AccountId: 011433970860
ContactId: 35a9efeb-f712-43f4-ac58-92c614d74a1a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 501950 ms
Total Talk Time (AGENT): 249997 ms
Total Talk Time (CUSTOMER): 165744 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/35a9efeb-f712-43f4-ac58-92c614d74a1a_20250307T18:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. I hope you can. So the insurance agent that sold me my insurance gave me, sold me PHCS medical bill repriser and said my doctor was in network. Come to find out, they're out of network. So now they told me to go ahead and submit a claim to ATL on behalf of myself to get the $100 reimbursement.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I emailed them in but I've heard no um word from you guys. Could you look them up or?
[AGENT][NEUTRAL] OK, sure. I could take a look at that claim, make sure that we've received that. What was your name?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] OK, and then [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] That number.
[CUSTOMER][NEUTRAL] is 683.
[CUSTOMER][NEUTRAL] 822759
[AGENT][NEUTRAL] OK, that's a bit too long to be one of our policy numbers. Give me just a moment. Um, let me see if that.
[AGENT][NEUTRAL] Might be a member ID, let's see.
[CUSTOMER][NEUTRAL] Yeah, that's a member ID.
[AGENT][NEUTRAL] OK, I don't know that I would be able to search using that [PII], um.
[AGENT][NEUTRAL] Let's see, if you don't have a policy number.
[CUSTOMER][NEUTRAL] What can you search by?
[AGENT][NEUTRAL] Um, I could start using your social.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Uh, I'm gonna read that back, make sure I heard that correctly, um, that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I did not get a result with that social, um, let's see if you wouldn't mind, um, spelling out your first and last name for me again, I could try searching that way.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK. [PII], two words, no [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then, uh, [PII]
[AGENT][NEUTRAL] OK. OK, one moment, let's see if I can find you that way.
[AGENT][NEUTRAL] OK, and just to verify, I apologize that was [PII], correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I don't have anyone with that last name in our system, [PII].
[AGENT][NEUTRAL] Are you looking at an ID card right now?
[CUSTOMER][NEUTRAL] What is
[CUSTOMER][NEUTRAL] No, I, I faxed in the APL to.
[CUSTOMER][NEUTRAL] Uh, what did I, who did I send that to?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] What's the email address I should be sending the EPL and the APL to?
[AGENT][NEUTRAL] Typically we don't accept claim information through email um but our email is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] We do have a fax number. [PII], um, but we do have a fax number and a uh mailing address.
[CUSTOMER][NEUTRAL] Yeah, um, what is it called? It's called, OK, so I should just go and fax these.
[AGENT][NEGATIVE] Um, you can, yeah, I just don't know why I'm unable to find you in our system at all.
[CUSTOMER][NEUTRAL] Is that the best way?
[CUSTOMER][NEUTRAL] Because they told me to um
[CUSTOMER][NEUTRAL] Shoot.
[CUSTOMER][NEUTRAL] Email it to customer service at 4 member something.
[AGENT][NEUTRAL] That is not us, um, give me just a moment I think.
[CUSTOMER][NEUTRAL] Is that wrong?
[AGENT][NEUTRAL] I think that is.
[AGENT][NEUTRAL] B uh BWA, uh, Business Workers of America. Give me just a moment because that sounds very familiar.
[AGENT][NEUTRAL] Yes, OK, so that is that group, um, OK, so I've got a group number let me try to see if I can find you within them give me just a moment so that information, um, Business Workers of America, that's that's who that is so let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Are you a um a business owner?
[CUSTOMER][NEUTRAL] No, I'm just a, an individual who purchased a private multi plan unknowingly.
[AGENT][NEUTRAL] Got you OK well that's honestly that's how they work so typically with us um the coverage we offer is through an employer or a group only um and they're the only ones that kind of operate outside of that so I can give you more of their information if you'd like, but that is their email the customer support at [PII] um it is a quite a large group, so bear with me just a moment I'm gonna see if I find.
[AGENT][NEUTRAL] You know if maybe your name is spelled incorrectly or something like that, see if I can't find you.
[CUSTOMER][NEUTRAL] So, so since I sent the email it to them, they would email it to you?
[AGENT][NEUTRAL] Um, if it's for claim information or is it, uh, to register through them? Do you know if you currently have that coverage?
[CUSTOMER][NEUTRAL] They told me I did. They, they told me to go ahead and email it to this um email so I can get reimbursement from my
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The the invoice I paid.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, um, what I would do is because I'm not seeing you at all in our system, so what I would do is I would reach out to them. I can give you their phone number if you need it, um, or you could simply wait for them to respond to that email um and explain uh the whole situation and that uh you know there was a mistake they might have entered in information incorrectly or something like that but we have no record of you in our system.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so what is their phone number?
[AGENT][NEUTRAL] OK, so it is [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So BWA.
[CUSTOMER][NEUTRAL] Sends the claims to APL to get reimbursed process correct?
[AGENT][NEUTRAL] Um, honestly, I'm not very familiar with how they operate. I know you yourself can send us those claims individually or of course if you find a provider that's willing to, they can as well, um, and it's possible they could file them for you.
[CUSTOMER][NEUTRAL] OK, I, I'm gonna skip then so I can send you the form I completed on APL with the invoice, correct?
[AGENT][NEUTRAL] You can. The problem is I don't have your policy number, and I don't see an active policy at all with us.
[CUSTOMER][NEUTRAL] So how do I get the policy number that they said, cause on my card, yeah.
[AGENT][NEUTRAL] Right, that's what I, mhm.
[AGENT][NEUTRAL] That's what I would say you should reach out to BWA um if they were the ones who got you hooked up with this uh coverage um to verify that your information is all correct um and if there's a mistake they can correct it and then um you know they'll either be able to give you that information they should be able to give you that information if they set it up for you.
[CUSTOMER][NEUTRAL] Oh great. OK, I'll start there. It's a.
[AGENT][NEUTRAL] I know. I'm sorry. I don't mean to shoot you back and forth.
[CUSTOMER][POSITIVE] Thank you. Bye.
[AGENT][POSITIVE] Of course you're welcome thank you.