AccountId: 011433970860
ContactId: 14c11048-3abc-428c-b72b-e56a40cf8468
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 421440 ms
Total Talk Time (AGENT): 227328 ms
Total Talk Time (CUSTOMER): 134828 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/14c11048-3abc-428c-b72b-e56a40cf8468_20250221T19:28_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, hi, uh, so I was enrolled in, um, benefits in a card and covered under, um, APL, um, until the end of December, um, and I received a bill for, um, the shoulder checkup I had back in May when I was still enrolled, um, and wanted to see if that would be covered by APL.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] As long as your policy was active at that time, then yes, um I could get up your I can get your policy pulled up and we can verify that um what was your name?
[CUSTOMER][POSITIVE] Yeah, that'd be great. Uh, [PII], first name is [PII]
[CUSTOMER][NEUTRAL] And then last name [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, do you have the policy number by chance?
[CUSTOMER][NEUTRAL] Yeah, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I'm looking at the card, um.
[CUSTOMER][NEUTRAL] I only have the um payer ID for 90 degree benefits. Does that help or?
[AGENT][NEUTRAL] OK, uh, no, let me try just searching using your name give me just a moment.
[CUSTOMER][NEUTRAL] OK, yep.
[AGENT][NEUTRAL] OK. I do believe I've found you. Um, what was your date of birth, please, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you just gonna verify a couple of the pieces of information really quick. Uh, can I get your mailing address?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you. uh, looks like it's a [PII] account.
[CUSTOMER][NEUTRAL] Yep, it's my full name [PII].
[AGENT][POSITIVE] Alright, thanks for verifying that information, let's see.
[AGENT][NEUTRAL] We've got your medical policy. Yeah, so that effective date was [PII]. So anything from that time, uh, you can absolutely still file claims for.
[CUSTOMER][NEUTRAL] OK, and how would I go about that? Apologies.
[AGENT][NEUTRAL] So there's a few different ways you can do that. Um, I am showing that your account is currently active us, give me just a moment. Let me.
[AGENT][NEUTRAL] Was it, is it supposed to be terminated?
[CUSTOMER][NEUTRAL] At all?
[CUSTOMER][NEUTRAL] Yeah, well, because, um, I'm no longer employed under Creative Circle, um, as of [PII].
[AGENT][NEUTRAL] Mm OK I might have to transfer you to uh benefits and a card for that then uh because I am showing that it's currently active but that being said, since it's currently active, you can um create an account on our online portal uh that's typically going to be the easiest and quickest way to get claim information to us. Do you have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yep, I'm on one right now.
[AGENT][POSITIVE] Perfect. OK, let me know when you're ready and I'll give you that web address.
[CUSTOMER][POSITIVE] Yep, I'm good to go.
[AGENT][NEUTRAL] OK, so it's the word [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. OK. Yep.
[AGENT][NEUTRAL] OK, so you'll select of course that you're a new user, um, and then you'll use all of it in oh sorry.
[CUSTOMER][NEUTRAL] Oh, I might, I might.
[CUSTOMER][NEUTRAL] I actually uh.
[CUSTOMER][NEUTRAL] Yeah, I actually had a log in so I'm actually logged in now.
[AGENT][NEUTRAL] Oh cool. OK, well that takes care of that so on that main page, uh there's going to be an option where you can upload claim documents um whenever you're ready uh if you wanted to write it down I'll let you know exactly what we do need for claims.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Yeah, I can write it down.
[AGENT][NEUTRAL] OK, are you ready?
[CUSTOMER][NEUTRAL] Yep
[AGENT][NEUTRAL] OK, so we need the itemized statement.
[AGENT][NEUTRAL] That shows diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so then of course you would just you would upload that and then the correct claim form which this policy is called hospital indemnity.
[CUSTOMER][NEUTRAL] You said hospital and
[AGENT][NEUTRAL] And that's
[AGENT][NEUTRAL] No, the Hospital indemnity is the name of this, uh, plan, so you would fill out that claim form for it. Um, once we have that information, it can take about 7 to 10 business days for claim information to process. Uh, you can keep an eye on the status, uh, through the website, or of course you're more than welcome to give us a call.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Do anything
[CUSTOMER][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] Alright, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Um, I think that should be it.
[AGENT][NEUTRAL] OK, um, now did you want me to transfer you to benefits and a card about terminating your policy or did you wanna wait?
[CUSTOMER][NEUTRAL] Uh, should I wait until this is processed, I guess?
[AGENT][NEUTRAL] That's completely up to you. um, all I know is that if the policy was terminated, you couldn't create an account. I don't know if you'll lose access to the account if the policy is terminated, so that's completely up to you.
[CUSTOMER][NEUTRAL] OK, um, then, yeah.
[AGENT][NEUTRAL] I can give you their phone number if you'd like to call them later.
[CUSTOMER][NEUTRAL] Uh, I think I can get transferred now, um, but real quick, um, on that itemized statement, so I did receive what is this, um.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Basically like a
[CUSTOMER][NEUTRAL] A bill, would that count as that?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It has to have those specific codes on it um and every provider is different of course how they do things so I would reach out to them wherever you went for treatment just to ask for that itemized statement that shows those codes just to be safe.
[CUSTOMER][NEUTRAL] OK, it's, it's the diagnosis and procedure code, right? It's just those two. OK, got it. Alright, yeah, if you could transfer me to uh a card to um get it closed down.
[AGENT][POSITIVE] Correct, yes.
[AGENT][POSITIVE] All righty.
[AGENT][NEUTRAL] Of course, do you want me to give you that phone number first just in case there's a disconnect?
[CUSTOMER][POSITIVE] Yeah, that'd be great.
[AGENT][NEUTRAL] OK, so that phone number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yep
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] You said [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][POSITIVE] Yes, alrighty, I'm just gonna put you on a brief hold while I get them on the line for you. Hope you have a great rest of your day, [PII].
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to