AccountId: 011433970860
ContactId: 3fc55e8f-2140-4649-bf47-1eba0a0ad4b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 821429 ms
Total Talk Time (AGENT): 360715 ms
Total Talk Time (CUSTOMER): 364750 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/3fc55e8f-2140-4649-bf47-1eba0a0ad4b3_20250304T20:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], how are you today?
[AGENT][POSITIVE] I'm doing well. How are you doing today, sir?
[CUSTOMER][POSITIVE] Good, good, good. I'm calling about my American Public Liga Select policy.
[AGENT][NEUTRAL] OK, I can help you with your policy, sir. Can I please get your name and your policy number?
[CUSTOMER][NEUTRAL] Oh where would I, where would I get the call center?
[AGENT][NEUTRAL] Do you have a car?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, just a reg, well, I have my regular Blue Cross Shield card. I don't have an APL card. It was never sent to me.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] All right, [PII], um, I can look it up with your social security number if you want, would like to give that to me, please.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, let me find your policy real quick.
[AGENT][POSITIVE] Thank you so much, [PII]. Can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then for security reasons can you please verify your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] Thank you, and then one more verification can you please give me your cell phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you sir and if we get disconnected is that a good number to call you back on?
[CUSTOMER][POSITIVE] Yes, it is, yes it is.
[AGENT][POSITIVE] All right, thank you. Well, how can I help you today besides get you a new card?
[CUSTOMER][NEUTRAL] Uh, need a claim, need to make a claim.
[AGENT][NEUTRAL] You need to make a claim, so alright, I'm going to um give you two options we.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] I don't even think I have, I don't even think I have a, uh, I don't even think I'm registered with you guys.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] To be honest with you.
[AGENT][NEUTRAL] Through the online service center, the portal? OK, that's really easy for you to do if you just go to [PII]
[CUSTOMER][NEUTRAL] Yes, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Secure
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] When you go in there for the first time you're gonna sign up as a new user.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And then your second option, the 2nd screen you'll get will say you're gonna choose I'm an individual with the policy.
[CUSTOMER][NEUTRAL] OK, but uh, what if I'm not, what if I'm going through my, this is through my company.
[AGENT][NEUTRAL] So you
[AGENT][NEUTRAL] Are you the um contact person with your company?
[CUSTOMER][NEUTRAL] So I don't know how to
[CUSTOMER][NEGATIVE] Uh, what do you mean contact person? No, I'm not contract. No, I'm employed by Mustang Steel Solutions, but it's going through Paychecks Oasis. Yeah, I don't know why they did this.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, no, um, with our online service center it's a direct link to your policy, so it'll be fine you'll just have to set up your own username and password.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um you'll be able to file a claim there through the online service center and if you choose not to do it that way we also have a website where you can get a claim form from.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And I can give that to you also.
[CUSTOMER][NEUTRAL] Yeah, can you email me that and I'll print it.
[AGENT][NEUTRAL] Uh, the claim form is actually on the website. I can give you the link to the website. Yes, sir. And that is.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Website
[CUSTOMER][NEUTRAL] Oh, this
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The website is is going to be [PII] without the secured in the front, [PII].
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When you get into that website, you're gonna go to the top right hand corner and there's a link that says claims and forms. You'll click that link and the claim form that you need is the med link claim form. It's M E D L I N K.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] You'll need your medling claim form, you'll need your explanation of benefits from your primary insurance, and you'll also need an itemized statement with your diagnosis code and procedure codes on it.
[CUSTOMER][NEUTRAL] What do I, what do I need for my uh employer?
[AGENT][NEUTRAL] You don't need anything from your employer, you just need your explanation of benefits from your primary insurance carrier.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So what I need there, what, what, how do I get that?
[AGENT][NEUTRAL] You call the primary insurance, uh, that you have your major medical with?
[CUSTOMER][NEGATIVE] Why do we have to do all that, why do we have to do all this if I'm, if I'm doing it all online? It doesn't make sense. You've got everything, you've got all my information.
[CUSTOMER][NEUTRAL] Obviously, I have a plan.
[AGENT][NEUTRAL] Mhm. Yes, I understand that, sir.
[CUSTOMER][NEUTRAL] I don't say I have a plan, so it's not, it's not like it's a, it's not like it's fraud.
[AGENT][NEUTRAL] No, it's not fraud, sir. You just have to have the correct documents in order for your claim to be processed.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] I mean I got a call Blue Cross Blue Shield.
[CUSTOMER][NEUTRAL] And ask them for what?
[AGENT][NEUTRAL] The explanation of benefits.
[CUSTOMER][NEGATIVE] That looks, man, it's ridiculous.
[CUSTOMER][NEGATIVE] Now you take our money and you'll still make it harder.
[CUSTOMER][NEUTRAL] Blue Shield, right.
[AGENT][NEUTRAL] Now there is another option for you if you'd like to contact the facility that you went to, to have your um medical work done and just ask them if they're willing to file the claim for you.
[CUSTOMER][NEUTRAL] Nope, because they take forever. They're a big that's MD Anderson. They're a big hospital. They're a big institution.
[AGENT][NEUTRAL] Oh, I understand, sir.
[CUSTOMER][NEUTRAL] How long, you know how long that would take?
[AGENT][NEUTRAL] Through MD [PII], I'm not sure.
[CUSTOMER][NEUTRAL] Yes, yeah, it take a while.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Wow, so I got to go through 3. I gotta go. I've already went through paychecks. I've already went to your website and I got to go through 3 more. That's 5 different websites I've been, I'm gonna go through.
[CUSTOMER][NEUTRAL] Just to get a form and file it.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] No wonder why we're such a, no wonder why, no wonder why [PII] is firing everybody.
[AGENT][NEUTRAL] Mm, well, I hope he doesn't fire me because I, I like my job and I like helping people.
[CUSTOMER][NEUTRAL] Man, you know.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, think about it. Think about it. 5 different websites just to get a form and file it. Think about it.
[AGENT][NEUTRAL] Yes, sir. Yeah.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Think about it, just think about it. It needs to be a little more simplified.
[AGENT][NEUTRAL] Oh, we just have one website to go to, sir. We just have one that has the claim form on it.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, cause I still got to go to Blue Cross Blue Shield and get that letter uh benefits explanation of benefits. So that's another website I got to go to.
[AGENT][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] So there's 2 right there.
[AGENT][NEUTRAL] I'm sorry about that, but they're a different company than ours so.
[AGENT][NEUTRAL] I apologize that you have to go through steps to be able to get your claim filed.
[AGENT][NEUTRAL] But once you get it all in, we'll review it, uh, it'll take 7 to 10 business days to process the claim once we receive it.
[CUSTOMER][NEUTRAL] Uh-huh. No, no, that's, yeah, no, that's fine because it's, it's, it's, it's a number of them. So I'm, you know, what I went through was stem cell replacement for cancer. So, I mean, this 1500 is not even gonna, this 1500 not even gonna put a dent in it. So I'm just sending you one bill to cover, cover the $1500 to cover some of it.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir, I understand.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] So yeah, OK, let me do that, let me do that and then I'll, I'll go care because it has carrier website. I can go to your carrier website, that's you, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Carrier is not us we're APL.
[CUSTOMER][NEUTRAL] No carrier website, you are the carrier, so it's your website.
[AGENT][NEUTRAL] Yes, that's the one I gave you with the AM, the one I gave you with the [PII], that's our website.
[CUSTOMER][NEUTRAL] [PII] OK, yeah.
[CUSTOMER][NEUTRAL] OK, so I'll go to sign in correct?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] If I've never done this before, OK, so the sign in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] New user, yes, I'm a new user.
[AGENT][NEUTRAL] Yes, you're a new user.
[CUSTOMER][NEUTRAL] And now I was gonna be, I'm an individual with APL insurance policy.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Next
[CUSTOMER][NEUTRAL] OK, last night.
[CUSTOMER][NEUTRAL] OK, social security, I gotta put the whole social security number down.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK, I'm just asking sometimes, you know, they just ask for the.
[AGENT][NEUTRAL] The last 4, yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] So this comes to me personally, correct.
[AGENT][NEUTRAL] Right, that's gonna come directly to, to you.
[CUSTOMER][NEUTRAL] OK, so put my so put my personal email down there.
[AGENT][NEUTRAL] Yes sir, and you're gonna need to use the one that we have on file for you, all of your information that we have, that's the one that you gave me, the [PII].
[CUSTOMER][NEUTRAL] Is that gonna be
[CUSTOMER][POSITIVE] [PII], OK, OK, I, I just put that in so you're good.
[CUSTOMER][NEUTRAL] OK, next.
[CUSTOMER][NEGATIVE] Oops, there seems to be a that, that's what, yep, you know what, that's why I already went here and you have a problem. That's what it was. You know, I went to next and you've got a problem with your website.
[AGENT][NEUTRAL] OK, if it's.
[CUSTOMER][NEUTRAL] Hold on, no, no, hold on, hold on, hold on, hold on, let me see, let me see, hold on.
[AGENT][NEUTRAL] Your policy because everything has to match that we have with what you're putting in.
[AGENT][NEUTRAL] And if there's one little thing wrong, then I'll have to fix it so that we can make sure you get in.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, no, no, no, it, it's just saying that there's another, so, OK, never mind, I guess I tried it already and I had trouble with it and y'all fixed it, so I'm already registered. That's what it was. So I'm registered. Tell me I'm already, yeah, so let me go here. I don't remember my password.
[AGENT][NEUTRAL] Oh, you're already.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can give you your user name.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] No, I know my user, uh, give me my username. It's not my email.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Oh, that's not good.
[AGENT][NEUTRAL] Let me check real quick for you, sir.
[CUSTOMER][NEUTRAL] Yeah, OK, go ahead, yes ma'am.
[AGENT][NEUTRAL] It's uh no, it's, it's [PII].
[CUSTOMER][NEUTRAL] OK user name.
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] So yes sir once you put that in you'll have to if you don't remember your password you'll just have to reset it so it can send you a link to do a new password.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, let me try some see let's try.
[CUSTOMER][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] OK, no, I'm in.
[AGENT][POSITIVE] Yay, awesome I'm glad you got in.
[CUSTOMER][NEUTRAL] Well, you can receive claim status, yeah, OK, so.
[CUSTOMER][NEGATIVE] I'm here now where do I need to go? Never.
[CUSTOMER][NEUTRAL] OK, I'm here. It tells me a medin group SP. This is what it's telling me my coverage policy number. OK, there's my policy number. OK, so what do I wanna do now?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] You wanna file a claim on the Medlink.
[CUSTOMER][NEUTRAL] OK, I'm here. OK, am I here? Is this where I need to be? Med link, so I need a highlight meddling? No.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] So I don't file it here?
[AGENT][NEUTRAL] You file it in the online service center, yes sir.
[CUSTOMER][NEUTRAL] OK, so where do I go? It says.
[CUSTOMER][NEUTRAL] Here's some med. I'm where I'm, I'm at the APL, so where do I need to, what do I need to get right now?
[AGENT][POSITIVE] OK, let me get in. I've got a a sheet that I can help with. Hold on real quick sir.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] No, no, go ahead, you're good.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're gonna go to um on the user dashboard you're gonna go to my claims.
[CUSTOMER][NEUTRAL] Right, OK, I see it and it says upload documents.
[AGENT][NEUTRAL] Yes, you'll need to upload your documents along there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Inside the online service center and then it'll prompt you from there as to what to do next to be able to submit the claim.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I don't need to do so this this way here I don't have to do the claim correct I can just do it online.
[AGENT][POSITIVE] Right, right, it'll give it to you there, yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, very good. That's good. So yeah, let me get all that taken care of. So when I do that, I'll submit the claim, but now I still have to do the uh explanation of benefits. I still have to get that from Blue Cross Blue Shield, correct?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, you'll need that and then and your itemized statement. Don't forget about that those three documents.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][POSITIVE] OK, yes, correct.
[CUSTOMER][POSITIVE] OK. All right, very good. All right, thank you so much, story. I'll get back now that I know I use a username.
[AGENT][POSITIVE] You're so welcome, [PII].
[CUSTOMER][POSITIVE] And my password I know how to get into it now I know what I need. OK, great, thank you so much and now I'm registered right you have a great day.
[AGENT][POSITIVE] Awesome good.
[AGENT][POSITIVE] You're welcome, sir. You have a great day too. It's been a pleasure talking to you. Thanks for calling APL bye bye, [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Same here.
[CUSTOMER][NEUTRAL] All right bye bye.