMER][NEUTRAL] Oh, so I have to literally give this to them for them to keep, or do I just have them because these are like.
[AGENT][NEUTRAL] Well they just typically scan it or enter in the numbers and then they give it back to you.
[CUSTOMER][NEGATIVE] Oh, cause you are like stickers, they're sticky, like I don't understand. Like I take them off and they're like sticky, like I could stick them on something. What am I missing something?
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] No, I'm not really sure.
[CUSTOMER][NEUTRAL] Oh, am I supposed, oh, I have to stick these together, OK.
[AGENT][NEUTRAL] Maybe they go over
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] One's the front and one's the back, right?
[AGENT][NEUTRAL] OK. I, I've never um had like the, the physical, I've never seen a physical ID from what I do, but that would make sense. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's what they did. I just figured it out. Yeah. OK, got it. Alright, so now it's a card, it's not exactly even but well well.
[CUSTOMER][NEUTRAL] OK, I get it. OK, so I give this to them and then they just hold on to this and and then when I'm there I get a super bill from them.
[AGENT][NEUTRAL] So I would give it to, like when you go into your appointment, I'd say like, hey, this is my secondary insurance can be filed, they'll typically just scan the card and give it back to you, um, and then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I would, what they have to do is they have to file with your major medical, wait for your major medical to send an explanation of benefits back to them, and then they file secondary with us, um, and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh OK so they'll file it with you.
[AGENT][NEUTRAL] Yeah, so if you give them the card, they should file it with us.
[CUSTOMER][NEUTRAL] And they
[CUSTOMER][POSITIVE] OK, so I don't have to worry about sending all that stuff then.
[AGENT][NEUTRAL] Yeah, so all the stuff from the past like um that your major medical sent you um information on, go ahead and send it to us and we'll read through it. Anything we need more information on we can request more information on and then anything going forward, I would just have that your provider's office make copies of your card or put it in your file, um, so that way you they can do all the billing for you and you don't have to worry about it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, alright, and then if I do mail it to you, um, I mean it's a lot, so it's probably gonna be expensive to mail it all, but um.
[CUSTOMER][NEGATIVE] Which I don't know if it's worth to, to mail it, but it's also so much to scan.
[AGENT][NEUTRAL] You might fax it. I mean, I wouldn't recommend mailing out all your original documents, um, just in case something gets lost in the mail and then you have to like request it all again.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, yes, yeah. I'll have to scan it then. I'll have to go, I, I'll have to go through my insurance and just go through everything and I'll just take out all the pieces, but when I send it to you, it doesn't have to be in any order, right? I could just piecemeal and just send it all over and you guys will do that.
[AGENT][NEUTRAL] Um, so you might fax it.
[AGENT][NEUTRAL] Yeah, yeah, they'll read through it.
[CUSTOMER][NEUTRAL] Alright, so I have to scan everything and get it to you now. What if I just start sending like, can I just start like putting like uploading stuff as I have it and then send it over?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, there's a file size limit I believe it's 20 megabytes um so you can just like upload to that file size limit and then hit send and like as as we get it we'll go through um each item.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK and then how long after, so do you guys literally reimburse me?
[AGENT][NEUTRAL] If you submit the claim, we reimburse you. Yes. If the provider submits the claim, we send the payment to the provider.
[CUSTOMER][NEGATIVE] Oh, but what if I've already paid? Oh, hold on one second, hold on 10 no, never mind. But what if I've already paid, oh no, because I'm not paying them up front today, so.
[CUSTOMER][NEUTRAL] What if I've already paid them?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then they send it to you.
[AGENT][NEUTRAL] If you've already paid them and they send us the bill, um, typically they would, I mean, in good faith that they would reimburse you the money you already paid them.
[CUSTOMER][NEUTRAL] OK. Sure, sure. OK. All right, very good. So I'll start, um, I will start getting stuff uploaded and how long after usually you receive everything you need, do you start, do you, uh, send me a check?
[AGENT][NEUTRAL] OK, yeah, absolutely, so turnaround time on average is 7 to 10 business days, um, and that would just be for like a single claim if you we're getting a couple of years of backlog information it could take them a while to go through it.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, and just put everything together, um, but typically like from here on out if you have, you know, you go to your appointment today and they're like, oh we're not gonna file, you know, secondary, we don't do that and you have to get the paperwork and you just submitted the one claim it is 7 to 10 business days on average.
[CUSTOMER][NEUTRAL] Sure, sure, no, absolutely.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so do I get, so do I get anything from them today, the super bill or do I wait until my benefits, um.
[CUSTOMER][POSITIVE] Well, I can at least get the super bill from them today, correct?
[AGENT][NEUTRAL] You can, but if they are willing to file like if they will file secondary, um, you should like they'll just have all that paperwork and they'll submit it to us, um.
[CUSTOMER][POSITIVE] OK, excellent. Alright, wonderful.
[CUSTOMER][POSITIVE] All right, very good. All right, thank you so much. I appreciate your help. Thank you.
[AGENT][POSITIVE] Oh, it's my pleasure. If there's anything else you need help with along the way, just give us a call back and we'll do our best to take care of you, OK?
[CUSTOMER][POSITIVE] Thank you so much. Bye-bye.
[AGENT][POSITIVE] My pleasure bye bye.