AccountId: 011433970860
ContactId: 4a7734ed-1694-4786-96ec-71407e975e0e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 862599 ms
Total Talk Time (AGENT): 168861 ms
Total Talk Time (CUSTOMER): 272080 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/4a7734ed-1694-4786-96ec-71407e975e0e_20250422T21:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, how are you doing? Um, my name is [PII]. I got a, uh, a text, uh, that said your claim is complete and then with a reference number, but I'm trying to log, uh, to to log in and actually create an account on the [PII] website, but it's saying it doesn't recognize my information, so I'm trying to figure out what I should do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, yes, I can help you with that. What is your policy number?
[CUSTOMER][NEUTRAL] The policy number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, like on the card, is that like the payer ID?
[AGENT][NEUTRAL] Uh, it should be a policy certificate or member number.
[CUSTOMER][NEUTRAL] I mean on the on the card uh there's a payer ID there's a group number, there's an in hospital benefits cert number and outpatient benefits cert number.
[CUSTOMER][NEUTRAL] Doesn't say policy number though.
[AGENT][NEUTRAL] Uh, what is your first and last name?
[CUSTOMER][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] [PII] is the last name.
[AGENT][NEUTRAL] OK. And how do you spell your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'll look you up that way.
[AGENT][NEUTRAL] I know the system is like pretty picky so if I log into to, if I go to your policy, I can help you.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, it's weird the car doesn't show that at all.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, I think I found you.
[AGENT][NEUTRAL] OK, [PII]. And what is your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Sorry, I just have to verify a couple pieces of information.
[AGENT][NEUTRAL] OK, and then the mailing address we have on file and email?
[CUSTOMER][NEUTRAL] The mailing address is [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, are you on a computer?
[CUSTOMER][NEUTRAL] I was doing it on my phone, but it's probably easier to do on the computer. Uh, give me a second, let me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To experience
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, now I'm in front of the computer.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you're trying to create an account, right?
[CUSTOMER][NEUTRAL] I don't think I registered. I don't recall registering for an account.
[CUSTOMER][NEUTRAL] Um, so
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, probably a new user, but I don't recall.
[CUSTOMER][NEUTRAL] I did it before or not.
[CUSTOMER][NEUTRAL] Maybe I did a long time ago.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, let me double check to make sure you don't already have one.
[AGENT][NEUTRAL] Just a minute.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, so it looks like you do have one.
[CUSTOMER][NEUTRAL] OK, is the username I is it his email address?
[AGENT][NEUTRAL] No, so your username is [PII].
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] His name is [PII]. OK, let me try what I.
[CUSTOMER][NEUTRAL] Send me a password.
[CUSTOMER][NEUTRAL] No, it's not that one reset your password. She deleted I see, OK.
[CUSTOMER][NEUTRAL] Oh, it says your password is expired. Maybe that's OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Mm, right, so maybe this should, maybe this will work for us.
[AGENT][NEUTRAL] OK, are you able to reset it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm trying now one second.
[AGENT][POSITIVE] OK. If you can, I can reset it for you.
[CUSTOMER][NEUTRAL] Let's see, yeah, just gave me the passcode.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] Alright, it looks like I am in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I guess, um, it just says the the claim was was finalized. I'm just trying to figure out what what they're talking or what that text was talking about.
[AGENT][NEUTRAL] OK, it doesn't give you a description of
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, in the, in the text that I guess, um.
[CUSTOMER][NEGATIVE] Shoot, I lost it.
[CUSTOMER][NEGATIVE] That's so weird.
[CUSTOMER][NEUTRAL] Oh my.
[CUSTOMER][NEUTRAL] Oh, this is a claim number, yeah, claim number 3.
[CUSTOMER][NEUTRAL] 589-735
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see it now, OK.
[CUSTOMER][POSITIVE] Oh, and then the amount paid. OK, perfect. I see it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Well, you've been very helpful.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I try, I tried. I just gave you one thing, but.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] All right. Have a good day bye bye.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, no, no, so, the, uh, actually, sorry, there is one quick thing, so this, this is a
[AGENT][NEUTRAL] No, OK, well.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it. OK, so I see, I see you paid this, so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] This is for, this is for my wife, [PII].
[CUSTOMER][NEUTRAL] Right, that she, that she paid to the hospital. And then when I saw the bill, I'm like, I said, you know, I said, [PII], did you give them your um AM public card?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The APL card and she said no, so call the hospital and they filed the claim retroactively. So in order to get, in order to get to get reimbursed, do I have to call the hospital now and say and say hey this is processed, can I get reimbursed now?
[AGENT][NEUTRAL] Uh, so you can just call them and then say, hey, I have this secondary, um, policy with APL and you can just give them, um, your card or
[AGENT][NEUTRAL] Uh, I would assume like you can fax it to them if you don't go in. Um, that would be up to them, but.
[CUSTOMER][NEUTRAL] No, no, no, I, I, I did that process already and they, they, they, they filed the claim on my behalf, um, after, after my wife paid the bill, but my wife didn't realize that when she went to the hospital that she should have given the APL card.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] Then, then when I saw the charge on the credit card, I said, I said what is this? And I realized that she never gave the APL information. I called the hospital, gave it to them.
[CUSTOMER][NEUTRAL] They and and that's why this this last payment was was processed.
[CUSTOMER][NEUTRAL] So the question is somebody needs to reimburse me. Is it APL is gonna reimburse me or is it the hospital itself gonna reimburse me?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Let me see, just a second.
[CUSTOMER][NEUTRAL] I guess the question is, wait, wait, this, this money that was paid, who was it paid to who?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because it was back to the hospital after I call them.
[AGENT][NEUTRAL] Yeah, there is.
[AGENT][NEUTRAL] There's a form, uh, let me look for it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just, OK, let me put you on a brief hold and ask one of my colleagues, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, thank you for holding.
[AGENT][NEUTRAL] So we would just need the EOB, so the explanation of benefits and the bill amount that says how much you paid.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Um, so rather.
[CUSTOMER][NEUTRAL] No, I think it's the one you just it's the one you just reimbursed. It's, it's the one that was just processed for the $2,358.
[AGENT][NEUTRAL] OK, so I see that we paid that one.
[CUSTOMER][NEUTRAL] You pay that to who, to the hospital or to me or to me or [PII] directly?
[AGENT][NEUTRAL] So it says that we pro we paid the provider.
[CUSTOMER][NEUTRAL] OK, so the provider is the hospital got it. OK, so then I have to call them to.
[CUSTOMER][NEUTRAL] To get it reimbursed. I understand.
[AGENT][POSITIVE] Yes, correct. Um, I can also.
[CUSTOMER][NEUTRAL] OK. So I will, I will do that.
[AGENT][NEUTRAL] Yeah, we sent, so we sent a check over to them.
[AGENT][NEUTRAL] Uh, would you like the check number just in case you need it?
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] OK, it is 203.
[AGENT][NEUTRAL] 92.
[CUSTOMER][NEUTRAL] I'm sorry, one second.
[AGENT][NEUTRAL] Oh, sorry.
[CUSTOMER][NEUTRAL] 20392.
[AGENT][NEUTRAL] 70.
[CUSTOMER][NEUTRAL] 70
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, 203-9270. Perfect. OK, well, thank you. I appreciate your help.
[AGENT][POSITIVE] Yeah, you're welcome. Well, thanks for calling APO. Have a good day. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] OK, bye.
[CUSTOMER][NEUTRAL] Yeah.