AccountId: 011433970860
ContactId: 009d67d3-9dd4-40a2-9da9-4bc4488c5c80
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 769250 ms
Total Talk Time (AGENT): 194092 ms
Total Talk Time (CUSTOMER): 297439 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/009d67d3-9dd4-40a2-9da9-4bc4488c5c80_20250502T14:07_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] Hi [PII], this is [PII], and I'm trying to reset my password.
[CUSTOMER][NEUTRAL] And it's telling me my
[CUSTOMER][NEGATIVE] I guess my user name is invalid.
[AGENT][NEUTRAL] Oh OK, I can help you with your username and your password, and [PII], may I have a good contact number in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] OK, it's [PII] and then my policy number is 02605164.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] All right, I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] And my email address is [PII].
[CUSTOMER][NEUTRAL] And then my home address is [PII].
[AGENT][NEUTRAL] Thank you and all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment, I'm just pulling up your um online service center profile.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so your username is [PII].
[CUSTOMER][NEUTRAL] Wait a minute.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Did you just
[CUSTOMER][NEUTRAL] My username, OK, hold on.
[AGENT][NEUTRAL] Hold on, sorry, sorry, sorry, it didn't switch over. I'm sorry. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me make sure.
[AGENT][NEUTRAL] Yeah, it didn't switch over. Hold on one second.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, here we go. So it's [PII]
[AGENT][NEUTRAL] And then [PII] [PII]
[CUSTOMER][NEUTRAL] I got that correct. OK, so now I'm gonna click on new password.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or better yet enter in the new password, OK?
[CUSTOMER][NEUTRAL] Alright, here we go.
[CUSTOMER][POSITIVE] OK, I've met all the requirements. I'm gonna submit.
[CUSTOMER][NEUTRAL] Come on, submit
[CUSTOMER][NEUTRAL] No, it's not submitting it's maybe it's locked. I don't know.
[AGENT][NEUTRAL] No, I'm looking at it on my end, so it's not locked. What is it? Are you trying to reset your password or your
[CUSTOMER][NEUTRAL] Correct, create a new password.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I would
[CUSTOMER][NEUTRAL] It's not letting me do it. OK, let me get out of here, right?
[CUSTOMER][NEUTRAL] I'll come back in
[AGENT][NEUTRAL] Mhm. And are you putting in the username and then clicking I forgot password?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I please create a new password. The user name is there. We agreed on that and then I tried to.
[CUSTOMER][NEUTRAL] Yeah it's not letting me go. OK, let me get out of there.
[CUSTOMER][NEUTRAL] I'm gonna come back in.
[AGENT][NEUTRAL] Is it saying it's something with the characters or what?
[CUSTOMER][NEUTRAL] No, it didn't say anything.
[AGENT][NEUTRAL] Is he giving you
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] OK, so I do.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so I don't know my password, so I'm gonna click here and say reset password and reinput my username.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm gonna click on next.
[CUSTOMER][NEUTRAL] And I'd like the number the verification sent to my mobile phone.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] It's not OK let's see.
[CUSTOMER][NEUTRAL] All right, here we go.
[CUSTOMER][NEUTRAL] So that
[CUSTOMER][NEUTRAL] OK, I did the verification.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm gonna enter a new password, OK?
[CUSTOMER][NEUTRAL] I'm gonna click submit.
[CUSTOMER][NEUTRAL] And OK now let's see now let's see if this works.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm in.
[AGENT][POSITIVE] You're in? OK, good.
[CUSTOMER][NEUTRAL] All right, um.
[AGENT][NEUTRAL] Was it
[CUSTOMER][NEUTRAL] I, I don't know what happened.
[CUSTOMER][NEUTRAL] OK, let me ask you this question, are you the same person that I can speak to about.
[CUSTOMER][NEUTRAL] Looking at a claim that I submitted.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so I did receive a.
[CUSTOMER][NEUTRAL] Believe it was a text from APL saying my claim was processed and to go online.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I'm
[CUSTOMER][NEUTRAL] I'm in the website where do I look at the claim now?
[CUSTOMER][NEUTRAL] Status processed.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] You, you see it there or you?
[CUSTOMER][POSITIVE] Cool.
[CUSTOMER][POSITIVE] Yeah, I do, I do.
[AGENT][NEUTRAL] OK. You found, no, I'm, I'm making sure you're in the right place, or do you still?
[CUSTOMER][NEUTRAL] It says uh my claims.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK, and there are 2 claims out there.
[CUSTOMER][NEUTRAL] And I guess should I go all the way over to the right and view the file?
[AGENT][NEUTRAL] Right, that's gonna be your explanation of benefits.
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] OK, so it's saying I need additional information.
[AGENT][NEUTRAL] Um, which claim number did you pick, um, did you choose?
[CUSTOMER][NEUTRAL] Um, I chose.
[CUSTOMER][NEUTRAL] Let me close it.
[CUSTOMER][NEUTRAL] I chose claim number.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Claim number 3591362.
[AGENT][NEUTRAL] So that one.
[AGENT][NEUTRAL] was a duplicate of the original claim.
[CUSTOMER][NEUTRAL] Correct, which is 358-6104. Let me click on that.
[CUSTOMER][NEUTRAL] You files there.
[CUSTOMER][NEUTRAL] So attached is my
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What exactly is missing? What, what do you need?
[AGENT][NEUTRAL] Hold on, let me pull up that claim.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Oh, so they, they're asking for, um,
[AGENT][NEUTRAL] The documentation showing if it was an accident or a sickness. So basically no diagnosis was, or they didn't see anything with the diagnosis on it. So we're just asking for something that shows if it was an accident or sickness. Um, it could be an itemized bill, um, it could be doctor's notes, discharge papers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so this is an itemized bill.
[CUSTOMER][NEUTRAL] That's attached from daycare urgent care.
[CUSTOMER][NEUTRAL] It says there were influenza.
[CUSTOMER][NEUTRAL] Test or lab work.
[AGENT][NEUTRAL] Hold on one moment. I'm pulling up the documents.
[CUSTOMER][NEUTRAL] But I could swear.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I can see with you.
[AGENT][NEUTRAL] All right, they're coming up. Hold on one moment.
[AGENT][NEUTRAL] OK, so this is an itemized bill, but this is your patient version. So these codes here, they are codes, but these are the procedure codes. So basically this is telling us what you received and how much you paid for, but we need to know why, which is the diagnosis. So there's a bill.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You need to OK, let me.
[CUSTOMER][NEUTRAL] Alright, let me do this.
[CUSTOMER][NEUTRAL] Let me close this. I wanna look at the duplicate claim.
[CUSTOMER][NEUTRAL] Because I know I uploaded.
[CUSTOMER][NEUTRAL] A diagnosis. OK, that's, that's the same one I close that.
[CUSTOMER][NEUTRAL] Let me look at the duplicate.
[CUSTOMER][NEUTRAL] American public explanation of benefits.
[CUSTOMER][NEUTRAL] OK, let's see. Daycare.
[CUSTOMER][NEUTRAL] Office, medical lab.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I guess I'm gonna have to go back to.
[CUSTOMER][NEUTRAL] And get that diagnosis.
[AGENT][NEUTRAL] So when you
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] Alrighty, yeah.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] So when you call the provider, you're going to ask them for for a universal bill. Well, this is an urgent care, so they may call it an itemized bill, they may call it a universal bill. It's the same document. They just use different words depending on where it is. Um, so it needs to have the diagnosis codes, the procedure codes, and then all the charges.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Diagnosis code procedure code, all the charges, got it. OK and then once I get it, do I upload it into my original claim which is 358-6104?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, no, you won't be able to. So when you submit anything on the online service and it's going to look like a new claim is being submitted, but when the examiner sees it, they'll see that's the additional information for the um claims that are denied.
[CUSTOMER][NEUTRAL] OK, so if I understood you correctly, so I'm gonna go right here into my website and I'm gonna upload files or.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] What's my first OK.
[AGENT][NEGATIVE] Because there's no way to get back to the original. It it's not gonna let you.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Understood. OK, all right, well thank you for your help.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, I think we got it. I appreciate it.
[AGENT][POSITIVE] Alright well thanks for calling APL have a great weekend.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.