AccountId: 011433970860
ContactId: 1ca6d18f-cb73-4c6f-a88d-54fadfc25cc9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 647119 ms
Total Talk Time (AGENT): 303845 ms
Total Talk Time (CUSTOMER): 264685 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/1ca6d18f-cb73-4c6f-a88d-54fadfc25cc9_20250313T17:45_UTC.wav
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[AGENT][NEUTRAL] Contacting ACL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm trying to file a claim for vision therapy with your company and I've had, uh, conflicting information and I'm trying to ensure that I faxed this to the correct person.
[AGENT][NEUTRAL] Yes, um, certainly. What is your policy number? I, I can tell you which fax it is and, and who to send it to you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Just give me a second here. Where is it? Alright, so policy number member number is.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] So 683-62.
[CUSTOMER][NEUTRAL] 90997.
[AGENT][NEUTRAL] And that's, that's your policy number? Um, let's see.
[CUSTOMER][NEUTRAL] I'm sorry, that's my, I'm sorry, that's my member number uh the policy number is that the group ID?
[AGENT][NEUTRAL] Uh, yes, it may be given with a 01 or 02.
[CUSTOMER][NEUTRAL] 01 02 no.
[CUSTOMER][NEUTRAL] I don't have that, no.
[AGENT][NEUTRAL] OK, let's see if we can't find it by.
[AGENT][NEUTRAL] Your name and, and how do you spell your last name, please?
[CUSTOMER][NEUTRAL] Uh it's [PII]
[AGENT][POSITIVE] Thank you. And your first name, please?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And I just need a date of birth, please, and the phone number.
[CUSTOMER][NEUTRAL] [PII] the phone number is [PII].
[AGENT][POSITIVE] I appreciate that. Thank you. And so our, uh, this is um a hospital indemnity policy and uh so that um
[AGENT][NEUTRAL] That is normally sent to uh a company called IMA so let me just check and make sure.
[AGENT][NEUTRAL] Now have you already, did you say that you'd already tried to go into our uh website and send it or or you've tried to fax it before or?
[CUSTOMER][NEGATIVE] Um, originally I had emailed this to customer support at 4 member services, and then I didn't receive any confirmation that it was received, so I contacted you about 3 weeks later and I was told that that was not the correct place to email this and that I needed to fax it to a different number that was given to me because this this this particular claim fell under additional benefits.
[AGENT][NEUTRAL] Yes, that's true. Now our fax number and normally we can't accept, uh, we aren't able right now to accept fax by email um that will probably end up being they're fixing that, but, um, so we have a fax number of [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright, that was the one they gave me on the 2nd call. OK, so that, that number is correct.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK, and you said that you did not receive faxes right now?
[AGENT][NEUTRAL] No, we don't receive emails. We, we can't, we can't take a claim by, by an email.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I totally understand, but that's what your form says so there's a form here, OK, so you understand.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, we, we did have it, yeah, we did it is confusing. We did have, uh we did have that capability, um, but what they're doing right now is they're revamping the site and making it more secure and um right now, not forever, but right now our email is not available, so yes, it is confusing and I'm sorry about that, but um in the future we should be fine, but right now we're just asking that you either mail it or email it in to us, please.
[CUSTOMER][NEUTRAL] You said mail or email or mail or fax?
[AGENT][NEUTRAL] Uh, no, you can make excuse me, not email, you could mail it instead of emailing it or fax it to us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so just to make sure that I have the right form, there's a form called the APL form it says hospital indemnity and everyday solutions claim form. Is that the correct form to send you?
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] OK, and so I fill in all my information on that and originally on the intake form where it had suggested to email it says your member ID is required on the claim form. So, um, I don't think there's a place for your member ID on the claim form if I remember right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, there's no place for the member ID on the claim form so.
[AGENT][NEUTRAL] Now, does it say, is there one for policy number? Is there, um, let me see if I can pull up that uh that form because there should be a place for you to, to be able to put in a policy number. Let me just see if I can.
[AGENT][POSITIVE] I grab this really quickly.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have it, yeah, I'm sorry, on the second page it's got APL policy number, so the policy number is that the group number or the member number? That's what I'm trying to figure out.
[AGENT][NEUTRAL] It will, it will be the number. It's, it's, um, it begins with a 02, and that's, uh, and just let me know whenever you're ready and I'll be glad to give that to you.
[CUSTOMER][NEUTRAL] OK, how come that number is not on my card? That's what I'm curious about here.
[AGENT][NEUTRAL] The benefits in a card, uh, um, benefits that you get from your, um, employer, there is an umbrella numbers and that's the number that's on your card, and, and that covers everything. Um.
[AGENT][NEUTRAL] And that is usually through IMA um.
[AGENT][NEUTRAL] Insurance Management Associates.
[AGENT][NEUTRAL] Uh, but then there are other policies, uh, such as dental, vision, medical, that, that, um,
[AGENT][NEUTRAL] Or through other companies. So there's kind of the umbrella company and then you have a bunch of other smaller companies that provide different benefits such as vision, uh, medical, um, uh, wellness, and each one of those uh smaller policies will have their own policy number. So the overall number that you have on that card, is it just for everything um that IMA is offering. Uh, the thing is though is that IMA is the only one who can pull it up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So then the other small companies such as, such as ours, uh, we have our own policy number for your um for your medical. And so what we will do is, uh, we will look it up either by your name as I did today, or if you like, I can give you the policy number that, that is through APL.
[CUSTOMER][NEUTRAL] OK, so the policy number is that for APL or or that's the actual policy number for the entire plan?
[AGENT][NEUTRAL] No, it's, it's the, it's the uh policy number for APL. So the, the uh member number that you have there is, is the one for everything.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] The um number that I'm giving you is just for APL.
[CUSTOMER][NEUTRAL] OK, I'm gonna write it down here. OK.
[CUSTOMER][NEUTRAL] No, I can't. OK, um, alright, so let's, let's get the APL number.
[AGENT][NEUTRAL] Yes, that is 02.
[AGENT][NEUTRAL] 60
[AGENT][NEUTRAL] 0713.
[CUSTOMER][NEUTRAL] OK, so 06600713?
[AGENT][NEUTRAL] Um, no, I, I'm sorry, my phone may be cutting in and out, um, [PII], it's 02.
[CUSTOMER][NEUTRAL] 02
[AGENT][NEUTRAL] 60.
[AGENT][NEUTRAL] 0713.
[CUSTOMER][NEUTRAL] OK, so 02600713.
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] OK, I got it.
[AGENT][NEUTRAL] And if you look on the 3rd page of your of your uh hospital and claim, it says APL policy number and that that is where you can put that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so that goes on the APL policy number on the last page of the claim form. OK, can I, can I handwrite it in because I've already printed this out and I typed it out. Is that alright?
[AGENT][POSITIVE] That's correct, yeah.
[AGENT][POSITIVE] Of course, absolutely. That there's no problem with that.
[AGENT][POSITIVE] You can certainly write it in.
[CUSTOMER][NEUTRAL] Alright, alright, so that's that's the APL number I should keep that handy for all these claims that I'm gonna file.
[AGENT][NEUTRAL] That's correct, yes, as long as we're doing medical claims and it's through APL, then yes, that's the number that you would use.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so when I file this and fax it over to you, how long does it take to get a response, you know, whether or not you're covering this because I was told it was to be covered and I realized that you need to claim first to determine the coverage.
[CUSTOMER][NEUTRAL] So how long does that process take normally?
[AGENT][NEUTRAL] It usually takes 3 to 6 business days.
[CUSTOMER][POSITIVE] That's not bad. OK, great.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm gonna fax this over. You said the only two ways you're receiving this right now are through fax and through mail, physical mail.
[AGENT][NEUTRAL] That's correct, yes, or, or through the, through the fax. That's correct. So the email right now is not, is not available.
[CUSTOMER][POSITIVE] Got it OK.
[AGENT][NEUTRAL] Is there anything else at all I can help with?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, I think we're ready to go. I'm gonna fax this over to you, alright, um, when we fax you over claims, what's the frequency that you wanna receive them because I've been trying to send them over every month.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, can I send them over every month? Is that how it works, or is that how you want?
[AGENT][NEUTRAL] Oh, you can send them in, yeah, it doesn't really matter. Um, you can send in a bunch of, normally what people will do, um, particularly at the end of the year, uh, is that they'll just send in every claim, you know, that this is, or, or sometimes they'll send it in every day or, uh, or they'll send it in as soon as they've been to the doctor. So there's no frequency, uh, you know, just, just go ahead and send it in whenever it's convenient to you. Uh, there's no timely filing, um.
[AGENT][NEUTRAL] And uh and so if you have 8 or 9 claims uh go ahead and send in the 8 or 9 claims all at once, that would be fine.
[CUSTOMER][POSITIVE] OK, sounds good I appreciate it thanks so much.
[AGENT][POSITIVE] OK, thank you for contacting AP have a good day.