AccountId: 011433970860
ContactId: 09ec3b5d-a8da-43f8-b550-ef51f2c600bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 728750 ms
Total Talk Time (AGENT): 409923 ms
Total Talk Time (CUSTOMER): 213462 ms
Interruptions: 8
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/09ec3b5d-a8da-43f8-b550-ef51f2c600bb_20250422T17:00_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I have a a couple of questions about my policies. Um,
[CUSTOMER][NEUTRAL] I'm pretty sure I have the policy where if I'll go just to the doctor, just for like, like I, I recently went cause I, I wasn't sure if it was a cold or COVID or whatever, that I can file a form and get like $50 back.
[AGENT][NEUTRAL] OK, so you have a question regarding your benefits on the policy you have with APL?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you. And Ms. [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your policy number please?
[CUSTOMER][NEUTRAL] Uh, I guess it's under the hospital number, um, 2331726.
[AGENT][NEUTRAL] OK, thank you. Give me a moment please to get your information pulled up. Once I do, Miss [PII], I will have to verify several things with you first for security and also any information that is provided would be a verification of benefits and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So first off, if you could please verify your date.
[CUSTOMER][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] I'm sorry, you, you, you, uh, went out for a second.
[AGENT][NEUTRAL] Can you please verify your
[AGENT][NEUTRAL] Yes ma'am can you please first off verify your date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then also your home mailing address please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, what was your unit number again? I'm so sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, alright, and then the phone number that we have on file for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] Thank you and the last thing to verify is gonna be your email address.
[CUSTOMER][NEUTRAL] Um, I think it's under my [PII], [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, thank you so much, Ms. [PII], for verifying all the information. Now,
[CUSTOMER][NEUTRAL] Or it might be under my work address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No ma'am, it's under your life now on your information that we had in our system, we did not have your unit number so just make sure with your employer that they have that because we received um information on an electronic file so if what we.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Receive doesn't match, it may remove that unit not added.
[AGENT][NEUTRAL] The rest of the address is correct. It just does not have your or it did not have your unit number on there. OK? So I just wanted to make you aware of that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So does she have, does she have to correct that?
[AGENT][NEUTRAL] Well, I have corrected it for the moment, but you need to make sure that they have it correct.
[AGENT][NEUTRAL] At your employer as well because like I said, if whatever they yeah whatever they have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll make a note of that.
[AGENT][NEUTRAL] can override whatever change I make.
[CUSTOMER][NEUTRAL] Yeah, and ironically, there's also another [PII] in the same.
[CUSTOMER][NEUTRAL] Complex.
[AGENT][POSITIVE] Oh, OK. Oh, wow. OK. So, yes, ma'am. I would definitely make sure that they have it correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, OK.
[CUSTOMER][POSITIVE] Yeah, I'll take care of that.
[AGENT][NEUTRAL] Otherwise, yes. OK. Um, what is the date of service, Ms. [PII], that you went?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To the doctor.
[CUSTOMER][POSITIVE] And look that up. Give me one second. I just filed my wellness claim, um, and that was super easy this time. Um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Cause I can't, did you do that today? Cause I can, oh.
[CUSTOMER][NEUTRAL] A couple of weeks ago.
[AGENT][NEUTRAL] Cause I see that we received an upload.
[AGENT][NEUTRAL] It shows today's date.
[CUSTOMER][NEUTRAL] Yeah, and this is the one for, um, like I don't know if I have the correct policy, um, because I'm very confused on all of this. This is like I know there is a policy.
[AGENT][NEUTRAL] This is your hospital, OK.
[CUSTOMER][NEUTRAL] Yeah, where like if you go to the doctor twice a year like 2 times a year for whatever reason.
[AGENT][NEUTRAL] Um, this is your hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK. Would that be under there?
[AGENT][NEUTRAL] Uh, let me
[AGENT][NEUTRAL] OK, so you went because you were sick. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, uh-huh.
[AGENT][NEUTRAL] OK, so let me.
[AGENT][NEUTRAL] But what I'm asking is did you upload something today? Well I'm pulling this other information up, did you upload something? OK, so it is, whatever you uploaded, I can see that that was uploaded. I can't see what it is because it's in line for review, but I do see we.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Yeah, that, that, I also, I have a cancer policy and that was for my mammogram.
[AGENT][NEUTRAL] OK. So I'll double check to make sure it went, if it's a wellness claim, it may
[AGENT][NEUTRAL] They just the system may put it on both policies or make on the cancer policy as well. OK, so for your, yes ma'am, for outpatient accident and sickness treatments, if you go to a doctor, you, the benefit is $50 per day and a maximum of 2 days per calendar year. So when you went to the doctor, you did not, you did not give them your APL information so they could file it. You're gonna be.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Honestly, I forget about this until we do our insurance renewal. Right. Uh, what happens is, um, we did our insurance renewal and then I'm always like, oh wait, I have those policies. I need to take care of that. Um, so, yeah, no, I did not give them that information.
[AGENT][NEUTRAL] filing it, is that correct?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK and just um I mean just for future reference I mean you you can file it that's perfectly fine it's just it's easier on you if they will file it for you typically because of the uh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Additional documents that you're gonna have to get from your provider to file the claim yourself?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's a specific claim form. Um, I can give you the website, Ms. [PII], and it show you where to get the claim form that you're gonna need to fill out.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And it has the instructions for the other documents that you will also need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you would go to [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] A
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] A public. hold on take too many M's.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you pulling it up now on your computer or whatever?
[CUSTOMER][NEUTRAL] Oh yeah, uh, and I actually, I actually have this, the site open. I just can't find like the wellness claim that was easy. There was just a little button there. I can't find where the form is for this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so now, so that's where I'm, that's what I'm gonna.
[AGENT][NEUTRAL] Show you so now you should see at the top of this it says claims and forms.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now I'm not talking about your portal just where it says OK so click on claims and forms.
[AGENT][NEUTRAL] Scroll down the page.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And about middle ways down, you're gonna see a heading that says claim forms and policy change documents.
[AGENT][POSITIVE] And bold black lettering. All right.
[CUSTOMER][NEUTRAL] Oh, it was all the way down there. Oh, OK, I didn't go far enough.
[AGENT][NEUTRAL] Uh, so the little box that says filter by product, click that green dropdown area.
[AGENT][NEUTRAL] And you will say the word hospital indemnity.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Click on the word hospital indemnity.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] And now you should see where it says hospital indemnity claim form and out to the right, it's a blue download form button just click where it says download form.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the form should open up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you will complete that form and sign it and then there's 4 bullet points.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] At the top that tells you what else you will need.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I'm gonna print it out right now.
[AGENT][NEUTRAL] Once you have all that together, you'll just scan it in. Mhm. You'll just scan it all back in once you have everything and save it on your computer and then log in to your portal and follow the steps.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For filing a claim.
[CUSTOMER][NEUTRAL] Sorry, that's a very loud printer. OK. All right.
[AGENT][NEGATIVE] Now if no one ever sent you a user guide.
[AGENT][NEUTRAL] Now do you have a user guide, Miss [PII] for the online service center because
[AGENT][NEUTRAL] Gives you tips on uploading documents and.
[AGENT][NEUTRAL] I mean it also tells you how to set it up but you've already done that.
[AGENT][POSITIVE] If you have, if no one's ever emailed that to you, I would be happy to send that to you and it just gives you like I said some helpful information when filing.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A client
[CUSTOMER][POSITIVE] All right, yeah, that would be great.
[AGENT][NEUTRAL] OK, well then I'll
[CUSTOMER][POSITIVE] That would be great if you could send that.
[AGENT][NEUTRAL] OK, well I'll send you that in a moment. It shouldn't, yeah, it shouldn't.
[AGENT][NEUTRAL] Go to your junk or spam folder, but if you haven't seen in about 5 minutes, you may want to check one of them. The email that you will receive will come from [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And in your subject line I will put APO on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Online service center portal user guide to recognize.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right. Well, is there anything else um that I could help you with at the moment, Miss [PII]?
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] Nope, that's gonna be it.
[AGENT][POSITIVE] OK, well then, thank you so much for calling APL and I hope that you have a very nice afternoon.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Yes, ma'am. Thank you as well.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Right. OK.