AccountId: 011433970860
ContactId: 74b1e377-c006-4193-8909-a047873ba2a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1553280 ms
Total Talk Time (AGENT): 848563 ms
Total Talk Time (CUSTOMER): 611277 ms
Interruptions: 8
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/74b1e377-c006-4193-8909-a047873ba2a0_20250212T13:41_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] Hi, you said your name is [PII]? Is that correct?
[AGENT][POSITIVE] That's correct. Yes, uh-huh. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I was calling uh because I, so I've been, I've recently been dealing with uh a couple of medical issues, um, and in that process, I was under the impression that when I scanned my AMed card, it would, it would, it would automatically um update with my gap insurance.
[CUSTOMER][NEUTRAL] Uh, which evidently wasn't the case. Uh, I'm, I'm finding out this now. Um, and I've been approved throughout the whole process. I mean, I could, uh, you know, once we go through it, I could, to be able to see that I've had the gap insurance that would be able to help me cover it. I was wondering how do I go about the process to maybe, uh, make the claim to see what the actual balance is or the coverage would cover.
[CUSTOMER][NEUTRAL] That makes sense.
[AGENT][NEUTRAL] OK. Yes, yes, it does. Um, now the first thing that we're going to need, of course, is your um policy number. So do you have that there with you, um,
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It should begin with a 01 or 02.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Your APL card?
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][POSITIVE] Yeah, I should have it here. Just give me one sec.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][POSITIVE] It is yes.
[CUSTOMER][NEUTRAL] Uh, it is, uh, would it be a group number? Would it be a group number?
[AGENT][NEUTRAL] No, it begins with a 01 or 02. It might be listed as a member number or a policy number, um.
[CUSTOMER][NEUTRAL] It says here.
[AGENT][NEUTRAL] So what we're looking for something, yeah.
[CUSTOMER][NEUTRAL] I have a I have a 0,
[AGENT][NEUTRAL] No, please go ahead. You hit a 0.
[CUSTOMER][NEUTRAL] Uh, yeah, I, I see here so it says in in hospitals, it says in hospital benefits cert number and then it says outpatient benefits cert number but it's two different numbers, but they both start with 02.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 02, uh, what is that? 02.
[CUSTOMER][NEUTRAL] So the, the top one is 02496462 ML 7.
[AGENT][NEUTRAL] Thank you. And if I could verify your name, and date of birth, and a phone number, please?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, that is [PII]
[CUSTOMER][NEUTRAL] And then my date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and I just needed a a uh callback number, please. I just need to verify that as well.
[CUSTOMER][NEUTRAL] Yeah, my call, my call back number would be [PII].
[AGENT][NEUTRAL] OK, thank you. Uh, now I do show that you've had gap insurance since June of last year, um, and, uh, what, um, you were mentioning that uh you had scanned your AvMed card. Uh, is there anything in particular that I can tell you, uh, you wanting to know whether any claims have been filed or?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well, that and I don't, I don't think any claims have been filed because every time.
[CUSTOMER][NEUTRAL] Uh, every time that they would ask me for my insurance card, I, I, I understand now that I had to show both the gap and the insurance card where I was always showing the, the insurance card itself, uh, under the impression that with showing the insurance card, the gap coverage would automatically have a claim open.
[CUSTOMER][NEUTRAL] So I guess what I wanna know is if if how you know.
[CUSTOMER][NEUTRAL] Cause I was told that this is possible, but I wanna know what in what direction I have to go to be able to make a claim on the gap insurance to have an adjustment of the price.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] Uh, of the co-pay price if you will.
[AGENT][NEUTRAL] Yes, absolutely. So let's go over your benefits first, um, and then we, then I'll let you know how to file a claim because it, it is, uh, frankly, it is pretty easy to file a claim once we, once we get this information going. So, um, for inpatient services, what we will do is we will pick up the deductible, co-payment or co-insurance from AMed up to $2000 per occasion and that $2000 renews every 90 days. So, um, you have that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] for
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then there is a per calendar day for outpatient services and that includes treatment within a physician's office, independent labs, durable medical of $750 per day. So you're looking at your card.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You, if you're looking at your card uh now, um, on the card.
[AGENT][NEUTRAL] It should have uh our web address, which is
[AGENT][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] I don't know whether you see that on the, yeah, good. OK, so we're good there, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Now what we will have to do in order for you to use this, uh in order for you to file some claims, is you will have to go into the um the uh website and you will see where it says workforce benefits that work for you.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] When you get onto the website and once you are ready to start filing the the claims, um, all you have to do is call us and we'll walk you through the process. So right now we're just we're just doing a quick overview and then when you're actually ready to do it, then we will help you get signed in logged in with a with a user ID and then um how to to submit the claims um so what you'll want to do is uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You will um you will go on to our website or you can mail it or fax it to us. It's just faster if you go on the website and you will create a uh user ID and a password and you'll have an account now once you do that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The documentation that we need.
[AGENT][NEUTRAL] In order for you to file a claim.
[AGENT][NEUTRAL] will be the itemized bills that you receive, say from your doctor, from the hospital, whoever it is who's billing you.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So let's just say that you have um you've gotten a bill from, say, uh, I'm just using this as an example, uh from a hospital. They will send you a bill.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Letting you know uh the dates of service, the dates that you were there, uh, the date, the date of your visit, um, what was done, and, and how much they're charging you.
[AGENT][NEUTRAL] That's usually what these things will show.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then you will have a corresponding.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] EOB from AvMed that shows the deductible, co-payment or co-insurance that is owed.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And we need those two things. And now one of the other things that we will need is a diagnosis code. Now that is, that's not gonna be on your bill and it probably won't be on your, it, it, I doubt it will be on your AvMed EOB.
[AGENT][NEUTRAL] Um, so we just need you to tell us what you went in for. So for example, let's just say that you had an ER visit on the [PII]. I would have a, a bill from the hospital.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] For that data service telling me what was the, the data service, the charge, um, and then I'll have a corresponding EOB from AvMed for that same date, that same charge and letting me know what my deductible co-payment or co-insurance is. And then what I'm going to write on the, on the ELB on the AVMed ELB is these charges are for a sprained ankle, uh, or these charges are, are for a cough, you know, something like that. You just have to write it on there.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I, I went to, I went to the ER on this day because I had a sprained ankle. And then what you're going to do is you will then go to our website.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you will sign in because you've already built a a a uh.
[AGENT][NEUTRAL] An account with us and on the website once you get into it, once you get into your special account, it will have a little green button on the on the left hand side that says uh um file a claim or start a claim and you can um submit those things to us and we see them in real time. And then what we will do is we will look at the AMed EOB and we will pick up the deductible, co-payment or co-insurance for for inpatient hospital up to $2000 per occasion.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Or for outpatient services up to $750 per day. Now, I will tell you that um that uh treatment within the physician's office is covered. The office visit co-pay is not. So, um, don't, uh, if you have an office visit co-pay, [PII], don't bother sending it in to us because you're not covered for that. But if there's treatment within the physician's office, if you go to the ER and um urgent care, uh, that sort of thing, or if you actually had an in-hospital event.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, those are the things that you need to send to us and, and there's going to be a, a, a claim form that we'll talk about when you're ready to file the claims, very easy to fill out. It can all be scanned in.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, or you can mail it or fax it to us. It's just, it's just it's gonna be a lot faster if you can get it to us through the, through the, uh, website. Now, is there, I know I went through that pretty quickly.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So, so for
[AGENT][NEUTRAL] Is there anything in particular or any questions that you had?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, so I mean, uh, a few if you don't mind, uh, so my first question would be just so I'm, I, just so I'm understanding fully is, uh.
[AGENT][POSITIVE] Yeah, absolutely.
[CUSTOMER][NEUTRAL] For the, so you're saying the, the, the gap doesn't cover like a regular kind of uh doctor's checkup, uh, if you will.
[AGENT][NEUTRAL] No, no, that is going to be, uh, we are accident and sickness. So let's just say that you went in for a wellness visit, OK? Um, that is not gonna be covered by your gap insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK, perfect. And then, uh, my follow-up question is, so, so what I'm dealing with just, just so you know, uh you have, you have awareness. So I, I recently, I was diagnosed with uh thyroid cancer and in my process, um, I I think I wanna say I was diagnosed with it, uh, it was, it was maybe a month or two after the, I, I re I started receiving gap insurance.
[AGENT][NEUTRAL] Uh, but.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Now the only issue is as I was going throughout the process, as I mentioned, all I would show them was my admin, so I would pay a co-pay. I've already started making uh minor payments here and there. Obviously I wasn't able to pay for the full thing. I think it was like $3000 for my surgery and, and, and another, God knows how much for, for all my visits regarding the cancer itself. But those two questions. For those, that this is what covers it, correct? If I'm understanding.
[AGENT][NEUTRAL] Absolutely. Yes, and I'm, I'm very sorry that you're going through that. Um, but the, but the cancer treatment is one of the things that, uh, yeah, so absolutely, please go ahead and and send those things in to us and, uh, um, now you, when you were in the hospital, and, and I'm not trying to pry, but I'm just, I'm just using this as an example. Were you in the hospital for 18 hours or more?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no worries, no way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, please don't, don't worry at all.
[AGENT][NEUTRAL] Do, do you know whether
[CUSTOMER][NEUTRAL] I was in the hospital uh for a day. Yes.
[AGENT][NEUTRAL] OK, did, so you were, so it was like an in and out.
[CUSTOMER][NEUTRAL] I was in the, I was in the hospital, I wanna say about about 24 hours, yeah.
[AGENT][NEUTRAL] OK, about 24 hours. OK, so.
[CUSTOMER][NEUTRAL] Kind of, yeah, in and out.
[AGENT][NEUTRAL] Um, so the reason that I'm asking is because, um, a lot of times anymore, uh, with a hospital visit, um, and this is just to give you an idea of your benefits, uh, a lot of times what they will do is they will have, where they have you in observation. And so if you're in the hospital for 18 hours or more, whether they actually give you a room and, you know, that kind of thing, um, we consider that an in-hospital event. And the reason that I'm bringing that up is because if it's an outpatient hospital event, it's $750 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If it is an in hospitals event, it's that $2000. And so that way you'll have an idea, you know, when you're thinking about it, um, and obviously send it all in to us, you know, and, and like I said, when you're ready to start submitting claims, let us know. We will walk you through the process. That's what we're here for. But um just for your peace of mind, so you'll kind of have an idea of what you might be getting, um, if it's, if you are in the hospital for 18 hours or more.
[AGENT][NEUTRAL] It's at $2000 whether you are assigned to a bed or not.
[AGENT][NEUTRAL] So we need to know that you were in there, you know, the uh the um admission date and the discharge date, you know, for any hospital visit you've got, if you have that information, let us know because that will be the difference between $750 a day and $2000 per event.
[AGENT][NEUTRAL] Yes, everything that you're talking about, that's it.
[CUSTOMER][NEUTRAL] As far as the coverage goes.
[AGENT][NEUTRAL] As far as the coverage goes, yes, but, but, um, the things that you were talking about, um, those things are covered. It's just, it's just that what you're looking at is, uh, is, you know, like you, you have your normal checkups. Um, if it's just a wellness visit, then no. But you know, uh, since you're bringing this up, you're gonna have a lot of checkups, um, with your, with your physician.
[CUSTOMER][POSITIVE] Wow, OK.
[AGENT][NEGATIVE] Because of your cancer.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is not a wellness check. I mean, it may, it may be considered that, yeah, it's, I, I don't know how to describe it. You know, you know how, you know how every year they'll ask you to get a well you know, and, and there's nothing wrong with you, but they just get that wellness check, that sort of thing. That's not covered. But if there, if you're going to your doctor, as you probably are going to be doing,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Sure, got you.
[AGENT][NEUTRAL] In relation to this, please send those in because, yes, that, that kind of thing is covered. Um, and I didn't want to give you the impression that it wasn't, you know. So if you're, if you're going to your doctor in relation to this, please, by all means, start sending this stuff in to us and.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] No, and, and, and, and I don't think you did. I, I, to be honest.
[CUSTOMER][POSITIVE] Yeah, to be honest with you, you, you've been great, uh, like, like the way that you're explaining it. I, I don't at all, I, and I completely understand as far as because the co-pay, listen, for, for, for a regular checkup my co-pay I think was like $50 well, you know, no big deal, it's just, you know, when, when.
[AGENT][POSITIVE] Good. OK, well,
[CUSTOMER][NEUTRAL] You know, between the biopsy and the, the, the ultrasound has started adding up. So I was like, dang, you know, I, I didn't know. And honestly, I was under the impression I was like, man, I guess like even with the gap insurance it's so expensive. But when it was brought to my attention by my company, the company I work for, they were kinda like, no, dude, you gotta show both. And I was like, oh God, no.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, well, it's, it is confusing. It's sort of like, um, you know, like we have to ask for a diagnosis code. Well, you know, even if you're in insurance, this, this is very complicated, you know, and that's why, um, and it, and it starts, you know, you, you just start shutting down or at least I do. This is personal. I just start shutting down. I didn't even wanna think about it. So, um, you know, actually, I, um, uh, I would actually suggest to you, um, that you send in everything that you've got because even if it's something that we can't cover, at least you'll know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Because, um, sometimes it's hard to know whether they, you know, I would just, I would just send it all in, you know, and, um, but yes, in future, uh, in future, uh, please present both cards. Um, now if your uh doctor or anything has any concerns about your coverage with us, please have them call us. Um, that is what we are here for. We will be glad to give them information over the phone, um, and let them know where to submit their claim, uh, but also, um.
[CUSTOMER][NEUTRAL] 100 with the yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Not to sound like a broken record, when you do start filing these claims, it's gonna start sounding complicated, but um, please, please let us uh help you um start filing those, uh, and, and we'll be there for you to help you with that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have, I have, I have all the documents.
[CUSTOMER][NEUTRAL] Yeah, I, I have all the documents in front of me. I was gonna, I was actually, um, I already have my portal set up. I was gonna start making the, the filing the claims now, uh, I don't know if you can maybe give me some guidance on, on, on like how to go through that.
[AGENT][POSITIVE] Awesome.
[AGENT][NEUTRAL] Yeah, sure. OK, so where are you at in the process?
[AGENT][NEUTRAL] Well
[CUSTOMER][NEUTRAL] So right now I click, I click upload files, uh, I, I've already, I already went through enter claim details which all it was was just my the my the name of the applicant which is my name, uh, select policy coverage, which is, uh, I guess it's automatically selected it's the one that that the only coverage that I have it's, it says 2496 uh 2496.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 462 M uh Medin select group Med sub active.
[AGENT][NEUTRAL] Yep, yep. Mhm.
[CUSTOMER][NEUTRAL] Yeah, so I click next then it says upload documents um.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] If I were to have because I have physical copies of them, would I have to get them from from online?
[AGENT][NEUTRAL] Yes, so when, when you start, um, when you start doing the uploading the, the documents, sometimes, um,
[AGENT][NEUTRAL] Uh, because a lot of your documents may actually be online, I don't know, um, you can actually upload them to a file and then and then transfer them to this.
[CUSTOMER][NEUTRAL] Right, and that would probably be the easiest way, yeah.
[AGENT][NEUTRAL] Does that make sense?
[AGENT][NEUTRAL] Yes, um, so, uh, yes, so if you can, um, yeah, you can actually just do this whole thing without, without paper at all. You can just get it all online and and just transfer it to this, and I'm sorry, I think that the little thing that says start a claim now is on the right side it used to be on the left, but um, yeah, you can do you can do it all online.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] putting
[CUSTOMER][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] You sign into
[CUSTOMER][NEUTRAL] Just for the sake of maybe going through one to see what it you know what the process is like.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the total combined file, uh, size can't exceed 20 megabytes. I'm just telling you.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] You may have to do it in in increments if it's a really big file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Yeah, yeah, I think it's pretty broken up, uh, just cause it, they're all different like uh.
[CUSTOMER][NEUTRAL] They haven't been one big uh.
[CUSTOMER][NEUTRAL] Transaction if you will.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Let me see here Frank.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Of course
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] Straight
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So here.
[CUSTOMER][NEUTRAL] And does, uh, would you know if.
[CUSTOMER][NEUTRAL] Uh, I mean, this might be a question that you might not know, but, uh, I was also receiving, so whenever they do the biopsy, they send it to pathology.
[CUSTOMER][NEUTRAL] Is our pathology, are pathology scans uh covered by insurance as well? Would you know that answer? They are?
[AGENT][NEUTRAL] Yes. Yeah.
[AGENT][POSITIVE] Yes, yes, it is, absolutely, yeah.
[AGENT][NEUTRAL] Yeah, that's a, it's, it's all, it's uh, yeah, there's a, whenever you have anything like this, there's, there's multiple things that are, um, there's usually about 20 things that go with each procedure. So, um, uh, the, let's see what else. I think you may have independent labs as well. So you'd have pathology, you'd have independent labs if you needed durable medical, um, all those things are separate, but they are covered under your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I understand.
[CUSTOMER][POSITIVE] OK, great, sweet, good to know, yeah, because.
[CUSTOMER][NEUTRAL] That was another thing, uh, was the pathology report was like a separate, it's own separate thing.
[AGENT][NEUTRAL] Oh yeah, radiology, pathology, it's all gonna be um all that kind of stuff is, is, uh.
[AGENT][NEUTRAL] Like I said, that usually the only thing that's not gonna be covered is like the offices that co-pay. So all the rest of that stuff, um, is, is gonna be covered.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Perfect. Alright, I'm just recovering something here on the account.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Let's say I went to cause yesterday, this is separate from, from everything else I'm referring to, but yesterday I went to, to an MD now. Uh, it was an urgent care here in, in, in [PII]. Um, and so my AdMed, my co-pay was $250. Uh, when I asked them about GAP, yeah, when I asked them about Gap, they told me that they don't accept it, but that I can make a claim exactly how we're talking now.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then that that fee should be paid.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's true. That's that's absolutely. And, and again just use your AdMed um EOB and just let us know what the uh
[AGENT][NEUTRAL] Um, why you went to, uh, the urgent care.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] Alright, um,
[CUSTOMER][NEUTRAL] This is strange.
[AGENT][NEUTRAL] Is something not uh downloading or?
[CUSTOMER][NEUTRAL] My, for, for whatever reason, my UHealth account is is uh.
[CUSTOMER][POSITIVE] Is acting kind of funny.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like trying to sign in.
[CUSTOMER][NEUTRAL] Let me see here and it's.
[AGENT][NEUTRAL] Now, that, that's for Amed? Is it?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, it's to get my uh.
[CUSTOMER][NEUTRAL] Well, I guess you know what, so would, would I be able to get all that information from Advent Amed?
[AGENT][NEUTRAL] You should.
[AGENT][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] I didn't think about it like that.
[AGENT][NEUTRAL] Yeah, see, they're gonna have all that. Anything that you've got, so let's just say you're on your doctor's portal, OK? Um, uh, anything that you turned into AvMed, they will have a corresponding EOB for. So if you're not, uh, like for your urgent care. So let's just say that, uh, you went back to the urgent care portal and, and you couldn't find what you're looking for since you turned in your AvMed card.
[AGENT][NEUTRAL] They'll have a corresponding EOB for that. So you can probably find what you're looking for.
[AGENT][NEUTRAL] On your AvMed portal.
[AGENT][NEUTRAL] Um, now, uh, and I'm assuming that you've made a, an account with them as well to find these things quickly because it's, um, that would probably be.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][POSITIVE] A really good idea if you did that.
[CUSTOMER][NEUTRAL] Well, I, I was trying to.
[CUSTOMER][NEUTRAL] I was trying to, I was trying to, um, log in now it seems like my account is locked, so what I might have to do is I'll just call [PII].
[CUSTOMER][NEUTRAL] Uh, right now, get that sorted out and if anything I could call back uh to make sure I go through the process correctly.
[CUSTOMER][NEUTRAL] Um, I don't wanna take up too much more of your time, uh, because, yeah, I, I just tried to log into [PII], so essentially just so I, I make sure that I'm understanding correctly is.
[AGENT][NEUTRAL] Yes, sure.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If, if, if, if my Advent insurance was ran, uh, was ran through all of those um different fees and, and all the.
[CUSTOMER][NEUTRAL] You know, like, all, all that, I could basically get the information that I need to upload over to to the gap insurance from AdMed's portal. I don't have to necessarily go to Jackson Health or you Health wherever I had the visits, correct?
[AGENT][NEUTRAL] Yeah, you, under normal circumstances, yes. Now, the only other time, the only time that I would ever suggest that you, that you actually go through the, I mean, the, the, the um itemized bills are great if we can get them. Um, but, uh, let's just say your hospital visits, when you had your hospital visit, your surgery, um, you would probably want to get the itemized bill for that just to just so that we could see that you were in the hospital, we would actually have to see that, you know, the, the admission date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the, and discharge date. We want to make sure that you're in there for 18 hours or more so that we can get those additional benefits. So, for your urgent care, for your, for your, uh, the pathology, stuff like that, if you can't get it off the thing, yeah, I would just go with the EOB uh letting us know what is going on and go from there.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK, cool, sweet, yeah, I'm gonna do that then for sure. I, I could get that report, uh, alright, so I'll do that. I'll I'll give her a call.
[AGENT][NEUTRAL] OK. Now, is there anything, anything else?
[AGENT][NEUTRAL] But are we, are we good?
[CUSTOMER][NEUTRAL] Uh, no, honestly.
[CUSTOMER][POSITIVE] We're good. Thank you so much. I appreciate your time and, and, and the, the, the detailedness, you know, it's, it's good to, to be aware of these things, so I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, call us back if you need any other questions or or help uh uh downloading this stuff, OK?
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Mhm. Thanks for contacting ATL. You have a very good afternoon.