AccountId: 011433970860
ContactId: 4aaa0261-5c50-41fb-9807-26017c6b4078
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 925260 ms
Total Talk Time (AGENT): 441937 ms
Total Talk Time (CUSTOMER): 310407 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/4aaa0261-5c50-41fb-9807-26017c6b4078_20250102T22:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], you're about the 3rd person we talked to here now we keep getting switched around, but anyways, I'm trying to find out, me and my wife um she had emailed in some payment requests for reimbursements.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] Everybody we've talked to they were gonna check into it and get back to us either the phone call got dropped, they never did call back and we call back and then we have to start all over again.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, no. OK.
[CUSTOMER][NEUTRAL] Wondering if you can help us somehow to figure out what's going on.
[AGENT][POSITIVE] Yes, absolutely, sir. I will do my best to get the help that you need. I'm so sorry that you have had calls dropped. Um, so what is the name on the policy? What is your name?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, [PII], what is your callback number? Just in case the call is dropped, I will call you back.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] I appreciate that. It is area code [PII].
[CUSTOMER][NEUTRAL] 493.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, sir. And then what is the policy number?
[CUSTOMER][NEUTRAL] It is my member number I guess is 680.
[CUSTOMER][NEUTRAL] 752
[CUSTOMER][NEUTRAL] 180.
[AGENT][NEUTRAL] OK, that policy number is too many digits to be one of ours. Um, can I get your social security number and see if I can pull you in that way?
[AGENT][NEUTRAL] Do you see it or do you see a policy certificate number?
[CUSTOMER][NEGATIVE] Hm, that doesn't make sense.
[CUSTOMER][NEUTRAL] Member I'll read it to you, member number 680,752,180.
[CUSTOMER][NEUTRAL] That's what's on his card.
[AGENT][NEUTRAL] OK, that that number is um a long number has too many digits to be one of ours. Do you see a policy certificate number or an inpatient or an outpatient certificate number?
[CUSTOMER][NEUTRAL] No, no, that's the only card that card he's got.
[CUSTOMER][NEUTRAL] And it's, it's right on the card just like a driver's license card it's the same size as that and when I explained it to them they were able to pull it up whoever I was talking to last.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know why I'd have a different. OK, give it through your social security.
[AGENT][NEUTRAL] On the back of
[AGENT][NEUTRAL] OK, yes.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Um, your social security number, if I can get that from you, sir, I can pull in, it'll pull in every policy that you have with us.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you, sir. I appreciate that.
[CUSTOMER][NEUTRAL] Let me ask her what the number is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and you said your name is [PII]?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] Let me make sure I've got the the um social security number right. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can I get the spelling of your last name? I wasn't unable to pull you up with the social security number. So what is the spelling of your last name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You ain't got nothing. It's [PII]
[AGENT][NEUTRAL] And you spell your first name, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, alright, let me look by your last name we're gonna keep on until we've run out of options we're gonna try to get you.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] I wonder, you know what really, I wonder who in the hell is charging me every month that goes on my credit card. Where's this money going then?
[AGENT][POSITIVE] I've I've actually got, I have found you.
[CUSTOMER][NEGATIVE] They can't even find me or nothing and I'm getting charged?
[AGENT][NEGATIVE] No, I have failed you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, can you verify your date of birth for me, please, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you and then.
[AGENT][NEUTRAL] For security reasons, can you please verify your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] OK, I pull it my email sheets or email is [PII].
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Do they have a PO box? Is that how you see it? Or do you have a PO Box [PII]?
[AGENT][NEUTRAL] Yes, I
[AGENT][NEUTRAL] OK, thank you so much. And then the phone number that you gave me to call you back on if we get disconnected, is that your cell phone number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah it's.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] Alright, thank you, [PII]. I appreciate you. I know it was a process, but we've got you pulled up now and you've got your policy all verified, so that's good.
[CUSTOMER][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you said that you
[CUSTOMER][NEUTRAL] So what's this member number on the card versus.
[AGENT][NEUTRAL] Let me actually give you your policy number that you have with us. Um, it's 241.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 8662.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 8662
[AGENT][NEUTRAL] 241-866-2.
[CUSTOMER][NEUTRAL] So how can we
[CUSTOMER][NEUTRAL] OK, so why wouldn't he have a card with that on there?
[AGENT][NEUTRAL] I, I'm unsure. I'm not, I don't know what card you're looking at, but the policy number with us is 241-8662.
[AGENT][NEUTRAL] And what I can do is I'm going to.
[CUSTOMER][NEUTRAL] The card that he has is THCF.
[AGENT][NEUTRAL] That is not our card.
[CUSTOMER][NEUTRAL] OK. OK, so what, what are you gonna do? OK, what's your name again?
[AGENT][NEUTRAL] We're, we're.
[AGENT][NEUTRAL] We, we are APL so what I'm gonna do is I'm gonna order a new card for you to be mailed to your PO box that I just verified with you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That way you have a card from us. OK, so, um.
[AGENT][NEUTRAL] Did you already send in your claim, sir?
[CUSTOMER][NEUTRAL] Uh yes we did, ma'am and it and it it is on a 5 23 24 this is my wife here too and she kind of takes care of this but if you hear another voice here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir. OK, I do see that we did receive a claim on that day.
[CUSTOMER][POSITIVE] We can, we can resend them to you or whatever is easiest.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull it up real quick.
[AGENT][NEUTRAL] I do see a claim that was received on that day.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What day is that?
[CUSTOMER][NEUTRAL] [PII]. 0, on the on the on the [PII] OK.
[AGENT][NEUTRAL] The day that you give them the [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so your policy effective date.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] Looking at the claim that was sent in on [PII], there's um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Multiple remarks on it. Let me give you the remarks that that the claims examiner.
[AGENT][NEUTRAL] has made, um.
[AGENT][NEUTRAL] One of them is the charges submitted are not payable because services were rendered prior to the policy's effective date.
[AGENT][NEUTRAL] So there were some charges in there that were sent in prior to [PII].
[AGENT][NEUTRAL] When your policy became active?
[AGENT][NEUTRAL] And then um the other one is vaccines and immunizations or the administration of injections are not covered under the policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] At
[AGENT][NEUTRAL] And then we also have laboratory tests are not a covered benefit under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] There were 3 reasons why the claim laboratory test lab work is not covered under the hospital indem you have a hospital indemnity policy, so your lab tests were not covered under this policy.
[CUSTOMER][NEUTRAL] What aren't
[CUSTOMER][NEUTRAL] Hm, OK. What's covered under this policy? Yeah, what that's what we're trying to find is what is this policy really cover and is it really insurance?
[AGENT][NEUTRAL] Um, it's not a major medical plan. It's a limited hospital indemnity plan that helps if you go into the hospital. Um, it helps with, uh, ambulance bin, like if you have to go by ambulance or by a helicopter, um, it has health screenings, um, per calendar year. What I can do is I can request that uh policy be mailed to you.
[AGENT][NEUTRAL] At your home address so you can look the policy up over or if you wanted to uh sign up for the online service center which is would be very beneficial for you it's a direct portal to your policy so you can get copies of your cards you can see your policy certification on there if you ever file a claim, you can get your claim status off of there also let me give you that website so at your convenience you can sign up.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I'm, I
[AGENT][NEUTRAL] It's um [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Dot Am like.
[CUSTOMER][NEUTRAL] R R U.
[AGENT][POSITIVE] Secured
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] So this isn't really considered as health insurance, is it, then?
[AGENT][NEUTRAL] So when you
[AGENT][POSITIVE] It does have some health benefits for you, but it's basically a hospital indemnity plan, which means um if you ever have to go into the hospital, it's, it's great for that.
[CUSTOMER][NEUTRAL] Good morning. OK, I wonder where I got this, so you don't know anything about if this PHCS.
[AGENT][NEUTRAL] I don't know what PHCS is.
[CUSTOMER][NEUTRAL] Car that I
[CUSTOMER][NEGATIVE] I don't understand what the hell I really got here hm, OK.
[AGENT][NEUTRAL] On that PHCS card, does it have um the name of the insurance company on it or is that the name of the insurance company?
[CUSTOMER][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] I think that is the name of it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then all that the other says is just group ID BWA.
[CUSTOMER][NEUTRAL] Mark Care
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mark care
[CUSTOMER][POSITIVE] It's got a benefit level.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah. Ask how much this policy is this policy that I have with you people in?
[AGENT][NEUTRAL] Yeah, that's not with that's.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, you have this you have this hospital indemnity plan with us through Business Workers of America. That card that you have is a different insurance company. There should be a number on that card that you can call them and ask them what um what kind of policy do you have and ask them to explain it to you.
[AGENT][NEUTRAL] So that you'll know what that card's for.
[CUSTOMER][NEUTRAL] Yeah we've been trying to.
[AGENT][NEUTRAL] Oh no, OK.
[CUSTOMER][NEUTRAL] OK, how much this plan?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, you know this plan that I have with you guys then?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] How much is that per month? Can you tell me?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] $17.80.
[CUSTOMER][NEUTRAL] OK. We don't have, she pulled up the um.
[CUSTOMER][NEGATIVE] A breakdown of my monthly bill and it doesn't even show $17.80 on there and what would it be called? What would it be listed as? How does it get billed?
[AGENT][NEUTRAL] Um, AP, APL, yeah, this is payroll deducted.
[CUSTOMER][NEUTRAL] That APL would it say?
[CUSTOMER][NEUTRAL] I'm self-employed.
[CUSTOMER][NEUTRAL] I don't have no payroll.
[AGENT][NEUTRAL] You don't work for Business Workers of America?
[CUSTOMER][NEUTRAL] No, I'm self-employed.
[CUSTOMER][NEGATIVE] This is screwed up. Business workers of America.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I wonder where my payroll check is.
[AGENT][NEUTRAL] Yeah, this, this plan that I'm looking at.
[CUSTOMER][NEUTRAL] Is that
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] Date of birth matches.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You've had this policy since [PII].
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEGATIVE] Oh, I wonder where in the hell I'm supposed to go to work every day.
[CUSTOMER][NEUTRAL] Oh, we got a thing here that's BWA Business Workers of America and then it has the PHCS card.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That that BWA would be Business Workers of America.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yep, well when they they sent to us when they sent it to us your card and the PHCS card are side by side. So these are together it's just the front and the back card. Oh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yeah, I see. Yeah, you turned this card over this PHCS card and it says you're BWA right on the back of it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so what I'm gonna do, I'm still gonna go ahead and order you a card to be sent to your home address.
[AGENT][NEUTRAL] Through our company.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] So that you have that with this policy number.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, um, so I really didn't, well, I didn't too much, but alright, yeah, if you can send that, that'd be great, and I guess we'll just have to see what else I can do here OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, well, [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Nope, nope, that'll be fine.
[AGENT][POSITIVE] All right. Well, you too have a, have a good rest of your evening and thank you for calling APL.
[CUSTOMER][NEUTRAL] And was [PII]
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome, sir. Bye-bye.
[CUSTOMER][NEUTRAL] OK, so let me ask you his wife.
[CUSTOMER][NEUTRAL] Bye yeah.