AccountId: 011433970860
ContactId: 43c39fcb-9a7f-4793-a0d1-0e1b1e2e2be0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 448730 ms
Total Talk Time (AGENT): 218601 ms
Total Talk Time (CUSTOMER): 249843 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/43c39fcb-9a7f-4793-a0d1-0e1b1e2e2be0_20250320T19:58_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[CUSTOMER][NEUTRAL] One year like from from one calender hi.
[CUSTOMER][NEUTRAL] Yeah, I'm having an issue uh getting um logged in. I've um I've actually had the service you guys uh for a few years now and I.
[CUSTOMER][NEGATIVE] My wife tried to log in, I think, and, and make some claims and had some issues. So I just really haven't worried about it since then, but now I'm trying to go back and I, from what I understand, it's up to a year you can make claims on, uh, and I can't, I can't uh get into the account, or I can't even set up an account, um.
[AGENT][NEUTRAL] OK, I can definitely help you with that. Yes, sir, I can help you register, but before we proceed, is it possible to get a name for you and a callback number, please?
[CUSTOMER][NEUTRAL] So I was just trying to see if I could get some help.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, absolutely. It's [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[AGENT][NEUTRAL] Thank you for that, Mr. [PII]. Do you happen to have your policy number by chance?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so yeah, I have, there's 3, and they're all sequential numbers, so I can give it to you however you, whichever one you'd like, um, I've got 3 different plans. I think it's hospital indemnity, cancer, and one more that I don't know what this acronym is. OK. 218.
[AGENT][NEUTRAL] You can just give me one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2101.
[AGENT][NEUTRAL] Thank you for that Mr. [PII], and I just need you to verify a couple things for me. Can you verify your date of birth and your mailing address, please?
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yep, [PII], and the mailing address I have moved since then, so I just, I'm gonna rattle off an address if it's not right, let me know. Uh, it's [PII], that that's probably the one that you guys have on file.
[AGENT][NEUTRAL] We do have that one on file.
[CUSTOMER][NEUTRAL] OK, yup.
[AGENT][NEUTRAL] And let me also get you to verify your email account.
[CUSTOMER][NEUTRAL] OK, so this might be the issue. So the email that I would assume it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is the email that we have on file. It is showing that you do have an active um online service account you already have set that up. I can give you your username and you can go under forgot password and elect the username to proceed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] That'd be awesome, OK.
[AGENT][NEUTRAL] OK, so your username is actually your first name, [PII]
[AGENT][NEUTRAL] And then it's your last name with the [PII] and then it's the number [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Um, and now just a few questions, uh, when I log in, um, so it's, uh, my wife is covered, uh, under this policy, I believe, uh, it, it, it shows we just had, um, one of the representatives come to our office, so she gave us a printout, it has her name and everything on it. Um, what is, uh, I was told that it goes back, is it a calendar year that we can make claims on?
[AGENT][NEUTRAL] We actually don't have a statute of limitations, so what that means is if you guys can come up with the bills, the itemized bills from wherever you had services rendered, you can file claims back to your original effective date and it looks like you guys were effective on [PII].
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] [PII]. Yeah, so and now, now when you say, uh, you know, provide the bills, I can, I can log into my United Healthcare, uh, which is our, our healthcare provider and see every time that we've gone and, and so on and so forth. So is that what you guys would accept as a bill if I take the UHC uh page, you know, the website, the information that they give, and I can send that to you guys, does that count?
[AGENT][NEUTRAL] And that's on all 3.
[CUSTOMER][NEUTRAL] Or do I need a physical bill from the hospital?
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] We need the physical bill from the physician's office and when you call them, you just need to let them know in the billing department that you need an itemized bill even if services were paid for in full. We still need an itemized bill of what was done um and of course if it's paid in full it'll show that and since you are filing the claims, you will see the payments on the information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK, now on my UHC I can go to, I it shows me every single itemized service rendered um on on my on my UHC account like when I pull it up, it'll tell me the urine test, the uh, lipid panel, you know, ER visit, etc. etc. etc. So I can if so that you're saying that still does not count it actually has to be from the hospital itself.
[AGENT][NEUTRAL] The yes sir, it has to be from the provider's office itself um and that's the reason is is because that way we are fully we fully have the information that we need from the provider in the event that we need to reach out for any additional information or if you know something.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Wasn't legible, um, that way we're not going through a third party and I understand that you know everything's listed on your major medical but that's sometimes the information that they capture still doesn't have everything that we need so that's why we often require you to go back to the provider.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Now, when I have to go back to the provider, I, I do have um a medical claim number, like I said again, this is all through United Healthcare. Is that the number I would have to provide, say East Jefferson Hospital, and then they could provide me with that, that claim breakdown, correct?
[AGENT][NEUTRAL] They should be able to look you up by name. It it really shouldn't be an indication of what your information was registered under. Um, when you call them, you should be just tell them that you guys were, whoever was the patient, you or your wife, and that you guys had some services rendered and you're wanting to, you had supplements, so you're wanting to get an itemized bill of what was done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You get it.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And um they can as long as they can provide you, you know, like I said, whatever was done doesn't matter as long as it was between the time of [PII] and now you guys are fine to submit that in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, great, thank you so much and I think that should be it and if I have any other issues I'll give you guys a call back.
[AGENT][NEUTRAL] Alright, Mr. [PII], and just so you know, now that you guys are registered on the online service center you can go down and download your claims through there as well, um, which is a little bit faster. You will get an immediate response that we received it we're working on it and it generally takes 5 to 7 business days to process as well.
[CUSTOMER][NEUTRAL] Oh, you sure.
[CUSTOMER][POSITIVE] OK, great. Thank you so much.
[AGENT][NEUTRAL] You're welcome, Mr. [PII]. Is there anything else I can help you with before you go?
[CUSTOMER][NEUTRAL] No, I guess so. I just, I guess just to make sure I understand, so all three policies that I have, there is no statute of limitations on when to click make claims correct on all three different policies.
[AGENT][NEUTRAL] That's correct. Our company doesn't have a statute of limitation on any of our products, um, so again, as long as you guys can get them we're good to go, right?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Right, OK, thank you so much I appreciate your help.
[AGENT][POSITIVE] Thank you Mr. [PII], for calling APL and you have a wonderful day as well.
[CUSTOMER][NEUTRAL] Yeah, you too bye bye.
[AGENT][POSITIVE] Thank you, bye.