AccountId: 011433970860
ContactId: b1d540ad-9569-4ff9-9841-a70246abcb53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 894030 ms
Total Talk Time (AGENT): 371576 ms
Total Talk Time (CUSTOMER): 265651 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/b1d540ad-9569-4ff9-9841-a70246abcb53_20250619T14:35_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII], and I am trying to file a bunch of claims for my dad and um
[CUSTOMER][NEGATIVE] I need to keep getting rejected and I don't know what I'm doing wrong.
[AGENT][NEUTRAL] OK, I can help you with that. Um, can I get a good callback number in case we get disconnected?
[CUSTOMER][NEGATIVE] Yes, because the power, I mean, the weather is terrible here [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, somewhere, hold on, uh, policy certificate number.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 99A0143158
[AGENT][NEUTRAL] Alright, give me just a moment.
[AGENT][NEUTRAL] OK, let me see here.
[AGENT][NEUTRAL] Can you verify his name and date of birth for me, please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Uh, birth date [PII].
[AGENT][NEUTRAL] OK and the address that we have on file?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK. Give me just a moment.
[AGENT][NEUTRAL] And you're trying to file a claim on his behalf?
[CUSTOMER][NEUTRAL] Yes, he didn't even have a computer.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] You'll need to go to [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you will click on create LSC account.
[CUSTOMER][NEUTRAL] Create what?
[AGENT][NEUTRAL] Create OSC account.
[CUSTOMER][NEUTRAL] I think we have already done that.
[AGENT][NEUTRAL] We got a new um online portal system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, and so it's not.
[CUSTOMER][NEUTRAL] It's not the same.
[AGENT][NEUTRAL] Uh, so yeah, you have to do it again, um, you'll need to, whenever you click on insured, only use the information or only put in the information that is required, um, and it will be your dad. And so, uh, you'll do last name, date of birth, and then the email address that we have on file. And do you want to confirm that email address with me?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh yeah, I don't know which one he's got. Let's see, it used because one of them is no longer in service. Uh, was it radial tire?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that would be the one that you'd use.
[CUSTOMER][NEUTRAL] OK, you pay that, OK, that's me.
[AGENT][NEUTRAL] I will say while you're on the site if you would like, um, if you're able to go to the resource center and um download a third party authorization form, if you would ever like um to have or if you would ever like uh for us to speak to you on his behalf um with anything regarding the claim status or anything that has his medical history on there, you'll need to fill out the authorization form and turn it back in and then that way we can speak.
[CUSTOMER][NEUTRAL] Yeah, we were
[AGENT][NEGATIVE] I wasn't able to find one. I wasn't able to find one on there.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We, we did it back in [PII] I think.
[AGENT][NEUTRAL] Yeah, I, I wasn't able to find one, so I would just go ahead and um fill one out and uh you should be able to.
[AGENT][NEUTRAL] File it on the site. Otherwise I would mail it back, um.
[AGENT][NEUTRAL] Because if you ever need to call for claim status, uh, we would need his authorization he can either give it to us on over the phone for one time or you can fill out that authorization form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I, I wasn't able to see it cause I did check just in case.
[CUSTOMER][NEUTRAL] OK, but I can still file for him, can I?
[AGENT][NEUTRAL] Yes, I'm not giving you any personal information.
[CUSTOMER][NEUTRAL] Yeah, I've got it all. OK, but what I, I mean every time I have.
[CUSTOMER][NEUTRAL] Haven't probably tried in several months, but whenever I was sending them in, they would say that everything I uploaded was illegible, and they would send me back a copy of it. It was perfectly fine, so I couldn't figure out.
[CUSTOMER][NEGATIVE] What? and and maybe I'm not sending the right information. I don't know exactly what I need to send.
[AGENT][NEUTRAL] Uh, it should be whichever claim you're trying to file, um, the claim form should have a list of everything that you might need, such as itemized bills. Um, it's important to check those bills or the receipts for procedure codes or diagnostic codes.
[AGENT][NEUTRAL] Cause we do bill, um, we do go off of those um procedure codes. So that's the big one. there's a, there's a whole list, um, on the cancer claim forms that says what you, what you might need, and it has a list right there of what you might need, um, any hospital admission or discharge papers.
[AGENT][NEUTRAL] Um, diagnostic test results, anything like that, you'll send in.
[CUSTOMER][NEUTRAL] OK, most of this over the last couple of years has been just travel and travel and um.
[CUSTOMER][NEUTRAL] Uh, lodging and then it's supposed to be covered under his policy. They used to pay it easily, no problem at all, but I was faxing it all in and I wondered if it would be better if I mail it in.
[AGENT][NEUTRAL] Um, you could do that. Do you have our mailing address?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I have is it [PII]?
[AGENT][NEUTRAL] No, that one is no longer valid.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] And it will be on the bottom of the claim forms as well, um, but I can go ahead and give it to you um whenever you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] Right, it's [PII].
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I will get back in and see if I can do any better on the new.
[CUSTOMER][NEUTRAL] Um, website, and I have times and they literally are going broke over this. But I've, I, I've got to get some of these claims get, you know, in to help them out and
[CUSTOMER][NEUTRAL] And like I said, most of the ones right now because he's been in a trial.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, has been just the travel and the lodging.
[CUSTOMER][NEUTRAL] That's all it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But do I have to send with that did I mean.
[CUSTOMER][NEUTRAL] It wasn't clear to me before. Do I need to send um.
[CUSTOMER][NEUTRAL] Anything to verify that he had an appointment or something?
[AGENT][NEUTRAL] Um, yes, I would go ahead and do that, um, especially if it has the hospital's address on it. We will, whenever we do travel, we will do based off of the uh address we have on file for the patient and the hospital address. And then, um, let me see.
[AGENT][NEUTRAL] Let me see what else you might need.
[CUSTOMER][NEGATIVE] Yeah, it's just very frustrating and you know, he's [PII], so you can imagine he thinks you just push a button and it's fine. No.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see here.
[AGENT][NEUTRAL] Yeah, I would, I would send it does show for uh transportation. It does ask where the treating location is. um I would fill out, I I would send any type of uh invoice or receipt with um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The transportation, um, you will want an itemized receipt that should show uh.
[AGENT][NEUTRAL] Let me see what it says here.
[AGENT][NEUTRAL] Uh, you'll want an itemized purchase, so whenever if you stay somewhere or you get a receipt.
[AGENT][NEUTRAL] You'll want to uh put that in.
[AGENT][NEUTRAL] With it make sure that it says the charge amount and the vendor company, uh, the address, and it'll have the telephone number on it which most receipts nowadays have all of that um and you'll want an itemized invoice or an itemized receipt that should also include the origin and destination.
[AGENT][NEUTRAL] Or the location when filing a claim for the non-local transportation.
[AGENT][NEUTRAL] So I would, I would also just put in there if you could get a doctor's note for a confirmation that you, that you had an appointment that day, um, just to show that you went there specifically for the, the uh treatment.
[CUSTOMER][NEUTRAL] Yeah, OK. He had several big surgeries last year.
[CUSTOMER][NEUTRAL] And um traveling back and forth. So they have, you know, he had flights and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Extended stays.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I would try and get as many of the itemized receipts as you can and um.
[AGENT][NEUTRAL] If you could just get basically like a doctor's note whenever you take your kid to the doctor and you ask for the doctor's note, um, unless there's a receipt or anything with that that already comes with that medical bill because you can file it all at the same time.
[AGENT][NEUTRAL] In the same claim.
[CUSTOMER][NEGATIVE] And that was another thing I was having an issue with every time I uploaded somebody said the document was too large and it would be one page so I couldn't make it any smaller.
[AGENT][NEUTRAL] Oh, it could be that it didn't meet, it, it could be that it didn't meet the
[AGENT][NEUTRAL] Yeah, um.
[AGENT][NEUTRAL] I hate to say if that's the case, I would, I would um try mailing it to us. I would still try to file it through the app, but if, if you're unsure and you want to get it taken care of, I would, I would also, I would mail it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that might be the best thing to do.
[AGENT][NEUTRAL] But yeah, it shouldn't, yeah, because it, it might have been the file type based off of what it is. It'll say, it should say on there. I believe it's like 2 megabytes that it can be um for data.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I was trying to include like the the receipt from the, you know, for his.
[CUSTOMER][NEUTRAL] Airline ticket
[CUSTOMER][NEUTRAL] And that's another thing.
[CUSTOMER][NEUTRAL] I can, can he just use the receipt from where he paid it like through American Express?
[CUSTOMER][NEUTRAL] Because, you know, boarding passes and stuff like that don't have prices on it.
[AGENT][NEUTRAL] And they didn't give you a, the airlines didn't give you a receipt?
[CUSTOMER][NEUTRAL] I'll have to look through this mound of paperwork that I have from my parents, but I don't think that they're, they gave me the credit card bills from American Express, which is where all his flights are booked and.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, you know, all the.
[CUSTOMER][NEUTRAL] Cab receipts in the hotel receipts. I have all that but.
[CUSTOMER][NEUTRAL] I wondered if that was an issue.
[AGENT][NEUTRAL] Yeah, they
[AGENT][NEUTRAL] Yeah, they, they will, they should be.
[AGENT][NEUTRAL] I mean, if you bought the ticket, they should be giving you a receipt or an email confirmation or something.
[CUSTOMER][NEUTRAL] OK, I'll look for email confirmations.
[AGENT][NEUTRAL] Yeah, and if not, I would call the airlines and let them know that you want a receipt whenever you do this.
[CUSTOMER][NEUTRAL] Yeah, he's going next week so.
[AGENT][NEUTRAL] Yeah, I would ask when you book the ticket, when you, when you buy the tickets or um or something, I would, I would try and get the, the receipt as best as you can.
[CUSTOMER][NEUTRAL] I wanna get.
[AGENT][NEUTRAL] Um, they should be able to give you one. I don't know why they wouldn't.
[CUSTOMER][POSITIVE] Yeah, OK, let me give this a try. If I have any more problems, I'll call you back.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Yeah, please do. um, we're here to help whenever you need us, OK?
[CUSTOMER][POSITIVE] Thank you so much. Bye.
[AGENT][POSITIVE] Great, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] OK.