AccountId: 011433970860
ContactId: 29b3ea3a-3b5a-4d51-b247-5ce4beb177af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1063180 ms
Total Talk Time (AGENT): 359121 ms
Total Talk Time (CUSTOMER): 457905 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/29b3ea3a-3b5a-4d51-b247-5ce4beb177af_20250611T19:07_UTC.wav
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[AGENT][NEUTRAL] Hey, this is [PII].
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] in claims. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I am wonderful. I have an insured on the line. She's trying to access her account. She said she called us several times and um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] She even reset her password and she still cannot access it and I've tried everything I know on our end. I don't know how else to help the lady.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, OK. All right. What is that, um,
[AGENT][NEUTRAL] Policy number I'm trying to get to that. I'm sorry.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] No, take your time.
[AGENT][NEUTRAL] OK. Uh, OK, now.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Are you ready?
[AGENT][POSITIVE] Yes, finally, yes.
[CUSTOMER][NEUTRAL] OK. It's 02.
[CUSTOMER][NEUTRAL] 603-763
[CUSTOMER][NEUTRAL] She's fully verified. Everything matches her email, date of birth, everything matches.
[CUSTOMER][NEUTRAL] Um, her callback number is.
[CUSTOMER][NEUTRAL] The number on the screen the [PII].
[AGENT][NEUTRAL] OK, got you, um, and this is [PII] on the phone or yeah, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you, I'll send it right over.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thanks, [PII]. Have a great day.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hi, Ms. [PII].
[CUSTOMER][NEUTRAL] Hi.
[AGENT][NEUTRAL] Hi, my name is [PII]. Uh, [PII] was telling me that you're having trouble logging into your online account.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And this is so last week I was having trouble um to upload stuff and see my claim process and I was told you guys were having trouble with the website. I tried logging in again today and it's not allowing me to log in.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, yes ma'am, I got you. Let me see, um, now when you go to log in you're going to the um AM public website and clicking that sign in button.
[CUSTOMER][NEUTRAL] Yes, so I'm on [PII] and there's a sign in button right here, and when I click on it and then I go to log in I put [PII] and then I'm putting my password in.
[CUSTOMER][NEUTRAL] And it is coming back saying.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] We can't seem to find your account.
[AGENT][NEUTRAL] OK, OK, yes ma'am. Now, have you um set up your account recently or?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Like in the last week, week or two.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I was in the hospital [PII]. I think I set it up around that time.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I sent, I uploaded stuff and I did get in the mail explanation of that you need an explanation of benefits from my insured and I've been trying to upload the stuff and I can't sign in.
[AGENT][NEUTRAL] OK, yes ma'am, um, we now if you, you're on that website right now instead of the log in, um, when you click on create your OSC account, um, we launched a new online service center like within the last.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][MIXED] 2 weeks, I think it's been 2 weeks and everybody is having to re-register um because it's new. And so I'm hoping that's the problem you're having. I'm hoping after you create it again um that there's no problem and everything um that you will see is the same though, you know, it looks cleaner, looks a little different, but your information is still there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I try.
[CUSTOMER][NEUTRAL] And then I get so the claim will be complete your OK account set up.
[CUSTOMER][NEUTRAL] Email address.
[CUSTOMER][NEUTRAL] And then everything that I started the claim with should already be in here correct?
[AGENT][POSITIVE] Yes, that's right. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim not verification is necessary. OK, send verification.
[CUSTOMER][NEUTRAL] I'm going to my email.
[CUSTOMER][NEUTRAL] OK, I have a verification code.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, verify code.
[CUSTOMER][NEUTRAL] I agree to terms, privacy policy accepted.
[CUSTOMER][NEUTRAL] OK, it says it's been successfully created, so go to dashboard.
[CUSTOMER][NEUTRAL] OK, log in like regular now, yes?
[AGENT][NEUTRAL] Yes, ma'am. Yes.
[CUSTOMER][NEUTRAL] OK, let me try this again.
[CUSTOMER][NEUTRAL] Then verification code again.
[AGENT][NEGATIVE] Oh no.
[CUSTOMER][POSITIVE] That that, listen, I'd rather be safe than sorry, right?
[AGENT][POSITIVE] Absolutely right. I'm glad you feel that way. Yes.
[CUSTOMER][NEUTRAL] OK. Verify code. That code is incorrect.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] That's weird. They just sent it to me and I'm looking right at it.
[CUSTOMER][NEUTRAL] OK, let me try it again.
[CUSTOMER][NEUTRAL] Let's send a new code.
[CUSTOMER][NEUTRAL] OK, we have a new code we are gonna try.
[CUSTOMER][NEUTRAL] Verify code.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Welcome next.
[CUSTOMER][NEUTRAL] OK now it says popping up start my claim.
[AGENT][NEUTRAL] Oh, that will always be there.
[CUSTOMER][NEUTRAL] But I already have a claim. What do I?
[AGENT][NEUTRAL] Um, that little button is always there. Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I'm sorry, I'm just looking because it is new for us too. I'm just looking to see what that will look like for you.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] No, I got
[CUSTOMER][NEUTRAL] OK, I see view my ID card, which is good because I did not have one of these before.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] And if you
[CUSTOMER][NEUTRAL] Yeah, it wasn't showing me this on the old.
[CUSTOMER][POSITIVE] Which is good.
[AGENT][NEUTRAL] And I can let me see what now I can order an ID card to be mailed out to you also.
[CUSTOMER][POSITIVE] Can you? That'd be great.
[AGENT][POSITIVE] I sure will, yes ma'am.
[CUSTOMER][POSITIVE] Yeah, I just went for my follow up a couple of days ago and they want an ID card and all I had was like my policy number and stuff so that would be great.
[CUSTOMER][NEUTRAL] And then let's see, so my policy, let me see, I'm not seeing.
[CUSTOMER][NEUTRAL] OK, there's that dashboard I'll go back to.
[CUSTOMER][NEUTRAL] Review the coverage details.
[CUSTOMER][NEUTRAL] So I'm not seeing my claim that I had opened.
[CUSTOMER][NEUTRAL] Actually 2 of them.
[AGENT][NEUTRAL] OK, um, on the dashboard.
[AGENT][NEUTRAL] On the left hand side, if you click on my policy.
[CUSTOMER][NEUTRAL] OK, I got it.
[AGENT][NEUTRAL] And you should see my details and claims like in the middle.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] They're perfect.
[AGENT][POSITIVE] Good. I'm sorry. It took me a minute to find that, but I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, no, no, no, no.
[CUSTOMER][NEUTRAL] OK. So it's saying processed.
[CUSTOMER][NEUTRAL] Hi this is
[CUSTOMER][NEGATIVE] So it's not giving me anything really. Um.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] 360. OK, so.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Like it's not reading, so this one is showing.
[CUSTOMER][NEUTRAL] Process but then it's showing no open claims but this one that's in front of me right here.
[CUSTOMER][NEUTRAL] The message I got in the mail was please provide copies of your explanation of benefits from your primary insurance carrier. How do I do that then if they, they're saying it's already processed? Where do I upload my.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So on that claim it does not say open claim it says processed or closed or whatever.
[CUSTOMER][NEUTRAL] Right?
[CUSTOMER][NEGATIVE] It says so on on the website where you put me into claims it says processed on the piece of paper that I got in the mail.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It says that.
[CUSTOMER][NEUTRAL] Remark, please provide copies of your explanation of benefits from your primary insurance carrier and it says um.
[CUSTOMER][NEUTRAL] You that it should be submitted within 180 days, so, but how do I, so I called Florida Blue this morning and I got that and I downloaded it. I don't see where I would put that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like attach it to this claim.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] So I open another one?
[AGENT][NEUTRAL] Let me check on that um to see what you should do in that situation because I would think it would still be open, but I mean I, I understand what you're saying it's showing process um but let me check on that, um, real quick. I, I'll put, I need to put you on hold just a second, but um thank you, thank you. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm done.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, this is [PII]. Um, I have an insured on the line and somebody, um, from the Meli you transferred her to me.
[AGENT][NEUTRAL] But I have a question back now, but um she was having trouble logging into the online service center and she's in there now and she said that she had submitted a claim and she got a letter from us saying that we needed the EOB from her primary.
[AGENT][NEUTRAL] And she got that today and she went out there and she's gonna upload it but it does not say that the claim is open it says that it's already been processed, so I didn't know what to tell her um of how to upload her EOB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For that.
[CUSTOMER][NEUTRAL] OK. Is she able to log into um her policy?
[AGENT][NEUTRAL] Uh, yes, yes.
[CUSTOMER][NEUTRAL] OK, because we have a new system and um everyone had to recreate their account so if she haven't done that yet, she would need to do that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, she did. And uh yes.
[CUSTOMER][NEUTRAL] So she's
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I showed her how to get to her claims and she said the only thing she sees says process so there's no way to add, you know, her EOB to it.
[CUSTOMER][NEUTRAL] OK, yeah, what she would need to do is uh resubmit a, a different claim, and, uh, if she, if she has the claim number for the claim that's already processed, make sure that she referenced that claim and we'll know to attach all the information together and pay it all under one claim.
[AGENT][NEUTRAL] OK, so she doesn't need to like.
[AGENT][NEUTRAL] Submit a new form or, or whatever.
[AGENT][NEUTRAL] Just upload that? OK, OK, alright, I'll tell her that.
[CUSTOMER][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Yeah, make sure that she referenced the claim number.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] OK, let me, I think I have a question. I'm just looking through these notes, you know, um, of that stuff. So on there where it says.
[AGENT][NEUTRAL] Does she need to click start your claim to upload that EOB?
[CUSTOMER][NEUTRAL] Yes, she does.
[AGENT][POSITIVE] OK, OK, got you. OK, yes, I will let her know. Thank you.
[CUSTOMER][NEUTRAL] OK. Is there anything else I can assist you with?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I think that's it. I think that's i[PII]
[CUSTOMER][POSITIVE] OK, well, I thank you, [PII], for calling ATL. You have a great rest of your day. Mm bye.
[AGENT][NEUTRAL] You too, bye.
[CUSTOMER][POSITIVE] Mm, thank you.
[AGENT][NEUTRAL] Hi Miss [PII].
[CUSTOMER][NEUTRAL] Hi, what did we find out?
[AGENT][NEUTRAL] Now I did find out that you do need to start a new claim, click on that start your claim, but she did say, um, if you, if you have that old claim number you can reference that number and they will add it to that um you don't necessarily have to go through all the yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] They will. OK.
[CUSTOMER][POSITIVE] OK perfect yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Thank you so much. I think so then I'll start the new, I was getting so frustrated because I'm like there is no way this insurance company's system is down for this long.
[AGENT][POSITIVE] Good.
[AGENT][POSITIVE] Right, right, and we did just switch over to the new one and um, yeah, yes, and letting everybody know they need to recreate an account has been, you know, um we've been working through that just say, uh but I'm glad you got in and no problem.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Oh, listen, I'm in health care. I know what you're talking. I know what you're talking about, trust me, we changed softwares and I'm like I can't find the patient. I can't find anything, so I get it. Thank you for your help so much. I will definitely work on this then. Thank you.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Yes, ma'am. You are welcome. And if you need anything, let us know, please. And I have ordered the ID card to be mailed out to you.
[CUSTOMER][NEUTRAL] I will
[CUSTOMER][POSITIVE] Fantastic. Thank you so much.
[AGENT][POSITIVE] You are welcome, Ms. [PII]. You are welcome. Have a good day. Thank you for calling ATL.
[CUSTOMER][POSITIVE] Bye. Thanks.
[CUSTOMER][NEUTRAL] OK, bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] Thanks.