AccountId: 011433970860
ContactId: 6f2c7cdb-af8a-42e2-85e8-e109e5d31cb5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 479529 ms
Total Talk Time (AGENT): 170742 ms
Total Talk Time (CUSTOMER): 265964 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/6f2c7cdb-af8a-42e2-85e8-e109e5d31cb5_20250124T14:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling Etel [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, my name is [PII] and um I have some questions about the claim that I filed last night online. I messed up and I want you to talk me through that.
[AGENT][POSITIVE] OK, I can help you with that. Can I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Your policy number?
[CUSTOMER][NEUTRAL] It is 252-254-4.
[AGENT][NEUTRAL] Can I get your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Can you verify your address?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][NEUTRAL] And lastly, can you verify your email address?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], thank you for that. And you said you, um, messed up on the claim you submitted and you had a question?
[CUSTOMER][NEUTRAL] Yes, so the files that I was was that I was uploading, I had 4 of them.
[CUSTOMER][NEUTRAL] And um when I got to the part in the claim where it said upload files, I just shift and I clicked all four of them and upload, but during that it, it just looked like it took one of them.
[CUSTOMER][NEUTRAL] And so what my husband and I did was we went ahead and we just sent the other 3 again.
[CUSTOMER][NEUTRAL] I mean we uploaded those.
[CUSTOMER][NEUTRAL] And it uploaded 3 more claims.
[CUSTOMER][NEUTRAL] And I, you know, on the, on the screen when you're looking at it.
[CUSTOMER][NEUTRAL] You know, the
[CUSTOMER][NEGATIVE] Uh, I did not scroll over to the right to see how you could view the files that wasn't on my screen or I would have known better.
[CUSTOMER][NEUTRAL] So yesterday we we uploaded 4 different thing, 4 different uh claims I guess that's what it looks like to me because when I scroll over when and view the files and I see what we did. Do you, can you see it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, we have 4 claims that we received yesterday.
[CUSTOMER][NEUTRAL] OK, so the one if it's the same screen as what I'm looking at the one that.
[CUSTOMER][NEUTRAL] It's the 2nd 1 and it's the one that doesn't have a PDF um.
[CUSTOMER][NEUTRAL] Little picture by it. That one.
[CUSTOMER][NEUTRAL] Is the one that holds that must have been the first one I uploaded because it does have all four parts that I was trying to send.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And the other ones are just parts of that. Does that make sense?
[AGENT][NEUTRAL] Yeah, so I mean, so when we process them, I mean, we'll look at everything that you sent, um, regardless if it's like duplicates or anything like that. Um, so as long as you got everything sent in the 4 documents that you sent, that's fine. I mean, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Cause we go through all of them.
[CUSTOMER][NEUTRAL] It's OK that it looks like 4 separate claims, OK.
[AGENT][NEUTRAL] Yes, ma'am, because we process, when we start processing the claim, we pull all the claims for um whatever claims you have that was sent in, and we process them all at the same time.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] OK, alright, OK, that's great that's what my husband told me he's like, [PII], they'll figure it out and I'm like, well I just wanna check that out and make sure that that they can't just go in and delete the three that we don't need but only that second one has the actual claim form with it and I know that you'll have to have that form. The others are just pieces of it so um while I have you on the phone um.
[CUSTOMER][NEUTRAL] I would like to um now another person told me and I haven't done this yet, this is something different than [PII]'s cancer claim here it's the wellness claim and um I never have turned those I haven't turned those in over the years, but I would like to and they said it was, you know, we could go back as far as maybe 10 years, I don't know, but um.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It said when I was looking in there, so I fill out a a wellness claim.
[CUSTOMER][NEUTRAL] But do I need a claim for each year?
[AGENT][NEUTRAL] No, ma'am. So, um.
[AGENT][NEUTRAL] You can put them all on the same. You can just put the dates on there.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And submitted this cause, I mean, yeah, so you can go back as far as when your policy first started, which I'm looking, you had a policy since [PII].
[AGENT][NEUTRAL] Um, so what's gonna happen is that, just say if you send some back for each year, we're gonna make copies of
[AGENT][NEUTRAL] Um, the first because we have to attach them to the correct policy, since you have, since you've had several policies.
[AGENT][NEUTRAL] Um, so, so the question is, I mean, so the answer is no, you don't have to send one for every year. Um, I mean, if you can fit them on the, the claim form, write them on there, or if you wanna attach like a, a sheet of paper, um, and write them on there and just make sure you put the, the doctor's name or the facility that you have the, the, the testing done.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] Um, that will be fine.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, um, on the claim form it asks you know on here the what what the test performed and I would maybe put mammogram or uh yeah uh or a colonoscopy or whatever it was and and so on the date for the mammogram what I just put like a range of years there?
[AGENT][NEUTRAL] Um, no, you have to put the specific date that you had the mammogram done.
[AGENT][NEUTRAL] Because what is um on the policies, yes, ma'am, because uh it only allows for one test per year, so we have to have like the date um that it, that it was done, um, because that's how we entered into the system.
[CUSTOMER][NEUTRAL] On the claim form
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Back to my question then at the beginning, so, uh.
[CUSTOMER][NEUTRAL] I, I need if I had like 10 mammograms over the last 10 years, I need, I'm gonna need a claim form for each one of them.
[AGENT][NEUTRAL] No, ma'am, you don't have to send a claim form for each.
[CUSTOMER][NEUTRAL] To give you the date of service.
[AGENT][NEUTRAL] No, you don't have to send the claim form for each one. Like I said, you can use one claim form and you can just, if you had to say 10, you can put as many on that front page or like, and if you, if you can attach, you can attach, like I said, another paper and write the others on there as long as you have the dates and the name of of the facility you had done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, and if something that that I'm doing is not right, y'all will contact me, right? So I can fix it.
[AGENT][NEUTRAL] Um, we will, um, we'll send out a letter to let you know that we need something else. Um, we don't necessarily call, but I mean if you wanna call us, um, say if you send something in.
[AGENT][NEUTRAL] And um you think it's incorrect, um, you can keep track online, but also, I mean, if you like call like about a week after you send it, um, normally it's processed by then.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] All right, I can do that then. All right, well I appreciate that you've been most helpful.
[AGENT][POSITIVE] No problem Miss [PII]. Was there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, that's good. I'll just check in later. Thank you.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Alright, no, no problem, thanks for calling A. You have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. Uh-huh, bye-bye.
[AGENT][NEUTRAL] Uh-huh. Bye.