AccountId: 011433970860
ContactId: 19bb311e-947e-4f67-a3fd-f65d2cffe96b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 641570 ms
Total Talk Time (AGENT): 347410 ms
Total Talk Time (CUSTOMER): 137454 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/19bb311e-947e-4f67-a3fd-f65d2cffe96b_20250626T12:25_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], this Lake thing in Lake and I was trying to file a claim, but I think my doctor already sent his porting in and I was trying to.
[CUSTOMER][NEGATIVE] I don't understand this part with, with, and then on my, on my card I can't see my policy number.
[CUSTOMER][NEGATIVE] It then faded out.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Mhm. OK. So you're the insured, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and you're trying to file a claim, but do you need to get your policy number, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, I can help you with that.
[CUSTOMER][NEUTRAL] Well, I'm one of the questions they asking me for the policy number.
[AGENT][NEUTRAL] You're, you need to get the policy number, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with again?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII] is the last name.
[CUSTOMER][NEUTRAL] [PII] N.
[AGENT][NEUTRAL] [PII]. OK, thank you. And what is your callback number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Thank you. And what is your poli you, OK, so since you said you can't read your policy number, Mr. [PII], what is your full social security number?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK thank you one moment while I locate your information first off.
[CUSTOMER][NEUTRAL] Uh, uh,
[AGENT][NEUTRAL] OK, and what type of claim are you trying to file?
[AGENT][NEUTRAL] Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] But who and who are illness.
[AGENT][NEUTRAL] Critical illness? OK.
[CUSTOMER][POSITIVE] Yeah, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so first off, Mr. [PII], um, I will have to verify several things with the for security and then also any information that's provided would be a verification of benefits and not a guarantee of payment. So first off, if you would please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you also your home mailing address please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you the phone number that is on file for you is the same as the one that you gave me so that is the best number that we should have is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you and the last thing to verify it's gonna be your email address.
[CUSTOMER][NEUTRAL] It's the number [PII].
[CUSTOMER][POSITIVE] [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, thank you. So now one question for you, Mr. [PII], have you ever set up your profile in our portals called the online service center where you can actually have access to your policy numbers and policy information, ID cards, and you can actually submit your claims to us for review through that portal? Has anyone ever mentioned that to you?
[CUSTOMER][NEUTRAL] Uh, no
[CUSTOMER][NEUTRAL] Uh, no, ma'am.
[AGENT][NEUTRAL] OK, is that something that you would be interested in?
[AGENT][NEUTRAL] Me sending you, OK, alright, so give me just a second, Mr. [PII] and I'm gonna go ahead and send you that email and these user guides, one will be to explain how to set up your profile and then the other one explains how to use the portal, OK.
[CUSTOMER][NEUTRAL] Oh yes ma'am. I, I.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So just give me one second to send that.
[AGENT][NEUTRAL] To you, OK?
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Alright, bear with me just one second.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And if you want to, I can go ahead and give you this policy number for your critical illness policy. Now there's not actually an ID card for this type of policy, it would be just your policy number.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] But your number is 02.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 19
[CUSTOMER][NEUTRAL] 02.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 19.
[AGENT][NEUTRAL] 60.
[AGENT][NEUTRAL] 90.
[CUSTOMER][NEUTRAL] 60
[CUSTOMER][NEUTRAL] 90
[AGENT][POSITIVE] Yes, sir, that is correct.
[CUSTOMER][NEUTRAL] That's 021-96090.
[AGENT][POSITIVE] Yes, sir, that is correct.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] OK, so the email that I'm sending to you, Mr. [PII] will come from care team at [PII].
[AGENT][NEUTRAL] And I did put APL online service center in your portal, I mean in your subject line I put APL online service center portal. So if I don't think that it will go to your junk or spam folder, but in the event that you haven't seen that within in just a few minutes in your inbox, you might wanna check one of them.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So that has just been sent to you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Now, was there anything else that I could help you with this morning?
[AGENT][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah, uh, yeah, my, uh.
[CUSTOMER][NEUTRAL] My, uh, my doctor nurse said she, she had emailed a part of uh uh this uh.
[CUSTOMER][NEUTRAL] Uh, the, uh, claim form and I was trying to check and see the dog get it yet. They say they faxed it one day last week, a week before.
[AGENT][NEUTRAL] So you said that they faxed it?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so, um,
[CUSTOMER][NEUTRAL] Is there any way you can see that they get it?
[AGENT][NEUTRAL] I can check just a moment. I can see that there is something that has been received for you that is in line for review, but I will have to pull up some additional information to see if I can tell if that's the provider that you're looking for so just one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Now, what we have received was from Lexington Medical Center, but it's not yet been reviewed. Is that
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's it. It's probably waiting on my part. Yeah, I gotta fax mine in.
[AGENT][NEUTRAL] Is that what
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, that's it for that matter.
[AGENT][NEUTRAL] Yes, so we just received that on the [PII]. So again, it is in line for review, but it has not yet been reviewed.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it it'd be good if I could just fax my in too.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] You can fax it or you can set up your portal. The most efficient way to receive information would be to set up that portal and upload your information, your claim portion.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] To the portal. Any of the documents that you're gonna be submitting, that's, that would be the best way to do that. If not, then the next best way would be to fax it.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And then if once the claim is reviewed, Mr. [PII], if there were to be any additional information that we needed that might have been missing.
[AGENT][NEUTRAL] Uh, once that information has been obtained by you or sent to us from the provider.
[AGENT][NEUTRAL] Then you know you would just upload any additional information that might be needed into your portal just like you would the initial claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and there is a way to when you set up your profile, Mr. [PII], just a couple of things you can actually opt in for text notification alerts once claims have been reviewed, so that you should get a text letting you know that we have, you know, finished reviewing a claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you couldn't log in at that point and see the status of it in your portal, even though you had gotten a text, then obviously you can call us and we would be happy to provide you that information over the phone because you'll get that text typically before you receive, you know, have access to your explanation of benefits in the portal because it has to go through our overnight processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, OK, thank you.
[AGENT][POSITIVE] Oh, OK. Well, you're very welcome. So is there anything else that I can help you with this morning?
[CUSTOMER][NEUTRAL] Oh, no, ma'am, that's it.
[AGENT][POSITIVE] All right, Mr. [PII]. Well, thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] OK, thank you and you too.
[AGENT][POSITIVE] Thank you so much. Bye-bye.
[CUSTOMER][NEUTRAL] All right, bye.