AccountId: 011433970860
ContactId: 552a935a-eb01-4100-85a5-c2b08430f024
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 619159 ms
Total Talk Time (AGENT): 267388 ms
Total Talk Time (CUSTOMER): 327509 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/552a935a-eb01-4100-85a5-c2b08430f024_20250609T16:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? This is [PII].
[AGENT][NEUTRAL] Hi so how how are you?
[CUSTOMER][POSITIVE] I'm good, it's Monday
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh yeah. I have, uh, Mr. [PII] on the line. He said he's spoken with you before, so I'm, I'm really glad I got you. Um, but, um, yeah, the policy number is 2487523.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's about his claim. He said he submitted some more information and he just feels like, you know, he should not be waiting that long. He said he don't want no special treatment, but he don't believe that he should be waiting that long for the claim to process and he wanted to speak to somebody in that department.
[AGENT][NEUTRAL] OK, when did we receive his claim 63? OK, alrighty, and he's been verifying so, correct?
[CUSTOMER][NEUTRAL] Yeah, recently. Mhm.
[CUSTOMER][NEUTRAL] It's been fully verified. Correct. Yes. Mhm. Yes, and he has some more um troubles about the website, but that one I can go ahead and report to [PII]. So I'll go ahead and do that just in case he mentioned it. Just let him know that I'm reporting the information of the website, the problems he's having with that.
[AGENT][NEGATIVE] OK, and that's the OSC issues, so people are still having issues with, uh, like I had, I spoke to a customer on a side note, sorry, I spoke to a customer a little bit ago that on a hub request I had to call them back and she said she's able to access it but it just keeps spinning and it won't advance and she can't view anything. Is that kind of what people are reporting generally?
[CUSTOMER][NEGATIVE] Yeah, I have been, yes, I have reported a few of those, even myself, I cannot view my claims, I cannot view my UOB, so I don't know what's going on there. And um, but also he's saying that there's like some information about um that is coming out on, on their, on their fine or something like that under his name and and there is no confirm they're not getting confirmation numbers no more, so I don't know. This is my 3rd call, they're not getting confirmation numbers.
[AGENT][NEUTRAL] They're not. OK. And so that is being um.
[AGENT][NEUTRAL] OK, but that is being looked at, right?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I'm gonna go ahead and report the confirmation for the first time on my end. I'm not sure if anybody else has um reported that, so I'm gonna go ahead and report that one so hopefully we'll get it fixed.
[AGENT][NEUTRAL] Got you, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, do you know, so, yeah, do you know, real quick, I'm sorry, um, if my customer that I called back, she said that she had already spoken to someone on the care team, they didn't indicate it in the notes, but can I assume it that she was reported as well? Do you know?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] And do you know who I would check with?
[CUSTOMER][NEUTRAL] If it was
[CUSTOMER][NEUTRAL] Uh, if it was not report, if it was not notated, more than likely it was not reported, but I can go ahead and check on the list. What is the policy?
[AGENT][NEUTRAL] 258.
[AGENT][NEUTRAL] 2109.
[AGENT][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she reported it today?
[AGENT][NEUTRAL] Well she called in in regards to a claim denial and wanted some further information because she they told her to to check her EOBs and of course she can't view them so she wanted further information and we wanted some more information regarding the attending physician form um so I sent that to her in an email but I did tell her I would inquire about her issues with OSC if I could find anything out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. All right. Um, yeah, we have to put in a spreadsheet and they go by that, um.
[CUSTOMER][NEUTRAL] Let's see if it's on the spreadsheet.
[AGENT][NEGATIVE] And I did verify like I said, she is active um and like I said she can get in, she just can't view anything it just spins.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And be the you know these uh-huh, and it was processed like not recently or nothing like that. It was processed um a few days at upron.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, hers was actually, well, hers was actually processed on 5:30, the claim itself.
[CUSTOMER][NEUTRAL] 5:30. OK, yeah, it should be there then um mhm.
[AGENT][NEUTRAL] But she, like I said, she re-registered and was accessing OSC on [PII]. Like I said, I did verify that [PII] had helped her with that. She was able to get in. She just can't view anything now. Like I said, when she signs in, it just spins.
[CUSTOMER][NEUTRAL] Got you. OK. I don't see the report here. I don't see that name or that person in the report. I can go ahead and just put her in just in case, OK?
[AGENT][POSITIVE] That'd be great thank you so much so, and you can go ahead and I'm sorry about that thank you so much.
[CUSTOMER][POSITIVE] You're welcome. OK. No, it's OK. No problem. Here he comes. Have a good day.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Thank you. Thank you for holding and being patient for me. I got Ms. [PII] on the line and she's gonna assist you from here, [PII]. Hi [PII].
[AGENT][NEUTRAL] Hi Mr. [PII], how are you?
[CUSTOMER][NEUTRAL] Um, I'm doing OK, [PII]. Seems like we're dancing again. I was just sharing with the late that, um, you know, your system is.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, not showing my name as the insured as far as the claims are submitted and.
[CUSTOMER][NEGATIVE] Um, it's, uh, it's really frustrating, [PII], honestly.
[AGENT][NEUTRAL] Understood, um.
[AGENT][NEUTRAL] Uh, yeah, I know they're working through those issues. I, I think [PII] might have, um, you know, let you know that information and she has added your name to their list because they're trying to iron out these issues that they're having as far as the website. Now she said that you had indicated um you needed some further information to about your claims.
[CUSTOMER][NEUTRAL] Well, I mean, obviously, so you guys don't have an automated system for your wellness at all it has to be manually touched?
[AGENT][NEUTRAL] Um, right now, yes.
[AGENT][POSITIVE] They are currently being manually processed, that's right.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I, I just, I mean I'm sorry, hold on that's funny, um, I flipped over a screen on my computer and it comes up with that anyway, um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I, I guess you know being a broker as long as I have this is has gotten really antiquated and.
[CUSTOMER][NEUTRAL] Um, that there's no checks and balances in place for you guys to, to basically take care of a client that's going through a long process or or deal like this.
[CUSTOMER][NEUTRAL] Uh, because the industry, I don't care what carry it is, uh, we could have got this stuff taken care of a long time ago.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] And that's the heartburn having Roxy and I'm having it with the standpoint and not necessarily for myself although it is frustrating it's more about I can't put a client over here with you guys with this this process and this support.
[CUSTOMER][NEUTRAL] So I guess I'm just sit here and wait until this gets done, which may be next week at this point for a simple wellness.
[AGENT][NEUTRAL] OK, understood.
[CUSTOMER][NEUTRAL] And I can tell you my clients would have walked already.
[AGENT][NEUTRAL] Well, again, I understand, I understand what you're saying um unfortunately, like I said with this system update, um, there were apparently issues they weren't anticipating and they're they're working through them now, um, and basically, I mean, as far as your claim processing, are you talking about like such as the turnaround time?
[CUSTOMER][NEUTRAL] But the turnaround time, yes, uh, a wellness, nobody out here has 7 to 10 days on a wellness.
[AGENT][NEUTRAL] Well, general
[CUSTOMER][NEUTRAL] And many are are.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Understood.
[CUSTOMER][NEUTRAL] And many are, are, um, you know, computer generated at this point.
[AGENT][NEUTRAL] Exactly, understood and like I said, we are working toward that process but unfortunately, like I said, at this time they are being manually processed. So um there is a little bit of um of, of, you know, usually it doesn't take that long, but when there's other issues, I think there's kind of like a backup here. So like I said, generally speaking, we try to do those claims, you know, sooner, but like I said, go ahead.
[CUSTOMER][NEUTRAL] Oh, and
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEGATIVE] Well that's the other thing that's a concern to me is that the way the system is messed up that I'm gonna have added time on top of it because the system is not properly showing uh what it should be showing and so you got some tech person that's working on that which doesn't get to the claims people which then further delays the potential for my claim to be taken care of.
[CUSTOMER][POSITIVE] You would think that you would have a a group or a manager that can come in and jump and take care of that.
[AGENT][NEUTRAL] Well, as I said, they are working toward those issues that you're speaking of. I do know that, um, and like I said I know that they are working diligently to to correct the issues within the online service center, um, you know, the portal itself, um.
[AGENT][NEUTRAL] But unfortunately, at this point, you know, it's just a matter of um like I said, getting those issues resolved.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Obviously there's not anything that I can do at this point um to help facilitate this further down the road which is disappointing but.
[AGENT][NEUTRAL] Just
[CUSTOMER][POSITIVE] Is what it is, so, uh, I, I hope that at some point this week this can get addressed and we can all move forward. So I appreciate your time, [PII] thank you.
[AGENT][POSITIVE] Certainly. You're welcome, Mr. [PII], and I will, um, you know, I will definitely take your concerns and share them um with, with the team. So, um, just know that like I said, we are um we are working through those issues, but like I said, I will definitely uh share your concerns.
[CUSTOMER][POSITIVE] OK all right thank you.
[AGENT][POSITIVE] You're welcome, Mr. [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You're welcome, Mr.