AccountId: 011433970860
ContactId: 3b8a0f92-fc8c-4011-92cd-ace4a39e4641
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 486380 ms
Total Talk Time (AGENT): 213145 ms
Total Talk Time (CUSTOMER): 215869 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/3b8a0f92-fc8c-4011-92cd-ace4a39e4641_20250515T21:32_UTC.wav
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[AGENT][NEUTRAL] For calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Hi, um, I'm calling, I'm trying to register online and it's, it says that they can't find my account.
[AGENT][NEUTRAL] OK. Do you have your
[CUSTOMER][NEUTRAL] So I'm just calling. Mhm.
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 02612127.
[CUSTOMER][POSITIVE] Good thing this is on the table because I like to have. [PII] and uh 111 1968.
[AGENT][NEUTRAL] And could you verify your uh name and your date of birth for me, please?
[AGENT][NEUTRAL] And what is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have a good callback number in case we are disconnected?
[CUSTOMER][NEUTRAL] Yes, area code [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then last thing, [PII], could I get your email address?
[CUSTOMER][NEUTRAL] Sure. [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, it looks like we have a work email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can we
[CUSTOMER][NEUTRAL] Change that cause
[AGENT][NEUTRAL] Yeah, sure.
[AGENT][POSITIVE] I like it.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Let me see. Oh, maybe that's why I couldn't make an account.
[AGENT][NEUTRAL] Yeah, it's gonna need to match up with what we have in the system, um, let's see.
[CUSTOMER][NEUTRAL] Probably.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But do you wanna change that to your personal email?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, can we do that?
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Um, OK, give me your personal email.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I've got that updated, um, so now you should be able to, if you go into that website.
[AGENT][NEUTRAL] Um, and it has to be from a laptop or desktop, can't be from a phone, um.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] To the new user. I'm an individual.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Should be able to enter your last name. You will need to enter your full social security number, no dashes.
[AGENT][NEUTRAL] And then your zip, and then that Gmail address and then your date of birth, and it should take you to the next step. Do you want to try it while we're on the phone?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um, and what, what is this policy good for? Cause I'm like, I'm not sure cause I wasn't given any information on it. I'm like, oh, OK, I'll buy that. Because I thought it, it, it's like a supplement.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] It is. So, um, let me pull up your policy so I can give you the dollar amount that it covers.
[AGENT][NEUTRAL] Um, and anything I quote is not a guarantee of payment. It's a basic outline of your policy.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Oh, I, yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yeah, that's fine. That's helpful, no matter what it is.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So this is a policy that after your primary insurance processes your claims,
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Um, this will pay for inpatient and outpatient services. So for example,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] For your inpatient benefit, if you're ever inpatient in the hospital. Once your primary process your claims, if you had deductible and co-pay, co-insurance left over, this pays up to $5000 per calendar year.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Sending the email, right? That's the email.
[AGENT][NEUTRAL] And then for your outpatient hospital benefits, if you ever were outpatient hospital, it pays up to $2500 per calendar year after primary processes the claim.
[CUSTOMER][NEUTRAL] Uh, let me check really quick, is it ES?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, um, what does it cover exactly?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's gonna be for
[CUSTOMER][NEUTRAL] Like uh for the outpatient I didn't get a response so that was.
[AGENT][NEUTRAL] Uh, it'd be for like anything outpatient in the hospital, diagnostic testing, um, surgery, so any services rendered while outpatient hospital.
[CUSTOMER][NEUTRAL] I sent it through the main email that's on the account. So it would cover some of cataract testing like cataract measurements.
[AGENT][POSITIVE] Yes, so they're in the hospital. Yes, that's correct. Mhm.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] If it's done in the hospital. So not if it's done in an outpatient center.
[AGENT][NEUTRAL] Um, let me see, this is, let me see what it defines as outpatient.
[AGENT][NEUTRAL] Yeah, it covers physical therapy facilities, um, outpatient hospital.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Revised hospital.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, it would be like a freestanding facility.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] It's just not gonna be like a doctor's office. That's what it excludes.
[CUSTOMER][NEUTRAL] Right. But if I have surgery at an outpatient surgical facility, it should help cover that.
[AGENT][POSITIVE] It would help cover that, yes.
[CUSTOMER][NEUTRAL] OK, and um so it's up to 2500 for the outpatient. OK. And um I have, how, how do I submit claims? Would I just call the same number and or I'd be able to do it through once I register?
[AGENT][NEUTRAL] Once you register, you'll have a dashboard on there and you'll see where it says like upload files. That's where you can upload your claims um as they're incurred. And then you can also, um, once you create an account, you can look at your policy certificate and read through that of, of, you know, everything that it covers on the policy. Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The coverages.
[CUSTOMER][NEUTRAL] OK. And um I have another, just one more question about do you go back in time at all?
[AGENT][NEUTRAL] We do.
[CUSTOMER][NEUTRAL] Like retro cover claims? Do you know what did.
[AGENT][NEUTRAL] Uh, well, it'll be your effective date is [PII]. So that's what we would go back to.
[CUSTOMER][NEUTRAL] Oh, you don't go back years, like if I didn't make a claim in past year when I had a claim.
[AGENT][NEUTRAL] Um, let me see if you've had another policy.
[AGENT][NEUTRAL] OK, so yes, it looks like you did have this policy from [PII] to [PII].
[AGENT][NEUTRAL] So you would be eligible to claim um anything on that policy. So, yeah, there's no time limit for filing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can, should I do, and I need my card from then or is it under the same policy? Will I be able to do it through the same dashboard?
[AGENT][NEUTRAL] You can do it through the same dashboard we'll look in our system to and we'll see your old account and we would apply it towards that.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much. I appreciate it.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good evening.
[CUSTOMER][POSITIVE] All right, thank you. OK, bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.