AccountId: 011433970860
ContactId: 67de2269-e9c8-4c9c-96fb-fb75d6caefab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1369959 ms
Total Talk Time (AGENT): 285645 ms
Total Talk Time (CUSTOMER): 529049 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/67de2269-e9c8-4c9c-96fb-fb75d6caefab_20250604T15:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, good afternoon, um, I'm calling because, um, somehow um I lost the online access it doesn't recognize my account, my email address.
[AGENT][NEUTRAL] OK, all right.
[CUSTOMER][NEGATIVE] And I tried my personal and my work and neither one is working.
[AGENT][NEUTRAL] OK. Is this for an individual policy or are you with a group?
[CUSTOMER][NEUTRAL] Uh, with a group.
[AGENT][NEUTRAL] OK, um, do you have your group number?
[CUSTOMER][NEUTRAL] Uh yes, it's uh 15493.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] And the funny thing is that I enter my personal email address and it sends me an a text with the you know forgot password and text digit verification and then I also enter my business email address and it does the same, but then when I enter it into the APL, you know, where it, where it it should go, it tells me that I can't find the email address, so I don't know what happened.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, well, you have to you have to create the account from scratch, so you're gonna have to recreate the entire account. You can't use any of your old data. Um, what is your first and last name?
[CUSTOMER][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And, and why would I have to do that?
[AGENT][NEUTRAL] We've, we've recre, we've updated our account, so we, you have to reset everything up. So and you are with the group, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, but it doesn't say that anywhere that I have to recreate it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, up until the end of the month of May we had, uh, on our old site we had had a message come up, um, let me look.
[CUSTOMER][NEUTRAL] Oh I haven't used it this year. I was gonna file like a whole bunch of claims uh from this year.
[CUSTOMER][NEUTRAL] Which I haven't done.
[AGENT][NEUTRAL] OK, and so just to
[CUSTOMER][NEUTRAL] But am I gonna have access to my history?
[AGENT][NEUTRAL] Yes. So is this for your own personal account or is it are you with the actual, I'm sorry?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, I'm with, uh, I'm, I'm with the business. I work for for the city of [PII], um, but, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] See, see, I.
[AGENT][NEUTRAL] So it looks like we have as the group contact, we have [PII] and [PII].
[CUSTOMER][NEUTRAL] No idea.
[CUSTOMER][NEGATIVE] I don't, I mean, I signed up 2.5 years ago and I have no idea who handles this.
[AGENT][NEUTRAL] OK, well
[AGENT][NEUTRAL] Uh, OK, that's what I was saying is this for your, this is not for your personal account?
[CUSTOMER][NEUTRAL] That's for my personal account, yes.
[AGENT][NEUTRAL] OK, this is for your personal account. OK. Do you have your policy number?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, yes, uh, hold on, uh, is it which number do you need the in hospitals, the outpatient?
[AGENT][NEUTRAL] Um, either one.
[CUSTOMER][NEUTRAL] Or the payer ID.
[CUSTOMER][NEUTRAL] Uh, OK, I'll give you the outpatient, uh, 02347828 M as in Mary, L as in lion 8.
[AGENT][NEUTRAL] OK. And do you have your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is your address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your email address?
[CUSTOMER][NEUTRAL] Well, I don't know which one you had, but the, the work email is [PII] or my personal uh [PII].
[AGENT][NEUTRAL] OK, yeah, that's the correct one, your Gmail account, so.
[CUSTOMER][NEUTRAL] I think it that's the [PII], right? Yeah, that's what I thought.
[AGENT][NEUTRAL] Uh-huh. Yeah, so when you go to the account, you're gonna create a new login.
[CUSTOMER][NEUTRAL] So create your OSC account.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then you'll be the insured.
[CUSTOMER][NEUTRAL] Agency.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You'll need your full social security number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My email which is the same.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] My birthday.
[CUSTOMER][NEUTRAL] OK next.
[CUSTOMER][NEUTRAL] Complete your account set up, continue.
[CUSTOMER][NEUTRAL] Yeah pass or.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, claim not verify email address.
[CUSTOMER][NEUTRAL] Send verification code. OK, first could do that, I guess.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Hold on, it's sending the verification code to my email address.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK, verify code.
[CUSTOMER][NEUTRAL] Uh, claim not verify email address verify you can now continue.
[CUSTOMER][NEUTRAL] OK, continue.
[CUSTOMER][POSITIVE] I agree to terms. I agree to the policy.
[CUSTOMER][NEUTRAL] Got the dashboard.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh verification code again seriously.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hold on, I asked for a verification code again.
[AGENT][NEUTRAL] Yeah, we will have a two-factor verification process just because, just enhancing our security.
[CUSTOMER][NEUTRAL] OK, but it gets stuck on the welcome to the online service center. The online service center provides 24/7 access to your APL, and then the login keeps on swirling.
[CUSTOMER][NEUTRAL] Like going around.
[AGENT][NEUTRAL] It might take up to 60 seconds or so.
[CUSTOMER][NEUTRAL] But again let me enter the six digit uh code. It just started doing that.
[CUSTOMER][NEUTRAL] Where it says log in, the little things are going out, you know, in circles.
[AGENT][NEUTRAL] Uh, OK, so you entered your email address as your, uh, and then your password that you created?
[CUSTOMER][NEUTRAL] I did that and then it asked me to uh verify my account again so it it did send me an email to my personal account. I copied the the um the code and when I was uh going back to enter the code is the screen switch to what I just read and the log in is swirling the, the little circle is is going in circle the little um.
[CUSTOMER][NEUTRAL] I don't know to do a thing next to log in.
[AGENT][NEUTRAL] OK, were you, yeah, try um try re-logging in.
[CUSTOMER][NEUTRAL] Should I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's try this again.
[CUSTOMER][NEUTRAL] Um verification code.
[CUSTOMER][NEUTRAL] OK, verify go continue.
[CUSTOMER][NEUTRAL] I think I'm in let's see.
[CUSTOMER][NEUTRAL] Yeah, I think so. Let me see if I can see in my history.
[CUSTOMER][NEUTRAL] And you're gonna claim status updates, OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so now my dashboard view policy details now and.
[CUSTOMER][NEUTRAL] Where do I see? Yeah, I changed here. Uh, how do I, where do I where do I find my history? Like I wanna know where I left off and when was the last, what was the city stop uh.
[AGENT][NEUTRAL] Um, let me see, it is.
[AGENT][NEGATIVE] Should be under the dashboard, there should be claim.
[CUSTOMER][NEUTRAL] Resource and.
[AGENT][NEUTRAL] Let me look.
[CUSTOMER][NEUTRAL] Claim support uh products.
[CUSTOMER][NEUTRAL] See um
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh this is claim support.
[CUSTOMER][NEUTRAL] Home shows me products.
[CUSTOMER][NEGATIVE] A really going term life cancer.
[CUSTOMER][NEUTRAL] Training.
[AGENT][NEUTRAL] OK, let's see, so.
[AGENT][NEUTRAL] OK, can you click on looks like uh my profile.
[CUSTOMER][NEUTRAL] And hold on.
[AGENT][NEUTRAL] And information.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Uh, let's see, my policy.
[CUSTOMER][NEUTRAL] Uh, where? I'm sorry, dashboard.
[AGENT][NEUTRAL] OK. Oh, my policy, to view your claims, click my policy.
[CUSTOMER][NEUTRAL] Alright bye
[CUSTOMER][NEUTRAL] OK and then claims I guess or my name?
[AGENT][NEUTRAL] Sorry.
[AGENT][NEUTRAL] And then view policy details.
[AGENT][NEUTRAL] And then click the claims tab.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh you policy details or does it say that is I see profile cover individuals policy details.
[CUSTOMER][NEUTRAL] And then where do I click?
[AGENT][NEUTRAL] And then you'll see click the claims tab to view your claims.
[CUSTOMER][NEUTRAL] Oh they tap on top uh OK, claims.
[CUSTOMER][NEUTRAL] No claims available.
[CUSTOMER][NEUTRAL] Processed claims.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And that doesn't show you the name of the provider.
[CUSTOMER][NEUTRAL] So how do I know who who this was? I mean like it doesn't show the name of the provider.
[AGENT][NEUTRAL] Um, let's see, uh, you should be able to download documents.
[AGENT][NEUTRAL] So you'll have to click on the claim and then download the document will show.
[AGENT][NEUTRAL] It'll pull up the explanation of benefits showing you the information regarding the claim.
[CUSTOMER][NEUTRAL] Yeah, I have the, uh, a little another circle going around uh on each claim on the right side says the claim number and they give me the policy they received coverage type amount amount paid but I can't, I don't, I don't have any.
[CUSTOMER][NEUTRAL] Like, uh, like what you're saying, uh, information or download or.
[CUSTOMER][NEGATIVE] I don't have anything to click on.
[AGENT][NEUTRAL] OK, so it doesn't have a download documents on each.
[CUSTOMER][POSITIVE] No, I think it's clickable.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEGATIVE] No, it doesn't.
[CUSTOMER][NEUTRAL] I don't know if that's what's swirling around on the bright side.
[CUSTOMER][NEGATIVE] But it doesn't come up.
[AGENT][NEUTRAL] Yeah, it'll take a while cause it looks like you have several claims.
[AGENT][NEUTRAL] So it's just it's pulling all of the data.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] That's on the recent ones, but on the older ones, I don't have a button to download.
[CUSTOMER][NEUTRAL] Like I'm looking at one from like [PII].
[AGENT][NEUTRAL] OK, what's, do you have the claim number?
[CUSTOMER][NEUTRAL] And it I don't.
[CUSTOMER][NEUTRAL] Uh, for example, this one is uh 3547 560.
[AGENT][NEUTRAL] OK. And that one you're not able to, it doesn't have a download document?
[CUSTOMER][NEUTRAL] Mm mm, none of them.
[AGENT][NEUTRAL] Is it still, is the circle still spinning?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No, no, that's for the newer ones, but this I picked this one because this one doesn't have the short lien thing.
[CUSTOMER][NEUTRAL] Like none of the old ones have that swirling thing and um.
[CUSTOMER][NEGATIVE] Uh, but it doesn't have a download button either.
[AGENT][NEUTRAL] Are you able to click on the actual claim, like in that box or?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEGATIVE] No, nothing is clickable.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Not the claim number my name nothing.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK. Give me one moment, OK? Um, can I put you on a brief hold?
[CUSTOMER][NEUTRAL] So, or, or at least, at least if you can tell me um if I have processed any uh co-payment claims this year, then that would help.
[AGENT][NEUTRAL] OK, let me
[AGENT][NEUTRAL] I know we're in the process of getting everything still transferred over because our website's brand new, so, um, it may take a few working few more working days um but you're checking on [PII], is that right?
[CUSTOMER][NEUTRAL] Uh, yes, if I have processed anything um because my last record that I find uh that I see is, uh, from December that I that I submitted was on [PII].
[CUSTOMER][NEGATIVE] But I don't think I have submitted anything in [PII].
[AGENT][NEUTRAL] Um, it looks like for [PII], uh, we've had a maximum payout of 58214.
[CUSTOMER][NEUTRAL] So I have to
[CUSTOMER][NEUTRAL] Yeah, but pay out like uh you pay directly to the to the um uh provider but like my co-payments like with the paperwork that I have to submit to start a claim.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For the for the co-payments.
[AGENT][NEUTRAL] So we paid out 2.
[CUSTOMER][NEUTRAL] I don't think I have made any.
[AGENT][NEUTRAL] Uh, $250 co-payments.
[AGENT][NEUTRAL] That's what we paid for [PII].
[CUSTOMER][NEUTRAL] Can you tell me?
[CUSTOMER][NEUTRAL] For [PII], can you tell me for for um what doctors and what dates?
[AGENT][NEUTRAL] Um let me see.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like [PII].
[AGENT][NEUTRAL] And that was for neuros.
[CUSTOMER][NEUTRAL] 2 I'm sorry for what what was that again? For what date?
[AGENT][NEUTRAL] Uh, it was for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Neuroscience consultants.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] 5
[CUSTOMER][NEUTRAL] So I should have received that payment, right?
[AGENT][NEUTRAL] Uh, it looks like that one went to
[AGENT][NEUTRAL] That one went to the provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The provider filed the claim, um, and then.
[AGENT][NEUTRAL] 359. Let me find the other 1, 3801.
[AGENT][NEUTRAL] This one was for date of service [PII].
[AGENT][NEUTRAL] And that was to [PII] and [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is it? [PII]?
[AGENT][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, and [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that was paid to the provider too?
[AGENT][NEUTRAL] Yes, that was.
[AGENT][NEUTRAL] And that's all we have for your office.
[CUSTOMER][NEUTRAL] OK, and the nearest line?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK, and the neuroscience was uh which which one because I go to one I have um.
[CUSTOMER][NEUTRAL] Um, I go to one and my son goes to one, so can you tell me which one it is?
[AGENT][NEUTRAL] Um, that one is.
[CUSTOMER][NEUTRAL] Neuroscience.
[AGENT][NEUTRAL] Uh, that one is for
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[CUSTOMER][POSITIVE] Alright perfect.
[CUSTOMER][POSITIVE] OK alright thank you.
[AGENT][NEUTRAL] OK. Is there anything else I can help with anything else today?
[CUSTOMER][POSITIVE] Thank you so much for your help.
[CUSTOMER][POSITIVE] Uh, no, not for now we're good.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too bye bye.