AccountId: 011433970860
ContactId: 10411ec5-913a-438f-bb25-917e2d8db8be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 767640 ms
Total Talk Time (AGENT): 264642 ms
Total Talk Time (CUSTOMER): 348187 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/10411ec5-913a-438f-bb25-917e2d8db8be_20250609T14:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] [PII], hi [PII]. I am trying to sign in and it keeps saying to me we can't find your account or it's saying an account could not be found under this ID, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and I, I, I don't know, it could be under two different emails, but, uh, can you try to, I have an account number I could give to you, um, let me see here.
[AGENT][NEUTRAL] What's the policy number? Are you calling for a group as an insured?
[CUSTOMER][NEUTRAL] Group, group, uh, I have a group, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the group number?
[CUSTOMER][NEUTRAL] In hospital benefits certificate number, does that?
[AGENT][NEUTRAL] That's the policy number. Either one of those outpatient or hospital, please.
[CUSTOMER][NEUTRAL] You know what? I could barely read it because it's an old card. I'll try [PII].
[CUSTOMER][NEUTRAL] 836 and Mary L 7. I don't know. I think that that could be it. It's hard to read it.
[AGENT][NEUTRAL] Uh, no, ma'am. Give me a moment. What's your social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, and Miss [PII], verify your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII]. Uh, my mailing address is [PII].
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] A twist, well, it could be under a twist [PII] or it could be under [PII].
[AGENT][NEUTRAL] It's the [PII] email and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, uh, [PII].
[AGENT][NEUTRAL] No, no, your phone number in case the call drops.
[CUSTOMER][NEUTRAL] [PII] yeah [PII].
[AGENT][NEUTRAL] OK, thank you. And when setting up on an online service center, are you doing it as an insured?
[CUSTOMER][NEUTRAL] Um, yes, what do you mean? I, I'm trying to go, actually, my daughter, my daughter [PII] is trying to get in. She's, she wants to submit a claim.
[AGENT][NEUTRAL] Like when you're
[AGENT][NEUTRAL] OK, you will have to select um go in as a new user.
[AGENT][NEUTRAL] So she or you would need to hit create your OSC account since our system was updated you have to create a new account.
[AGENT][NEUTRAL] And then select insured since you're the individual on the policy.
[CUSTOMER][NEUTRAL] OK, can, can we do it together so I see what you're talking about? OK, so she goes to she goes, let me just.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] Hold on a second, because I can't even get in. Like when I try to even get in, it doesn't allow me to get in. Hold on. Oh, but I was using the forest travel. Let me, let me just.
[CUSTOMER][NEUTRAL] Let me, let me go back. Hold on a second. Let me go to American Public Life. OK, I'm here at American Public Life. So click on this, on American Public Life, and then where do I go?
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] The site you should be at is [PII].
[CUSTOMER][NEUTRAL] I should, uh, secure. I'm at uh [PII].
[CUSTOMER][NEUTRAL] That's not it, it says [PII].
[AGENT][NEUTRAL] The website to go on to created account is [PII]. It should say welcome to the online service center.
[CUSTOMER][NEUTRAL] OK, let me just send it to her.
[CUSTOMER][NEUTRAL] OK, hold on, let me send this charges that's easier.
[CUSTOMER][POSITIVE] Secured, secured.
[CUSTOMER][NEUTRAL] Tell me again secured.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You've got mail.
[CUSTOMER][NEUTRAL] With
[CUSTOMER][NEUTRAL] [PII] [PII]
[CUSTOMER][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] That's where she has to go to register, right?
[AGENT][POSITIVE] Correct, secured. [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So to register. OK, so let me ask you something else. Um, my husband, um,
[CUSTOMER][NEUTRAL] Actually, it was my daughter. Um, we went, we were in [PII] and we went to an urgent care with her. Um, what are we in now? Well, I think it was back in March. And we, I submitted a claim. I did the, did we ever get paid for that?
[AGENT][NEUTRAL] What was the date of service and your daughter's name?
[CUSTOMER][NEUTRAL] It was under [PII]
[CUSTOMER][NEUTRAL] Her name is [PII].
[CUSTOMER][POSITIVE] And um it was a good question because um I think we were there on [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In that, in
[CUSTOMER][NEGATIVE] I could have sworn I received a text from you saying that it was paid, but
[AGENT][NEUTRAL] I see one for [PII].
[CUSTOMER][NEUTRAL] Yeah, that's probably in [PII].
[AGENT][NEUTRAL] Uh, not sure. I had and pull up the client. Give me one moment.
[AGENT][NEUTRAL] So Care now urgent care.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that claimant process is can I use receipts to process claims. We need the itemized billing showing diagnosis and procedure codes and the primary EOB for the data service.
[AGENT][NEUTRAL] Yeah, because it looks like we just received a receipt. We cannot process claims from a receipt.
[CUSTOMER][NEUTRAL] Well, I submitted
[CUSTOMER][NEUTRAL] You cannot, but I got it, I got something saying that they paid the claim.
[AGENT][NEUTRAL] Not from, no, ma'am. You probably receive a text that a claim has been processed, but it wasn't paid.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Because additional information is needed for this claim, we are needing itemized billing, showing diagnosis and procedure codes and the primary ELB.
[CUSTOMER][NEUTRAL] OK, is there something you can email me that I can send to the this primary care? Because I thought that for some reason we got paid and I don't even, I don't even know where I put it um let me just see here.
[CUSTOMER][NEUTRAL] Oh, maybe this is it. Hold on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know where it is um let's see.
[CUSTOMER][NEUTRAL] No, that's fine.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Could you email me something what I need so I could send it to them?
[AGENT][NEUTRAL] You can just present them with your card, your policy number, and our phone number, and they can call verify benefits and we can let them know where to submit claims.
[CUSTOMER][NEUTRAL] But they don't do that. That's why they, they sent it to me. Oh, so they would have to send it to you directly, not from me.
[AGENT][NEUTRAL] Well, they can submit the claim or you can, but the only thing we received from you is just a receipt, which we cannot process claims for a receipt. Uh, we need the actual billing showing diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Diagnosis.
[AGENT][NEUTRAL] And the explanation of benefits uh from your primary insurance carrier.
[CUSTOMER][NEUTRAL] Wait, procedure.
[CUSTOMER][NEUTRAL] Diagnosis and procedure codes, but this is for an urgent care, so you pay the $50 that.
[AGENT][NEUTRAL] We still need that information in order to process the claim because it will have the diagnosis codes stating the reason for the visit and procedure codes and what procedures were performed.
[CUSTOMER][NEUTRAL] And then what do you need from my insurance?
[AGENT][NEUTRAL] The explanation of benefits or EOB for that data service.
[AGENT][NEUTRAL] That will show what your primary insurance applied towards deductible, co-pay or co-insurance.
[CUSTOMER][NEUTRAL] And what, what was the date of this you said?
[AGENT][NEUTRAL] Uh, let's see, looks for data service [PII] of this year.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] This year and it's under [PII], right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So now I have to call, do you have their information? Do you have their telephone number and all that?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Only number I show on the receipt is [PII].
[CUSTOMER][NEUTRAL] OK, [PII] and where would they send this to?
[AGENT][NEUTRAL] Uh, they can send it to us by fax or they can send it to you and you can submit that information to us. But, um, our fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and do you have an email they can send it to?
[AGENT][NEUTRAL] No, ma'am, uh, claims cannot be sent email.
[CUSTOMER][NEUTRAL] Claims cannot be sent to email. OK. And the explanation of benefits, um, I have to call my insurance on that one, right?
[AGENT][NEUTRAL] You'll have to contact your insurance, yes, ma'am, and request the EOB or explanation benefits for that data service.
[CUSTOMER][NEUTRAL] Explanation benefits for
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] OK, wow, I didn't even know. Now let me ask you, are you able to provide my, my cards here are really bad. Are you able to supply me with new cards? Because I could barely see them.
[AGENT][NEUTRAL] Uh, yes, ma'am. We can have it emailed to you and also once you've set up on the online service center, you can upload the cards to print, but I can definitely email it to you or send a request to have it mailed.
[CUSTOMER][NEUTRAL] Yeah, if you can, but the email is not gonna be like I, I rather have it mailed because those are hard cards, right?
[AGENT][NEUTRAL] Yes ma'am, I'll send a request for your cards to be mailed.
[CUSTOMER][POSITIVE] Yes, that would be great.
[CUSTOMER][NEGATIVE] This way and can you, oh, by the way, can you give me my account number because I don't, I don't even, I could barely see it.
[AGENT][NEUTRAL] It's 214-836-1.
[CUSTOMER][NEUTRAL] 2148361 and that's inpatient?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Either inpatient or outpatient is still the same number.
[CUSTOMER][NEUTRAL] OK, 2148361. OK.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] I appreciate that. I will give them a call to submit all that stuff so I can, and I should be paid whatever I paid them, right? The 80, what does it say? How much was it? $80?
[AGENT][NEUTRAL] Well, I can't get that guarantee. As secondary, we only pick up what primary insurance applied towards the deductible, co-pay or co-insurance, not how much you paid.
[CUSTOMER][POSITIVE] Well, usually I, usually it's a $50 co-pay, but I don't remember what, all right, I'll just ask them. Don't worry about it. Thank you, appreciate it.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You're gonna send me the cards, right? You're gonna send me the cards.
[AGENT][POSITIVE] Yes, ma'am. I sent a request, so hopefully you'll receive in 3 to 5 business days.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Perfect. Thank you. Have a great day.
[AGENT][NEUTRAL] Alright you too