AccountId: 011433970860
ContactId: a44924df-4296-43ab-bb6b-f915b57a992c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 595390 ms
Total Talk Time (AGENT): 234179 ms
Total Talk Time (CUSTOMER): 237231 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/a44924df-4296-43ab-bb6b-f915b57a992c_20250220T19:38_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Hi, um, I called earlier today and spoke with someone else about trying to submit a claim, um, so I'm trying to go online and do that, but whenever I'm selecting files, it tells me that the files are too large.
[CUSTOMER][NEUTRAL] So I was only able to put one of the documents in there.
[AGENT][NEUTRAL] OK, um, let me have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the policy number?
[CUSTOMER][NEUTRAL] Yes. It's 02515497.
[AGENT][NEUTRAL] Thank you. And can you verify um your date of birth, mailing address and email address for me?
[CUSTOMER][NEUTRAL] [PII] [PII]. What was the other thing? Do you ask for my address?
[AGENT][NEUTRAL] Yeah, the mailing address just to make sure we got it correctly.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you. OK, and you said that um you were able to upload just one?
[CUSTOMER][NEGATIVE] Yeah, I've never done this before, um, and so when it asks you to upload documents I was trying to upload my bill and also the explanation of benefits and it won't let me submit both of them because it says the file is too large.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you can always send them separately um we put them together here um are they PDFs or they're pictures?
[CUSTOMER][NEUTRAL] There, there are pictures that I took on my phone through like scanning, so they turned into a PDF.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And you cannot make them smaller through the PDF app?
[CUSTOMER][NEUTRAL] Nope.
[AGENT][NEUTRAL] OK. Yeah, can you try to send them one by one?
[CUSTOMER][NEUTRAL] OK. So I'll just go ahead and click submit because it says.
[CUSTOMER][NEUTRAL] Um, somewhere it said something about like if you don't have all of your
[CUSTOMER][NEUTRAL] Documents together. There's missing information that can affect your claim, but I guess that won't matter. I can still just submit these separately.
[AGENT][NEUTRAL] Yeah, that means that if we don't have all the documents we need, then that will delay the claim but if you send them one by one and we have them all here, we can just put them together and make, you know, make one claim with all of them together here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So as long as you have the claim form, the itemized bill, and the explanation of benefits.
[CUSTOMER][NEUTRAL] So I clicked some.
[CUSTOMER][NEUTRAL] OK, I do have the itemized bill that has the codes on there. It's still thinking at the moment. It's like says submitting but it hasn't come through. And the explanations of benefits actually had two different bills that I'm gonna be filing claims for today. So one of them, I have Blue Cross and Blue Shield and I did get.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] An explanation of benefits sent in the mail for that one specifically, but I don't have explanation of benefits for the other one.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. Then when I'm sorry. Go ahead.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh OK OK.
[CUSTOMER][NEUTRAL] Um, so the explanations of benefits, something I'm supposed to get for that, like a specific breakdown from that particular bill, or is it just benefits in general from my insurance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, it's per day of service, so it's gonna be for that particular service that you receive for that day, um, and it's gonna have the amount applied towards the deductible co-payment and co-insurance, which that's what we help with, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So yes we're gonna need a copy of the explanation of benefits if you don't send it before we process the claim, that's when we're gonna go ahead and just let you know that we still need that information to continue the processing of the claim, um, but yeah, we need an EOB or explanation of benefits for each date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so I just
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] I got it to go through that it submitted, but I don't see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't really know where it went.
[AGENT][NEUTRAL] OK, let me see if it's here.
[CUSTOMER][NEUTRAL] Like where am I supposed to, OK.
[AGENT][NEUTRAL] OK, so it did not go through.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] If you're doing it at the same time that you're talking on the phone it's probably not gonna work, but um you need to probably go back all the way back again, just close that um um what you, what you was working on right now and go all the way in again because sometimes um it will.
[AGENT][NEUTRAL] Like kick you out, time out, um, and you need to go ahead and just go into that policy again to restart doing the submission again for it to work, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, before I do that, just to make sure I'm doing this right, so to upload a claim, do I just click the button that says upload files?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm. Correct, yes, and, and, mhm, go ahead.
[CUSTOMER][NEUTRAL] And then click my name and then I click the med link and then um I'll just upload documents is that all you do?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's all you do. If the claim goes through successfully, you're gonna receive a confirmation number. If you do not receive a confirmation number, the claim did not go through. It's a lot easier to use a computer, a desktop laptop to send in claims because the phone sometimes it will give you an error saying that it's too large because it's the phone is how it's set up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so it will be a lot easier, but if that's the only way that you have to do it is in the phone. You can try it again, um, just make sure you have everything closed that anything else is open so it will have enough space for it to work.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I have been submitting it on my laptop.
[AGENT][NEUTRAL] Oh, OK. Mhm.
[AGENT][POSITIVE] Yeah, and that's the best way to send it to the laptop.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then uh claims form where how do I know? because I I was told that I also need to upload.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, or fill out a claims form, so where do I go for that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You go to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, not the secured. [PII].
[AGENT][NEUTRAL] No, just regular [PII].
[CUSTOMER][NEUTRAL] And then is there a particular claims form that I need?
[AGENT][NEUTRAL] Yeah, it's gonna be the meddling claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me pull it up real fast just in case I have some questions.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And then do I fill this out two separate ones for each of my claims?
[AGENT][NEUTRAL] No, just one is, is enough. Just one because all we need to do with that is just verify your information and get your permission to um process that claim by your signature and um so any claims that you send just 11 claim form we'll go ahead and process it with that claim, one claim form. We just need one.
[CUSTOMER][POSITIVE] OK. All right. Thank you very much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] I do not think so.
[AGENT][NEUTRAL] All right. Well, if you have any other questions, just feel free to call us back, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon. Bye bye.
[CUSTOMER][NEUTRAL] Bye.