AccountId: 011433970860
ContactId: 6653bf0f-7790-44cf-bf8b-4ba262457025
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378369 ms
Total Talk Time (AGENT): 180311 ms
Total Talk Time (CUSTOMER): 203373 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/6653bf0f-7790-44cf-bf8b-4ba262457025_20250306T15:59_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII]. May I give you my policy number, please?
[AGENT][NEUTRAL] Yes, sir. Could you please give me your name again? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] As in zebra again.
[AGENT][NEUTRAL] OK, Miss.
[AGENT][POSITIVE] OK, thank you. And Miss [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And now your policy number, please?
[CUSTOMER][NEUTRAL] OK, I am, I am, oh my goodness, my employer changed his, uh, the company, the insurance company, uh, starting on [PII], but I have a concern regarding, uh, my previous benefits. The number is 00964.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 810.
[AGENT][NEUTRAL] And that's your APO policy number, is that correct?
[CUSTOMER][NEUTRAL] Yes, that's the policy number 00964810.
[AGENT][NEUTRAL] OK, so Miss [PII], I will need to verify several things with you first for security and also any information that is provided would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and your home well just.
[AGENT][NEUTRAL] And also your home mailing address please.
[CUSTOMER][NEUTRAL] My home
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have for you is the same as the one that you gave me, so just to re-verify that that is the best phone number we should have, is that correct?
[CUSTOMER][NEUTRAL] Yes, that's my cell phone, yes.
[AGENT][NEUTRAL] OK, thank you. And lastly your email address and this does appear to have been your work. Mhm.
[CUSTOMER][NEUTRAL] It's my name
[CUSTOMER][NEUTRAL] Yeah, my email is my name and my last name [PII].
[AGENT][NEUTRAL] OK, so again we have your work email address on file.
[CUSTOMER][NEUTRAL] Oh, OK, that will be [PII].
[AGENT][POSITIVE] OK, thank you so much. So, yes, ma'am, how can I help you today?
[CUSTOMER][NEUTRAL] Thank you. Uh, uh, I'm so sorry that my the AirbnISD, which is the district which I work for, changed the policy with another provider, but the last two years, [PII] and [PII], I didn't submit the diagnostic texting benefit.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And I wanted to know if even uh I'm not an actual or current uh customer or patient if I'm able to send uh the, the two mammograms that I have done on the [PII] and [PII] to see if I can get the $100 for each one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Ms. [PII], so you're wanting to know if you can still submit a wellness claim, your screening benefit for years [PII] and [PII]. Yes, ma'am, you can, because APL.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, because I have all of them submitted, but not the last two.
[AGENT][NEUTRAL] Yes ma'am. APL does not have a timely filing limit, so as long as your dates of service were during the period of time which your policy was active, then yes ma'am, you can still file those with us. Mhm.
[CUSTOMER][NEUTRAL] OK, OK, thank you, because I wasn't sure as uh um um it's not current right now. I don't, I didn't know if I was able to. OK, I have I have submitted this before uh via fax. Is there any way that I can do the same?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh yes ma'am you can still send that to us uh via fax. Do you have our fax number? It should be on the wellness claim form.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Well, what I have done always is I send the two letters with the negative results and I put a fax cover with the information of my policy and everything and, and I always have received a check back so I never had a claim through using the form.
[CUSTOMER][NEUTRAL] So, I have been
[AGENT][NEUTRAL] OK, so you can.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so if that, you can submit it that way and then if we were to need additional information, obviously you will be notified of that on your explanation of benefits. And then, you know, you could provide us anything that we were missing.
[CUSTOMER][NEUTRAL] Yeah, yeah, I know, that will.
[CUSTOMER][NEUTRAL] Yeah, I never had that kind of issue before, so hopefully it works smoothly. Can I have the, the fax number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. It is [PII].
[AGENT][NEUTRAL] 36594.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm sorry, uh, it's 1877. What else? I'm sorry.
[AGENT][NEUTRAL] Uh-huh. 365.
[AGENT][NEUTRAL] 942-3 attention claims.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, OK, and according to my records, I got paid all but not 23 and 24, right? Because uh I'm not sure. I think that the last two is the one that I, I haven't uh submitted but.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I guess I got, I got paid for the 22, but I'm not sure.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Yes, ma'am. I don't see that we have received anything from you since [PII], [PII].
[AGENT][NEUTRAL] was when the claim was received.
[CUSTOMER][NEUTRAL] So you didn't get any?
[AGENT][NEUTRAL] For the year
[CUSTOMER][NEUTRAL] So the last game that you received was on the [PII] for the 21?
[AGENT][NEUTRAL] Ma'am, no ma'am, we received a claim in [PII].
[AGENT][NEUTRAL] For days, yes, but we have not received any claims for you for the years [PII] and [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so I was right. I was just double checking, but yes, I was right. OK, great. Thank you so much. You have been very helpful. Thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes ma'am. OK.
[AGENT][POSITIVE] Well, you're certainly very welcome. And is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] That'll be all, that'll be all for now. Thank you so much.
[AGENT][POSITIVE] Well, you're welcome, [PII], and thank you again for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you, you as well. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you too. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.