AccountId: 011433970860
ContactId: 176fba2a-8d0c-4bd4-a680-57aa26c5b11a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 470399 ms
Total Talk Time (AGENT): 121470 ms
Total Talk Time (CUSTOMER): 192450 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/176fba2a-8d0c-4bd4-a680-57aa26c5b11a_20250224T18:18_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEGATIVE] Hi, I am calling um because I just recently got my ID card uh through my um work, my job, but they sent it to me through email. I don't have a physical card. I never got one from you guys. And then I went to the doctor and I had to pay some stuff and they told me I could do a claim through you guys.
[AGENT][NEUTRAL] OK, uh, what is your name? I can verify with you on how to submit a claim.
[CUSTOMER][NEGATIVE] Yeah, the problem is that when I try to log in through the website, I try to register as a new user, it says that I'm nowhere to be found.
[AGENT][NEUTRAL] OK, what is your name and the policy number, please?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So, my name is [PII], last name [PII] And then I'm not, I'm not sure. Would it be group number? The card that I have says group number.
[AGENT][NEUTRAL] No, ma'am, on your card, do you see a policy number or policy slash certificate number?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It doesn't say policy numbers. It says, um, group number and then there's a hospital benefit certificate number and outpatient benefit certificate mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Either one the in-hospital or outpatient, either one is fine.
[CUSTOMER][NEUTRAL] OK. So whenever you're ready. So 02, OK, 0259.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] 6844 and then M as in Mary, L as in lion, number 7.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[CUSTOMER][NEGATIVE] Oh, and I think I know why this is, I just realized my card is misspelled. My last name is misspelled.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think that might be the reason why I'm not.
[AGENT][NEUTRAL] OK, and verify your date of birth, mail address and email address for me, please, Ms. [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII]. Address is [PII].
[CUSTOMER][NEUTRAL] And then what was the last thing email?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Oh, I'm not sure if it, it could be [PII], or it could be my work one. I don't know if that'll work.
[AGENT][NEUTRAL] I don't show either one, so which one would you prefer us to have in our system?
[CUSTOMER][NEUTRAL] Uh, the one that I just gave you, [PII].
[AGENT][NEUTRAL] And you said your last name is [PII]?
[CUSTOMER][NEUTRAL] Mhm. [PII] Mhm.
[AGENT][NEUTRAL] [PII] OK, give me one moment, let me correct it in our system.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] So just to verify, [PII], correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK, so I have changed your, um, I've added your email address and changed your last name. So, um, I would say try to set up now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm going to send a request for them to send a copy of the corrected card.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I think I have one question because I was reading about how to claims. So when I went to the doctor, I went to the ENT and I didn't have my card or anything because um I guess um there was an issue here. I wasn't a roll on time.
[CUSTOMER][NEUTRAL] Um, but then they, I just have the receipt of what they charged me for, and here I was reading that it's asking for.
[CUSTOMER][NEUTRAL] In more specific I need to say what is it that it was done and all of these things.
[CUSTOMER][NEUTRAL] So should I, I'm going back to the doctor. Should I ask them for something else, or?
[AGENT][NEUTRAL] Well, in order to submit a claim, we will need the billing, itemized bill showing diagnosis and procedure codes and the primary insurance EOB or explanation of benefits since we are your secondary.
[CUSTOMER][NEUTRAL] Mhm, so I guess, but I have it won't work, right? Because it's just uh basically.
[CUSTOMER][NEUTRAL] So it's, it's like a receipt of basically what they charged me for it so I have the address and the name of the doctor and everything but.
[AGENT][NEUTRAL] No, ma'am, we need the actual billing showing diagnosis and procedure codes and primary EOB or your major medical explanation of benefits for the data service.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] Mm, OK, I guess I'll just ask for that when I go back. OK, thank you.
[AGENT][NEUTRAL] Uh, yes, ma'am. Uh, is there anything else, Ms. [PII] I can assist you with today?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] No, let me take a look really quickly to see if I can sign up for this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then, yeah, I guess that will be it once I do that.
[CUSTOMER][NEUTRAL] I'm almost done.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 15 and 60 yeah.
[CUSTOMER][NEUTRAL] No, it's saying the same thing. No user was found with information that was entered.
[AGENT][NEUTRAL] OK, and when you're setting up on the online, are you um doing.
[AGENT][NEUTRAL] New user and then individual?
[CUSTOMER][NEUTRAL] Yeah, I'm an individual with APL insurance policy.
[AGENT][NEUTRAL] OK, and verify your social to make sure we have it correct in the system.
[CUSTOMER][NEUTRAL] So it will be [PII].
[AGENT][NEUTRAL] OK, and, and you are using your social when trying to set up?
[CUSTOMER][POSITIVE] Yeah, OK, now it's working. I guess it needed some time. OK, that's all I need then. Thank you so much for your help.
[AGENT][POSITIVE] Alright, you're [PII]ome. Thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye.