AccountId: 011433970860
ContactId: c907bb88-1c95-4fd6-b05f-c50a4fb63381
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232110 ms
Total Talk Time (AGENT): 117866 ms
Total Talk Time (CUSTOMER): 87219 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/c907bb88-1c95-4fd6-b05f-c50a4fb63381_20241231T16:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I have a quick question. Um, as I am uploading claims, do I need if I have multiple days of service, do I need to put each one as its own claim, or can I bundle them?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well, let me see what type of policy you have. If it's day, then I would do each day. If it's the year, then you can bundle it. Um, let me take a look and see. May I have your name and a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] It is 2400539.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] All right, and I have your policy here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] It is, um, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] I think the email address on file is gonna be [PII].
[AGENT][POSITIVE] Alrighty, and thank you so much for verifying your information. All the information provided is a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Um, so yeah, I would split them up by date by date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I really am still trying to learn exactly what was covered by the policy. So if I submit stuff that's not covered, they just ignore those claims, correct?
[AGENT][NEUTRAL] Well, can, so it'll still, it'll be denied, but the denial reason I'll tell you like it's not covered or not in this location, you know, whatever the reason was.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] And so I can just go in and just submit each one of my because it's a lot of data of service but I can just go in and just submit as many claims as I need.
[AGENT][NEUTRAL] Mhm. Now, if you have
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Something that's like multiple, uh well, multiple things, but one data service, you know, that, that could be one, but if you upload every each time you upload it's gonna give you a new um claim number. So like if you mess up or something, don't like freak out if you see another claim number. Some people, you know, get nervous like, oh my God, you just gave me a new one, you didn't mess up. It's just the service center. So when the examiner gets it, they'll see us all together though just in case that happens.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and so like my pathology report, if I just upload it what am I good or do I need to upload it multiple times?
[AGENT][NEUTRAL] Oh, no, you just need to upload the um pathology report once if you're trying to prove like a diagnosis and then um
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] If it's needed again, they'll ask, but usually the pathology is only for like the the first occurrence benefit and then all the others will have like the bill with it.
[CUSTOMER][NEUTRAL] OK. Yeah, they've asked for it and they've asked for a second. Yeah, they've asked for a 2nd 1 because I had, I have two pathologies, 11 was first diagnosed and then one after surgery. So they've asked for the 2nd 1. So I've uploaded that one, but I didn't know if I needed to upload it again with anything else.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, you shouldn't, but if they need it, they will ask, but you shouldn't have to. They probably just want the before and after to make sure, you know, see what the outcome was.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you so much.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Nope, that'll be it.
[AGENT][POSITIVE] Alright, well, thanks so much for calling APL and happy [PII] Year.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.