AccountId: 011433970860
ContactId: 3f3b2cc1-8d7f-4e02-bde5-cbd98de34f33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 912739 ms
Total Talk Time (AGENT): 220099 ms
Total Talk Time (CUSTOMER): 368326 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/3f3b2cc1-8d7f-4e02-bde5-cbd98de34f33_20250613T14:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. I had a question regarding um my gap insurance.
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][NEUTRAL] I don't, that's part of my question. I'm trying. I just called my benefits department and they emailed me some information on how to file a claim and how to log on the website, but when I try to log on the website.
[CUSTOMER][NEUTRAL] Although she gave me a wrong email address, so that might be part of my problem. um can I give you my social?
[AGENT][POSITIVE] Uh, yeah, that will work.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, can I get your first and last name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name is [PII].
[AGENT][NEUTRAL] OK, and then Mrs. [PII], can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then can you verify your address and your email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, it looks like we don't have an email on file. OK, so [PII]?
[CUSTOMER][NEUTRAL] Correct, that's probably why I couldn't request a, yeah, because I was trying to log in and it was saying error it didn't know me.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me get that updated.
[CUSTOMER][NEUTRAL] So I was trying to create an account, yeah.
[AGENT][NEUTRAL] Yes, you, you'll create your account, you'll be the insured, and then there's a two-factor verification process, um, where it'll ask for a verification code twice. Um, let me get your address or your email address updated. Give me just a moment.
[AGENT][NEUTRAL] And do you have a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so I've got your email address updated and then.
[AGENT][NEUTRAL] That you effective [PII], your policy is still active.
[AGENT][NEUTRAL] And then when you um successfully log in, you'll be able to print your ID cards if you like, and there's policy information and.
[CUSTOMER][NEUTRAL] Yeah, that's that's what I was trying.
[AGENT][POSITIVE] OK and then is there something I can help you with? You wanna walk through that first and make sure it's successful or?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I'm actually, I, I got past the error thing, so let me just finish the rest of this, um.
[CUSTOMER][NEUTRAL] You don't mind just waiting 1 2nd.
[AGENT][POSITIVE] Yeah, absolutely, take your time.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 7.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Right, just waiting for the code to come, um, so she also she did send me the information on how, how to file a claim, um, and also just to verify, so she told me I had $500 inpatient, 250 outpatient, so if I went for an MRI, obviously that's considered outpatient.
[CUSTOMER][NEUTRAL] And then if I went if I ended up having surgery, then that would be.
[CUSTOMER][NEUTRAL] $500 inpatient.
[AGENT][NEUTRAL] Uh, yeah, let me pull up your plan and make sure that's correct.
[CUSTOMER][NEGATIVE] I'm not getting the
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, yes, that's not a guarantee of payment basic outline of your policy for, yes, you're inpatient, that's correct, $500 per confinement, and then your outpatient is $250 per current.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] Did that process of registering online, I don't recall it asking me for a phone number. Is that just gonna get texted to the phone number that you have on file? Because I'm not getting a code.
[AGENT][NEUTRAL] Uh, no, the code will be sent to your email address.
[CUSTOMER][NEUTRAL] Oh, well that would make sense. Let me just pull that up.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh there it is.
[CUSTOMER][NEUTRAL] 648-661.
[CUSTOMER][NEUTRAL] OK, what does that painla not verified 80 wait, I is not not 7 is not 7.
[CUSTOMER][NEUTRAL] It says claim not verified email address in brackets.
[AGENT][NEUTRAL] Um, was that from?
[AGENT][NEUTRAL] Can you click, so can you clear out your browser history and then start over?
[AGENT][NEUTRAL] I don't know if it retained from because I just updated it so if you did anything right right before that it would give an error code.
[CUSTOMER][NEUTRAL] Alright, let me, let me start again.
[CUSTOMER][NEUTRAL] Log in
[CUSTOMER][NEUTRAL] OK, now it's saying we can't seem to find your account.
[AGENT][NEUTRAL] OK, and then you did put under the insured?
[AGENT][NEUTRAL] And then,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Are you on uh your phone or is this through a um laptop?
[CUSTOMER][NEUTRAL] I'm on the computer.
[CUSTOMER][NEUTRAL] Yeah, I might, yeah.
[AGENT][NEUTRAL] You know what browser you're using?
[AGENT][NEUTRAL] Like Google Chrome or?
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Microso
[CUSTOMER][NEUTRAL] Yeah, I think I'm on Google Chrome.
[CUSTOMER][NEUTRAL] Should I try edge maybe?
[AGENT][NEUTRAL] Um, no, it should, it shouldn't matter. Um, Edge, Safari and Google Chrome will work. Um, give me just a moment.
[CUSTOMER][NEGATIVE] I'm not sure if it even took like the the logging of the creating of my username and password though because.
[AGENT][NEGATIVE] It doesn't look like it did.
[CUSTOMER][NEUTRAL] I think that was all part of.
[AGENT][NEUTRAL] Yeah, it looks like.
[CUSTOMER][NEUTRAL] OK, so maybe I need to start from scratch.
[AGENT][NEUTRAL] Yeah, if you could start from scratch cause it looks like I got to the next step when I started from scratch, so.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] 6.
[CUSTOMER][NEUTRAL] OK, so I'm getting to the continue.
[CUSTOMER][NEUTRAL] Ask me.
[CUSTOMER][NEUTRAL] So should I send the verification code but not complete the new password confirmed password display name and all that stuff just put the email address in and then click the button that says send verification code.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] [PII], right, did that.
[CUSTOMER][NEUTRAL] Just waiting for codes.
[CUSTOMER][NEUTRAL] Alright, got the code
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Do I hit the verify code before I put all the password information in?
[AGENT][NEUTRAL] So did you enter the pass or the verify code?
[CUSTOMER][NEUTRAL] I entered the code and now I'm asking do I click the button that says verify code first?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now
[CUSTOMER][NEUTRAL] Now you can continue. OK, so putting in the password.
[CUSTOMER][POSITIVE] I agree. I agree.
[CUSTOMER][NEUTRAL] OK now it says it's been created so.
[CUSTOMER][NEUTRAL] No, I have to log in.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sent code oh she can do code every single time.
[CUSTOMER][NEUTRAL] Just waiting for the code.
[CUSTOMER][NEGATIVE] Oh, dishonest people make life so difficult.
[CUSTOMER][NEUTRAL] Verify code.
[CUSTOMER][NEUTRAL] Alright, I am in OK.
[CUSTOMER][NEUTRAL] So now it says to get my
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm just gonna take me at all like tutorial.
[AGENT][NEUTRAL] Um, so if you go to your dashboard, you should be able to see, um, on the right side it'll say start a new claim.
[CUSTOMER][POSITIVE] Awesome.
[AGENT][NEUTRAL] And then there'll also be a place, I think it asks, well, do you want to print your ID cards?
[AGENT][NEUTRAL] look at your ID cards.
[CUSTOMER][NEUTRAL] OK, just
[CUSTOMER][NEUTRAL] Just trying to get through this uh 733.
[CUSTOMER][NEUTRAL] OK, so on the.
[CUSTOMER][NEUTRAL] OK, on the left side of the, so on the dashboard.
[CUSTOMER][POSITIVE] I see, oh yeah, view your ID card, perfect.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Awesome, so that, oh, I don't see an ID card, but it does give me the policy number and the stuff that I need, so.
[CUSTOMER][NEUTRAL] Which is the 2405464 OK so.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Is it best to have the insurance, the, the providers submit these, or should I just be doing them after my insurance pays and just deal with getting reimbursed? Does it matter?
[AGENT][NEUTRAL] If it, it doesn't matter, but if the provider submits, they usually they're gonna have everything that we need to process the claim typically if you try to do it sometimes you're might be having trouble accessing like getting a diagnosis code and the procedure code, the things that we need to process the claim. So we found a lot of success with the providers submitting, but if they submit, we'll be paying them, um, typically if there's an assignment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We that's fine. I, I don't care.
[AGENT][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] Yeah, that, that's fine because I, I mean they did send me, I mean I have the explanation of benefits, but the bill that they sent me doesn't give diagnosis code and procedure code. It only breaks out like MRI, pharmacy, radiology, supplies, surgical services, so I need more than that. You want diagnosis? OK, OK, I'll just give them a call and give them the information. So basically I'm giving them the policy number.
[AGENT][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] And then what about uh oh I see I can click on this little thing for the ID card.
[CUSTOMER][NEUTRAL] And then they would mail the claim to the [PII].
[AGENT][NEUTRAL] Yeah, uh, there's a couple different ways they can submit, but yes, that's, that's an option, faxing and then they can file electronically, yeah.
[CUSTOMER][NEUTRAL] Oh, they can now, uh, below you, where is the information for them to know how to file electronically?
[AGENT][NEUTRAL] Um, were you able to click?
[CUSTOMER][NEUTRAL] Do they just know how to do that?
[AGENT][NEUTRAL] Now, um, did were you able to click on the card to view card? Did it pull up an actual card?
[CUSTOMER][NEUTRAL] I am, yep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] It did, yes.
[AGENT][NEUTRAL] OK, so on there it should show.
[AGENT][POSITIVE] Let me pull it up real quick and look at yours. I'm saying the right thing.
[CUSTOMER][NEUTRAL] It does have the address. It does not have it does have a fax.
[CUSTOMER][NEUTRAL] I mean there is a website it's just at [PII].
[AGENT][NEUTRAL] Um, it looks like, OK.
[AGENT][NEUTRAL] Oh, there's a payer ID in the upper right hand corner. That's their electronic ID to file electronically, yeah.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK, so they would just know how to do that because they know how to do that.
[AGENT][POSITIVE] Yeah, exactly.
[CUSTOMER][POSITIVE] Perfect. All right. Thank you so much for your help today, [PII]. I, it was [PII], I'm sorry. I
[AGENT][POSITIVE] Yes, that's right, yeah, that's right, and.
[CUSTOMER][POSITIVE] Yes, it is [PII], yeah, OK, awesome.
[AGENT][NEUTRAL] OK, anything else I can help with?
[CUSTOMER][POSITIVE] Thank you so much for your help. I appreciate it. No, that should do it.
[AGENT][POSITIVE] OK, perfect. Well, I hope you have a great day and a great weekend.
[CUSTOMER][POSITIVE] You as well take care.
[AGENT][NEUTRAL] OK, thanks for calling [PII]. Bye bye.
[CUSTOMER][NEUTRAL] OK, bye bye.