AccountId: 011433970860
ContactId: 6052a0ec-67ce-4b28-981a-2fbeca84e66c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256700 ms
Total Talk Time (AGENT): 102355 ms
Total Talk Time (CUSTOMER): 125639 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/6052a0ec-67ce-4b28-981a-2fbeca84e66c_20250218T15:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public. This is. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling, um, I have a medical claim that I'm not 100% sure if the doctor's office has submitted it to you guys over there, um, at American Public, but, um, I just got off the phone with my primary insurance, and they had recommended for me to call you guys directly, um, and maybe provide the EOB to see if GA will cover any of the costs.
[AGENT][NEUTRAL] OK, may I have your policy number and I'll get your file pulled up.
[CUSTOMER][NEUTRAL] Yes, ma'am. Give me one second. Um, so it's gonna be 02564459.
[AGENT][NEUTRAL] May I have your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes ma'am. So my name is [PII] and my cell phone is [PII].
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] So, can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] Yes ma'am, um, so [PII] and address [PII] and my email is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. And do you have the data service?
[CUSTOMER][NEUTRAL] I do, yes, ma'am. So it was gonna be [PII].
[AGENT][NEUTRAL] OK, and as of right now, I do not show that claim in history, so there are 3 items that you would need to submit this claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You would need your itemized bill from your provider.
[AGENT][NEUTRAL] You would need your primary insurance explanation of benefits.
[AGENT][NEUTRAL] And then you would need the Medlink claim form, which you can obtain online at [PII].
[AGENT][NEUTRAL] With those 3 items you can file the claim yourself.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. And um where do I submit it when I'm ready to file it?
[AGENT][NEUTRAL] If you register your account, you can upload the claim there.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] You can fax it or you can mail it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And just out of curiosity, um, I think that I have all of this that I need besides the claim form that I can pull. Is it, I guess my question is, does it, is it, uh, does it matter whether it's sent in by the patient or by the provider like within like time frame or anything like that because the doctor's office has submitted has finally sent me a bill, um, so I just don't know if it'd be any quicker. Is there any difference in time processing time from the provider from the patient.
[AGENT][NEUTRAL] No, ma'am. Whichever submits the claim first.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's how it's processed. So you can actually tell the provider to submit on your behalf or you can file on your behalf.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, all right. Well, I
[CUSTOMER][NEUTRAL] I had called them and asked them to submit it and I just, I guess they have it so I may just go ahead and try to do it on my end uh and is there a way that I can see like what will be the information when I know whether gap's gonna cover some of it or not.
[AGENT][NEUTRAL] So if you go to [PII].
[AGENT][POSITIVE] Register your account. It'll walk you through step by step. You can actually upload and submit your claim there, and you can always see everything that's in your account. You can see the provider that submitted it, the EOBs, you can get your ID cards, everything is there.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, perfect, alright, well I think that that is it, so I will try to get that filed today.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] I think that's it.
[AGENT][POSITIVE] [PII], thank you so much for calling American Public Life. Have a great day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][NEUTRAL] Bye bye.