AccountId: 011433970860
ContactId: 42b220c3-65de-4381-99d1-2bea9f4db634
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1524170 ms
Total Talk Time (AGENT): 266887 ms
Total Talk Time (CUSTOMER): 419550 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/42b220c3-65de-4381-99d1-2bea9f4db634_20250221T18:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How you doing, sir? I'm calling to try and check on the status of a claim, a reimbursement claim.
[AGENT][POSITIVE] OK, I'm happy to check on a claim for you today. Do we have a policy number?
[CUSTOMER][NEUTRAL] Um, I have a member number.
[AGENT][NEUTRAL] OK, what's that?
[CUSTOMER][NEUTRAL] 683-586-852
[AGENT][NEUTRAL] Give me just one moment here.
[AGENT][NEUTRAL] OK, that's unfortunately not bringing anything up for me. I can check by name or social or do you have a claim number by chance?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I don't have any of that. I just got my name and my social I can give you. Um, I'm [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yeah, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Uh, I'm [PII]. That's [PII], [PII], added [PII].
[CUSTOMER][NEUTRAL] Last of [PII] as Perry, Roger, Ida, [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] What state do you live in, [PII]?
[CUSTOMER][NEUTRAL] I'm in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And just to confirm, the first name spelling was [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So [PII].
[CUSTOMER][NEUTRAL] It'll be uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh, I'm so sorry. I see me try that.
[AGENT][NEUTRAL] Nothing's coming up here by name. Let me.
[CUSTOMER][NEUTRAL] I I do a social
[AGENT][NEUTRAL] No
[AGENT][POSITIVE] Yeah, we can try the social [PII] go ahead when you're ready.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm gonna close out of my system and pull back up a new one, try that, see if that helps us here.
[AGENT][NEUTRAL] Who is the who is the policy through like who's your employer, [PII]? I'm not, I'm not able to.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, it's in that, it's a managed care policy. I don't, it's not through an employer.
[CUSTOMER][POSITIVE] And all this is just making me even more uh
[CUSTOMER][NEGATIVE] Worried cause I feel like I've been bamboozled. Now I know for sure that I've been bamboozled, and I've been directed to you who's supposed to have my information. I'm not in the system, so.
[AGENT][NEUTRAL] And the social was [PII] and what were the last four again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Did you do the claim online or did you submit it in the mail or fax it? How did you submit the claim?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I submitted the claim through email.
[CUSTOMER][NEGATIVE] Um, and then managed care people told me that you guys got it. That's how I got your phone number. This is like, it's been like 40 days. I was told not to bother anybody for 30 of them. I did it for 35. Now I gotta figure out what's going on.
[CUSTOMER][NEGATIVE] Which makes me upset because I'm not even in the system, so.
[AGENT][NEUTRAL] Mm, OK. Let's see.
[CUSTOMER][NEGATIVE] And the worst part is no one has any good information for me. They just kick me to the next person, kick me to the next person, kick me to the next person, and the business never gets handled. I'm $750 in the hole.
[CUSTOMER][NEGATIVE] And another $500 waiting on reimbursement, that's $1250 and I don't have a job, so I am highly upset.
[AGENT][NEUTRAL] Yeah, do you by chance have the email um that you sent it to?
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] I do, uh.
[AGENT][NEUTRAL] What's, what's the email address?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Uh, I sent it to um member services, uh.
[CUSTOMER][NEUTRAL] Let's see this email customer [PII].
[AGENT][NEUTRAL] OK, well that, that helps me some, so hold on just a second.
[CUSTOMER][NEUTRAL] And it was a [PII] that I got the form from that I actually emailed it back to her and then I was told to email it to the other people. This all happened on [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm gonna search under the group number um and pull up the list of everybody that's showing active. It's gonna take a second just to search here, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I'm still here. I'm just scrolling through the list.
[AGENT][NEUTRAL] OK, and when you spoke, [PII] with the business workers of America people,
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] They were not able to give you any sort of certificate number claim, OK.
[CUSTOMER][NEUTRAL] Nothing.
[CUSTOMER][NEGATIVE] Nobody, nobody's been able to give me anything but to run around.
[AGENT][NEUTRAL] When you spoke to them they just stated that they that we had received the claim that was all that they gave you.
[CUSTOMER][NEUTRAL] Yes, she just told me that uh that the claim was I had to contact APL to basically find out the status of it. That, that's what she just told me like 5 minutes ago.
[CUSTOMER][NEUTRAL] So they like they went in their system and they were able to find that I guess to contact you. I'm not sure how it works. I just know every time I call somebody go get help.
[AGENT][NEUTRAL] OK, and then
[AGENT][NEUTRAL] The number you called, was it the [PII] number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, the claims number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I don't.
[CUSTOMER][NEGATIVE] Cause he was really, was really bothering me. So just to give you the, the quick rundown. When I signed up for this in December and I talked to the sales agent or whoever was telling me the, the service, they told me that if I made two payments, that the state will subsidize the rest and that, you know, $2025 would be good as long as I made my first two payments, $250 a month.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I made those two payments. I got charged another 250 for the third month. When I called to find out what was going on, they basically told me that there was nothing they could do, that they could stop the payment from happening for the following month, but there was nothing that they could do. So then I also explained how, OK.
[CUSTOMER][NEGATIVE] I'm paying $250 a month, but I'm still paying for therapy out of pocket. How do I get reimbursed? They gave me the claim form. I filled that out. Um, for 30 days, I got to run around about that cause I was calling to find out is there something I need to do? What should I be doing? Should I be waiting?
[CUSTOMER][NEGATIVE] That just passed a few days ago and now I'm calling to find out and this is where I get to run around and nobody knows about the queen and nothing's happening. So I really feel like after reading all the fine print,
[CUSTOMER][NEGATIVE] You know, after 30 days or within 30 days, if you're not happy with your services, you can be reimbursed or you can get your money back. Well, I think they told me to wait 60 days before anything just so that they knew that I would not get that money back. And then what really bothers me is I have not been able to use the services whatsoever. So I'm just out of $750 while still paying for my out of pocket medical costs. So I am highly upset.
[AGENT][POSITIVE] Yeah, I'm sorry for the first.
[CUSTOMER][NEGATIVE] And then again, all of that while I have no job.
[AGENT][NEUTRAL] Sorry for the frustration, [PII], and it wouldn't be under any other name, it would be just under your name, right?
[CUSTOMER][NEUTRAL] I'm the only person, that's it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, well, the only other thing I can think to do is to place you on hold and we contact BWA together and see if we can get a policy number because if I can't find the policy unfortunately I can't, I don't have a way to check a claim, you know.
[CUSTOMER][NEUTRAL] And then you don't get the policy from the member's number, huh, cause that's the only thing that I have is the member's number.
[AGENT][NEUTRAL] I mean, I don't.
[AGENT][NEUTRAL] Because it says when you sign up, did you ever receive a text or an email welcoming you to BWA with a link to sign in to a portal?
[CUSTOMER][NEUTRAL] Um, I did receive that.
[AGENT][NEUTRAL] OK, so that states that's where you go for like your card information. The customer will receive a text and email welcoming them to BWA with a link to sign into their portal. No cards are provided by APL um all of that is located online it looks like. Have you tried signing into any of that?
[CUSTOMER][NEGATIVE] Uh, I did sign into that and it doesn't have anything other than what I signed up for. It doesn't, like, nothing that I've done with this service has been fucking useful, like to my friends, but nothing has been useful. I called the doctor, doctors can't use it. Uh, my therapist can't use it. I can't use it. So I don't understand why they would even sell me something like this, like.
[CUSTOMER][NEGATIVE] Yeah, if that agent was in front of me, I'd be kicking his ass right now.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] Cause I specifically explained to them that I do not have a job. So anything that I'm doing needs to be working, and then for them to just fucking take my money like that is just
[CUSTOMER][NEGATIVE] Yeah, and now I can't even get the reimbursement on the back end.
[CUSTOMER][NEUTRAL] When I do what I'm supposed to do.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] This is why people just don't follow the rules cause you follow the rules and you still get rid of.
[CUSTOMER][NEUTRAL] Offer trying to have some damage insurance.
[CUSTOMER][NEGATIVE] And like for me this just doesn't even make sense. You guys are all tied together. There's no reason why I should be in the system but not in the system, have a claim but don't have a claim. They can find me, but I can't be found, but they know how to find my money.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, let me get somebody on the line with BWA Donovan because I don't know what else, how else to help at this point. Um, do you mind holding? Do you want me to call you back? What works best for you?
[CUSTOMER][NEUTRAL] I hope.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance.
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance. Our hours of operation are Monday through Friday [PII] Central Standard Time. If you know your party's extension, please dial it now.
[CUSTOMER][NEUTRAL] For customer support, press 2. For agent support, press 3. For claim support, press 4. For provider support, press 5. Thank you.
[CUSTOMER][NEUTRAL] You are currently caller number 25, [PII]ng to speak with a representative. The estimated hold time is currently 17 minutes. Thank you for your patience.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII], their whole time is kind of long. I don't know that if you want to stay on hold. It's saying that it's 17 minutes. Do you want me to call you back at this number?
[CUSTOMER][NEGATIVE] What's gonna happen? I would like for you to call me back. What's gonna happen is it's gonna keep you on hold for so long and then it's just gonna hang up on you. That there's no way of getting in contact with any of these people. This is why I'm so pissed off.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] I look, I'm working to do what I can for you um so I have no issue calling you back if that's what you would prefer or you know you can stay on hold. I just wanted to check in with you.
[CUSTOMER][NEUTRAL] No, I, I'll let you call me back. I'll jump in the shower and hopefully we can get this resolved. I am upset. I'm not upset with you. You are like the one person who is fucking trying to help me out.
[AGENT][NEUTRAL] Yeah, no, I mean, look, I, I, I totally get where the frustration's coming from and it's absolutely valid so I just wanna make sure your callback number is [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, alright, I will most definitely call you back if you don't answer I'll leave a message I'll try again, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Yeah, you're welcome.
[CUSTOMER][NEUTRAL] You are currently caller number 20 waiting to speak with a representative. Thank you for your patience.