AccountId: 011433970860
ContactId: 563877e5-de58-4981-ba94-2fcaeffef964
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 532960 ms
Total Talk Time (AGENT): 189210 ms
Total Talk Time (CUSTOMER): 259090 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-2.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/563877e5-de58-4981-ba94-2fcaeffef964_20250509T21:26_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hello, so I recently, honestly accidentally enrolled for your guys' coverage for my, for my work WSI. I didn't even finish verifying nothing and they just started pulling it from my, my, uh, checks. So and then when I do try to use the insurance since I might as well use it if I'm paying for it, it, it doesn't hardly cover nothing and I don't have any pharmacy insurance like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] It's not a good deal for me and honestly a pain in my ass so.
[CUSTOMER][NEUTRAL] I don't know if I can cancel it or what the deal is, but.
[AGENT][NEUTRAL] OK, uh, what is your name and the and the policy number, please?
[CUSTOMER][NEGATIVE] I don't know the policy number to tell you the truth. I don't know how to use anything about it. I didn't even register completely and they started saying my name is [PII].
[AGENT][NEUTRAL] I'm sorry, say again?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And verify your date of birth and mailing address, please?
[CUSTOMER][NEUTRAL] Um, I was born [PII]. I live [PII].
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, yes, sir. Um,
[AGENT][NEUTRAL] Looks like the policy you have with us is a limited medical entity plan. Uh, if you would like to cancel your policy, you will have to call benefits and a card, and they'll be able to assist you.
[CUSTOMER][NEUTRAL] Why do I have to call them? I think I'm through APL. I don't know what that is.
[AGENT][NEUTRAL] Since this is a group policy, uh, in order to cancel coverage, you will have to contact your group and they will send us information showing that you no longer want the plan.
[CUSTOMER][NEUTRAL] OK, so what I, what are you, what, what are you useful for?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEGATIVE] You can tell me what my coverage. I'm confused as what this line is for. You tell me my policy coverages and you can verify my coverage. You just can't. I'm just confused as to.
[AGENT][NEUTRAL] Well, we can't cancel your policy since it's a group plan, you will have to contact your group and they can cancel the policy for you.
[CUSTOMER][NEUTRAL] Why told me the why.
[CUSTOMER][NEGATIVE] I didn't have to contact them to set it up like I don't know what the fuck that is. This is.
[CUSTOMER][NEUTRAL] This is a non
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] So, can you see that recently?
[CUSTOMER][NEGATIVE] Can you see like uh what my insurance is covering at the moment or anything what's why they brought me why they direct me here?
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh, we can verify your benefits. Uh, the policy you have, I show you have benefits for confinement in hospital, surgery if performed in a facility or office, ER, urgent care, office visit benefits, um, diagnostic like MRI, CT, CAT scan, PET scans. Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, does it show that like I went to the doctors or hospital or anything like that?
[AGENT][NEUTRAL] Well, I don't show we received any claims for you.
[CUSTOMER][NEGATIVE] I don't know what that uh receiver claim would be, but I know I went to the doctor, and that was a little bit before I, uh, or a little bit after I had applied for the insurance, and they want $700 from me when I'm so confused because I should have insurance on act like this whole situation is frustrating. I didn't even.
[CUSTOMER][NEGATIVE] I can't even get a hold of the right people. Insurance sucks as.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] You'll have to give the provider your information and then they can.
[AGENT][NEUTRAL] Call us, verify benefits and information to make, but we hadn't received the claim, so you have to contact your provider if you did have service perform and let them know your insurance company had not received the claim.
[CUSTOMER][NEUTRAL] I did that.
[CUSTOMER][NEGATIVE] You haven't received the claim. You never received a claim, but they sent me a whole.
[CUSTOMER][NEGATIVE] A whole link that I put y'all's information for my insurance on it, it just hasn't fucking went through. I don't understand. Like it's really pissing me off. I'm paying 50 to $50 a week for this stupid ass insurance that doesn't do nothing for me, and I can't even fucking get directed to a person I need to talk to. Like you can't help me. I'm not, I'm sorry to be rude to you, but this insurance is the most stressful thing I've ever had to deal with.
[CUSTOMER][NEUTRAL] Like y'all gonna trying to something different.
[CUSTOMER][NEUTRAL] So I have to call a benefits and a call.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] If you wanted to cancel your policy, since your policy is a group plan, you have to contact them and they can cancel, send us information to cancel. But as far as claims, we hadn't received any claims. So if you've given the provider our information.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Why
[CUSTOMER][NEUTRAL] OK, let me ask you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][POSITIVE] Continue that's my question. I'm sorry.
[AGENT][NEUTRAL] I'm sorry, I can barely hear you.
[CUSTOMER][NEUTRAL] You're entering
[CUSTOMER][NEUTRAL] You were answering my question before you stopped. I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] But, um,
[AGENT][NEUTRAL] As far as any claims, we don't know about any service that was performed until we receive claim, um, a billing from a provider or yourself, but we hadn't received anything, so there's no claim for us to process.
[CUSTOMER][NEGATIVE] That makes no sense when I uploaded y'all's information on to where I was supposed to pay for it like.
[CUSTOMER][NEGATIVE] Fucking bogus. You just like no claim on that? What do I gotta do? I gotta.
[AGENT][NEUTRAL] Uh, you can contact the medical provider and they can submit the itemized billing or you can submit the itemized billing to our office either.
[CUSTOMER][NEGATIVE] Is that the hospital? Who is that? Who's that? The hospital? This is so fucking stupid.
[AGENT][NEUTRAL] Where you receive service, yes, that's a medical provider, it's hospital, physician, or whoever, uh,
[CUSTOMER][NEUTRAL] Oh, I'm sorry, um.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And, and tell them what? Tell them what? Tell the hospital what?
[AGENT][NEUTRAL] You can give them your, you can give them your policy information, which I can give you your policy number and they can call and verify benefits and we can let them know where to submit claims.
[CUSTOMER][NEUTRAL] I already did that though. I just didn't do it over the like talking to them. I did it.
[CUSTOMER][NEGATIVE] On a fucking link that they sent me. This is.
[AGENT][NEUTRAL] And then that you have to contact the, contact the hospital where you receive treatment and let them know we hadn't received the claim.
[CUSTOMER][NEGATIVE] I'm about to get pissed off.
[CUSTOMER][NEGATIVE] I'm fucking mother.
[CUSTOMER][NEGATIVE] I swear to fucking God, dude.
[CUSTOMER][NEGATIVE] Oh, how can you deal with an insurance company? I'll never go to a hospital again in my life.
[CUSTOMER][NEGATIVE] I'll die before I did that stupid shit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, that's fucking ridiculous.
[CUSTOMER][NEGATIVE] Can I, can I get a number to call them cause it's not like it directed me to you. I don't fucking know what to do.
[AGENT][NEUTRAL] Number to call who the provider, we wouldn't know the provider's number since we hadn't received any claim information from them.
[CUSTOMER][NEGATIVE] I uh better hard to.
[AGENT][POSITIVE] Yes, I can give you their phone number. Let me know when you're ready.
[CUSTOMER][NEUTRAL] That's not what I'm talking about.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] [PII] and if you like I can transfer you to them.
[CUSTOMER][NEUTRAL] [PII] you could transfer me, OK.
[AGENT][NEUTRAL] OK, hold on one moment, I, yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] I already got it rolling down thank you.
[AGENT][NEUTRAL] OK, do you want me to transfer or you wanna call him yourself?
[CUSTOMER][NEUTRAL] I'll just go ahead and give them a call.
[AGENT][NEUTRAL] OK. Uh, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] You know,
[AGENT][POSITIVE] OK, uh thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] OK.