AccountId: 011433970860
ContactId: 0e49108f-e9f5-499e-8329-603ec87511c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 517989 ms
Total Talk Time (AGENT): 227446 ms
Total Talk Time (CUSTOMER): 162175 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/0e49108f-e9f5-499e-8329-603ec87511c2_20250519T20:09_UTC.wav
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[AGENT][NEUTRAL] afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Um, my name is [PII], and I'm just calling to check on the claim that I put in in April.
[AGENT][NEUTRAL] OK, Ms. [PII], you're wanting to check claim status on a claim for yourself, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And Miss [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 683
[CUSTOMER][NEUTRAL] 806-005
[AGENT][NEUTRAL] Is that a member ID number?
[CUSTOMER][NEUTRAL] Yeah, that's the number I did you want the group number?
[CUSTOMER][NEUTRAL] They didn't, I, that's the thing, are you saying the policy number for it?
[CUSTOMER][NEUTRAL] The insurance for the policy number for the client.
[AGENT][NEUTRAL] Uh, policy number for APL, for your policy with APL.
[AGENT][NEUTRAL] That's OK. I, I can look it up with the number you gave me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Miss [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. So first off, I will have to verify several things for security. So if you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, what month?
[CUSTOMER][NEUTRAL] Fine, um, this month, May.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, thank you and then your home mailing address please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have for you is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, thank you and the last piece of information to verify is your email?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and Ms. [PII], what is the data service that you submitted a claim for?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I can't really remember the date of uh oh the date of service, um, I think it's [PII] and [PII].
[AGENT][NEUTRAL] OK. So Ms. [PII] there.
[CUSTOMER][NEUTRAL] Those are the days that I went to.
[AGENT][NEUTRAL] OK, and that was.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, so now here at APL we do not have any claims on file for you on this hospital indemnity policy, no, ma'am?
[CUSTOMER][NEUTRAL] You don't?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I did what they told me to do. I broke my leg and so I went to a place. They sent me somewhere where um I guess I'm not a network or whatever.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And I did go to the uh urgent care clinic where I was in that network but they couldn't do.
[CUSTOMER][NEGATIVE] I guess they couldn't do it or could, which is really nothing because all they did was give me a boot and I come in every every month and let them do two X-rays for 10 minutes and they charged me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I, and so I sent those two bills that I called the insurance company. They told me to fill out this claim form and email it or fax it to them. I did both.
[CUSTOMER][NEUTRAL] I hadn't got anything back on my email saying it's been processed, they received or anything. I'll call to see if they received it and a young lady asked somebody that was I guess in the room with her has she seen it.
[CUSTOMER][NEGATIVE] Or whatever, and she said, yes, we got it. We got the claim. So I don't know what's going on, but I can't keep paying $400 for this insurance and my bill is $400.
[AGENT][NEUTRAL] Do you know where you faxed it to? Because I don't see where we've even, there's been no calls here at APL.
[CUSTOMER][NEUTRAL] I faxed a brown's liberry.
[AGENT][NEUTRAL] No, ma'am. I'm
[CUSTOMER][NEUTRAL] I faxed it to brown fly beans.
[AGENT][NEGATIVE] Now who you faxed it to because we don't even have a, I mean, we've not had any, we've not spoken to you here at APL.
[CUSTOMER][NEUTRAL] I'm sorry, but the
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There's no.
[CUSTOMER][NEUTRAL] I know they told me to fill out a form. They told me to download a form and I did everything they told me to do. I had to fill out some paperwork and fax it over, um.
[AGENT][NEUTRAL] Do you happen to have the fax number that you faxed it to Ms. [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, I don't, and I have my paperwork, but I do not know where my folder is at this time. I was looking for it earlier, but I can't find it and um.
[CUSTOMER][NEUTRAL] I just thought maybe you guys will have it. I don't know. I don't know.
[AGENT][NEUTRAL] OK, so what I'm gonna do, Ms. [PII], give me just, give me just a moment here.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what I'm gonna do, Miss [PII], is I'm going to send you an email that's going to have a user guide for our portal here at APL and I'm also going to attach to that the hospital indemnity claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, but anyway, OK, so yes, I'm sorry, I'm trying to.
[AGENT][NEUTRAL] Look at too many things at once, so the email that you're gonna get from me will come from [PII].
[AGENT][NEUTRAL] Again, it will have 2 attachments. One of them is our portal user guide.
[AGENT][NEUTRAL] Where you can set up your portal. Once you set up your portal, Ms [PII], you can actually upload your claims information directly into that portal from a computer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the instructions for how to do all of that is included in that user guide. I'm also attaching the claim form for this type of policy that you have and the claim form on page one it has instructions.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's got about 4 bullet points, and that tells you what documents you will need to submit along with the claim form for our review.
[AGENT][NEUTRAL] So I'm gonna send you that now and again it's going to come from [PII]. I don't think that it will go to your junk or spam folder, but again, you know, if you haven't seen it in a few minutes, you may want to check one of those folders just to verify.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just got it.
[AGENT][POSITIVE] Perfect. OK. So, yes, ma'am, that, that has two documents attached to it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll get, I'll read this and do what it says and send it back.
[AGENT][NEUTRAL] OK, yes ma'am, because without you knowing exactly where you sent it to, I, you know, I don't, there's not any notes on your profile here at APL where we have spoken to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you know I don't know exactly where your claim was sent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I'll get this done. Thank you. Thank you so much. I appreciate you.
[AGENT][POSITIVE] All right. Well, you're welcome. Yes, ma'am. It was my pleasure in speaking with you. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Uh, no, ma'am. You've been quite helpful. I thank you.
[AGENT][POSITIVE] OK, well, you're very welcome and again, it was my pleasure. So thank you for calling and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] See you too bye bye.
[AGENT][NEUTRAL] Yes, ma'am. Bye bye.