AccountId: 011433970860
ContactId: 2be1ab54-f0cf-443d-b29f-4a9a97be935c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1766680 ms
Total Talk Time (AGENT): 619120 ms
Total Talk Time (CUSTOMER): 486606 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/2be1ab54-f0cf-443d-b29f-4a9a97be935c_20250602T18:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, um, I, this is [PII] and
[CUSTOMER][NEUTRAL] I erase by accident all of my information that contain my login IDs, account numbers, passwords and all that. I erased them. Now I'm trying to figure out how to get into my um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My portal and see if I can uh submit a claim for uh the well the wellness claim.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] To ATF
[AGENT][POSITIVE] OK, I can help you with that.
[CUSTOMER][NEUTRAL] And instruct me how to.
[AGENT][NEUTRAL] Yes. Um, do you have the policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, I don't. I, I lost everything.
[AGENT][NEUTRAL] You don't. OK, um, one moment.
[CUSTOMER][NEUTRAL] I can give you my social.
[CUSTOMER][NEUTRAL] If you
[AGENT][NEUTRAL] OK. Um, yes, bear with me just a minute. I'm just gonna go ahead and pull another system that I can use your social, OK?
[AGENT][NEUTRAL] And let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, yeah, it's OK.
[AGENT][NEUTRAL] What's that callback number? Mhm.
[CUSTOMER][NEUTRAL] It's [PII]. Yes, [PII].
[AGENT][POSITIVE] OK. OK, thank you. OK, I'm ready for that social.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, for security, may I have your date of birth, mailing address and email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, the email address is [PII].
[CUSTOMER][NEUTRAL] My mailing address, I'm not sure which one you have. You might have the.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Or you might have the [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so we do have the PO box. The PO box.
[CUSTOMER][NEUTRAL] Which one is still?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] That right now.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, in order to log in, uh, let me see, claim, uh, no, no, no.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, it's 8
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] Yeah, that is our website, Ms. [PII]. It's [PII]. Now, um, let me review your account really quick because I think
[AGENT][NEUTRAL] I think this group is no longer with us. Let me double check, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment. Do you mind holding for me?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] sent.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] I was on hold for a while.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, um, I was checking to see if the groups deal with us, um, the groups deal with us, but I don't see that you have an active policy.
[CUSTOMER][NEUTRAL] Uh, the group is with you, but I don't have a policy.
[AGENT][NEUTRAL] Um, this policy was terminated back in [PII].
[CUSTOMER][NEUTRAL] In [PII], so just recently.
[AGENT][NEUTRAL] Recently this year. Mhm.
[CUSTOMER][NEGATIVE] Why, why was it terminated? I don't understand.
[AGENT][NEUTRAL] It is saying that it was terminated, um, let's see.
[AGENT][NEUTRAL] It's just saying that it was terminated based on the system changes, so I'm not sure um if this is not correct, we're gonna need your employer to call us to see if we can go ahead and um correct it if it's not correct. But based on the group, it looks like you don't have a policy with the group no longer.
[CUSTOMER][NEUTRAL] Well, that's weird because I did not terminate it and uh um.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The benefits still still go through [PII].
[AGENT][NEUTRAL] Mm, yeah, that that's not what we have here on the system based on the notes, your policy did terminated on January. So if, if this is not correct, if you feel that it's not correct, just call your HR and see if they still have you on the list with the group. And if they do, they just need to send us something indicating that you still have this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'll call them right now.
[CUSTOMER][NEUTRAL] OK, and when I call you back, the department should I ask for?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, you can speak to any of us or you can ask for me. My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Don't worry.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, one second, OK, I'm trying to write down some stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] When was it active? What day was it active, um, my policy?
[AGENT][NEUTRAL] Active, um, OK. Yeah, let me get that. OK, so this was effective and active [PII] and it's indicated that it terminated on [PII].
[CUSTOMER][NEUTRAL] Yeah, definitely it's a mistake, but I'll, I'll, I'll ask him and I'll call you back, OK?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, yes. Once we fix that, we can get you um registered again because you probably need to register again. But yeah, right now, it's not gonna let you because it's indicating that it's uh terminated, OK?
[CUSTOMER][NEUTRAL] OK, so you say you can register me again if once I figure it out who I was.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] On.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, in order to do my claim for a well, uh, wellness checkup, I think it's called the wellness program, you have that one, right?
[AGENT][NEUTRAL] Yeah, we do have the wellness um benefits. If you did the uh the wellness testing before [PII], um, you can go ahead and send those in. Um you can send it by regular mail or fax since you cannot go in the website, um, because the policy is terminated. Now, um, if you wanna wait and get this resolved and then do it online, you can do that as well. So I'm, I'm not sure which one you wanna go by or you wanna do.
[AGENT][NEUTRAL] Uh, but right now if you have any, uh-huh.
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] What's the fax number to fax you there though.
[AGENT][NEUTRAL] The form. OK.
[CUSTOMER][NEUTRAL] The pro
[AGENT][NEUTRAL] Mhm, yeah, all we're gonna need is the claim form and the claim form you can find it on our website at [PII]. If you go to [PII] and click on claims and forms, you're gonna see the wellness claim form and you're gonna fill that one out and send it by fax or mail. The information is in the bottom of the first page, but the fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, I see the fax number here, fax documents, other ways to submit. So file claims online 24/7, but I cannot sign in.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, and you cannot sign in right now until we get this resolved so you just need to fax it or mail it right now.
[CUSTOMER][NEUTRAL] So the
[AGENT][NEUTRAL] If you need to submit one, OK. Mhm.
[CUSTOMER][NEUTRAL] Or the mail.
[CUSTOMER][NEUTRAL] Now, um,
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] What, what is the form that I need to fill out I don't see it.
[AGENT][NEUTRAL] It's gonna say wellness claim form. If you go to [PII], you're gonna click on claims and forms and then you're gonna go to the 2nd page.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I think it's gonna be the 3rd page. Bear with me. They just put some new stuff. It's gonna be the 3rd page. I'm sorry, 3rd page.
[CUSTOMER][NEUTRAL] OK, so I'm scrolling down, down, down.
[AGENT][NEUTRAL] OK, yeah, scroll down and you're gonna see the numbers 123 in the bottom.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, when you go to the first one, you're gonna see on the end of that first list you're gonna say everyday solution claim form and then you're gonna see 123 in the bottom, click on 3 and it's gonna give you that one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 3, OK. Oh OK. Wellness screening pay benefit claim, OK, um.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] So what, what, uh,
[CUSTOMER][NEUTRAL] Which ones are considered wellness?
[CUSTOMER][NEGATIVE] In the screening, because I tried to claim uh for a um mammograph that I did, but I, I, I, I, I got a reply in the mail saying that it was not covered during that time when I did it. I mean, I was already under the insurance, but it, it, it was talking about that there was a 30 days.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] Probation, I don't know.
[AGENT][NEUTRAL] Yeah, let me look at your benefits and see, mhm, yeah, let me go ahead and, and look at your benefits and see exactly when you were qualify and which test what what is gonna qualify, OK? One moment.
[CUSTOMER][NEUTRAL] Non-covered.
[AGENT][NEUTRAL] OK, I'm waiting on the paperwork to pull up, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, it's 4 pages.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well this claim form, OK, I'm gonna save this one and.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I guess I have to clean it out.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, you cannot do the electronic fillings, right?
[AGENT][NEUTRAL] Mhm, yeah, yeah, you have a 30 day waiting period, so that means anything that you do after that, 30 days after the, the effective date.
[CUSTOMER][POSITIVE] No, you can get up that fun.
[AGENT][NEUTRAL] So if you did any testing like let's say [PII] or starting [PII], that's the ones that you need to send in.
[CUSTOMER][NEUTRAL] So it start in [PII], OK, [PII], right?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] [PII] because right now that is the termination date. If that changes, then yes, you can send any claims that you have for [PII].
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I have, uh, OK, tell me what, uh what tests and screenings.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Counts for claims.
[AGENT][NEUTRAL] OK. All right. So the test that you can um
[AGENT][NEUTRAL] Claim and this is one test per year, OK? Let's see, so it's gonna.
[CUSTOMER][NEUTRAL] Uh, one more day? OK.
[AGENT][NEUTRAL] Yeah, it's one per year, uh.
[AGENT][NEUTRAL] one minute.
[AGENT][NEUTRAL] OK, so that's gonna be mammogram, breast ultrasound, breast tomography, breast cancer blood test, colon cancer blood test, colonoscopy.
[AGENT][NEUTRAL] Virtual colonoscopy, ovarian cancer blood test, Pap smear, chest x-ray, thin prep Pap test.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] And it looks like that's gonna be the ones that are for you.
[AGENT][NEUTRAL] Then you can send in.
[CUSTOMER][NEUTRAL] What was the last one I X-ray?
[AGENT][NEUTRAL] Uh, after the x-ray, it's a thin prep Pap test.
[CUSTOMER][NEUTRAL] But, OK, I don't know what that is.
[AGENT][NEUTRAL] It's a Pap smear. It's just a, a different Pap smear.
[CUSTOMER][NEUTRAL] Ah, Pap smear.
[AGENT][NEUTRAL] Mhm. It's just call then prep.
[CUSTOMER][NEUTRAL] Well, I did, but
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I just don't remember if I did it before the [PII].
[CUSTOMER][POSITIVE] Oh, that's good.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Now what about the son? Oh no, CT scan. I did MRI. I did MRI of the abdomen to, you know, to, uh, check all the vital organs in it for, for cancer.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] That's not on the list?
[AGENT][NEUTRAL] That's not on the list. You can send it to see if they can consider that based on the coding, but it's not on the list, so I cannot guarantee that one. the only thing we do cover is like an ultrasound. There will be a press ultrasound or a chest x-ray.
[CUSTOMER][MIXED] OK, but the ultrasound also is very specific, chest ultrasound?
[AGENT][NEUTRAL] It's gonna be the breast ultrasound.
[CUSTOMER][NEUTRAL] Breast ultrasound. What about the other ultrasound, the, like the abdominal ultrasound. That doesn't count?
[AGENT][NEUTRAL] That, no, that's not listed.
[CUSTOMER][NEUTRAL] Uh, what, what is the list online? Where do I go see it more? Maybe some blood tests, routine blood test is also included, maybe. Because I used to have one of these, but it was with MetLife. MetLife had a whole lot and I had to, you know, I did claims for wellness claims for 3 years in a row.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I remember it was 4.
[AGENT][NEUTRAL] Um, OK, the information is not gonna be online until you register, but it's not gonna let you register because you're not active right now. So what I can do is send the request for the certificate to be sent out to you. Either I can send it by email or regular mail.
[CUSTOMER][NEUTRAL] Yeah, email is fine.
[AGENT][NEUTRAL] Email, OK. I can go ahead and send it to this email. Let me go ahead and do that. All right, now, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] You have my email?
[AGENT][NEUTRAL] I do have your email. We have the ISD email. Is that OK or you need to be sent to the personal email?
[CUSTOMER][NEUTRAL] No, no, no, no, I just, no, no, no, no, just send it to my personal email.
[AGENT][NEUTRAL] What is your personal email? We don't have your personal, we have your work email.
[CUSTOMER][NEUTRAL] Oh, you don't have that? Oh wow, OK, OK. It's uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me repeat it back to you. That's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes ma'am, thank you, yes.
[AGENT][NEUTRAL] You're welcome. OK. Let me, let me put that one in. One moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Almost there trying to attach the documents, OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Large file.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] All right, here we go.
[AGENT][NEUTRAL] OK. Let me know when you get it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh, yes, ma'am. I'll, I'll, I'll look at it right now.
[CUSTOMER][NEUTRAL] Do not hard, but I'm gonna.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And refresh it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not yet, but.
[CUSTOMER][NEUTRAL] You again.
[AGENT][NEUTRAL] Mm. Let me refresh my system.
[CUSTOMER][NEUTRAL] Yeah, yeah, I got it now, policy certificate.
[AGENT][POSITIVE] You got it.
[AGENT][NEUTRAL] Yes. Mhm. Yes. If you open the certificate and you go to page, um, if you scroll down to page 24, it's gonna say cancer screening benefit rider and it's gonna give you the testing that is covered, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Page 24, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm the decider.
[CUSTOMER][NEUTRAL] Benefits.
[CUSTOMER][NEUTRAL] The session like that provides for loss is OK.
[CUSTOMER][NEUTRAL] Diagnostic testings. OK, I see 15 of them.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That sn or I know.
[CUSTOMER][NEUTRAL] OK, so those are the only ones you can uh do wellness claim.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] Go
[CUSTOMER][NEUTRAL] OK, well, I'm gonna go check the.
[CUSTOMER][NEUTRAL] My the days when I did um
[CUSTOMER][NEUTRAL] Some of the test Pap smear I guess because the mammogram I did it way too early. I didn't know that there was probation or I mean.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Oh, yeah, so that's not gonna count. That's too bad.
[AGENT][NEUTRAL] Mm yeah. Mhm, yeah, there's a 30 day waiting period.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, no, even though it's already terminated, I can still send you the claim if it was done within that time frame, OK, uh.
[AGENT][POSITIVE] Period of time. Correct, yes, that is correct.
[CUSTOMER][NEGATIVE] Yeah, I call the company right now because if they terminated for for whatever mistake, I ask them. But if they investigate and they say, well, yeah, it was a mistake, so that means that I was, I wasn't paying for that for the portion of that time.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Anywhere from [PII] to up to today, I, I stopped paying.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, if they say that it was, uh, that is that we need to fix it, they will go ahead and send the information. That means that they've been um taken out of your check and they just, we just probably haven't been notified, um, and they can go ahead and we can fix that and go ahead and fix it back from the day that it's supposed to be active. Uh, now, if they say that you've been terminated, then they will let you know exactly why they terminated you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK, I'll, I'll investigate that. So now tell me, uh, the, the, the yearly routine exam that they, you know, they perform on, on you as pap smear.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It says lab required, lab tests required. So that means, what documents I have to submit in order for that?
[AGENT][NEUTRAL] The Pap smear? No, you don't have to send anything. All you need to put is the date on the claim form, besides Pap smear, all you need to do is put the date and put the name of the doctor and the number, the phone number of the office where you did the testing, and we'll go ahead and verify with them all this information. So you don't have to send any additional documents. This certificate was done before we created that new form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, so the new form doesn't require or doesn't request for any documents to be sent with it. It's just the information of the doctor, so that's all you need to send.
[CUSTOMER][NEUTRAL] Ah, got you. OK, OK. Just the form by itself and the date and you verify. OK, that's easy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, uh-huh, yes.
[AGENT][NEUTRAL] Mhm, yeah, it's really.
[CUSTOMER][POSITIVE] Thank you so much, ma'am, for the.
[CUSTOMER][NEUTRAL] OK, I'll, I'll call back if I need to, OK?
[AGENT][NEUTRAL] You
[AGENT][POSITIVE] OK, no problem. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] No, that, that's all for me. Appreciate.
[AGENT][POSITIVE] OK, well, all right. Well, you, you're welcome and thank you for calling ATL. You too have a good day. Bye-bye, Miss [PII].
[CUSTOMER][NEUTRAL] Have a
[CUSTOMER][NEUTRAL] OK bye.