AccountId: 011433970860
ContactId: 7012af00-748b-4873-a3ac-5f5ac104e5e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 811090 ms
Total Talk Time (AGENT): 239513 ms
Total Talk Time (CUSTOMER): 250168 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/7012af00-748b-4873-a3ac-5f5ac104e5e5_20250617T18:20_UTC.wav
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[CUSTOMER][NEUTRAL] the.
[AGENT][NEUTRAL] Hello, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I was just um contacting you guys because as I'm trying to file the claim, it tells me um payment payment details that no claims available.
[AGENT][NEUTRAL] OK, um, who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh, it's a good uh number in case we get disconnected.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] Um, 026-03059.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Sorry, what was that?
[AGENT][NEUTRAL] Uh give me just one moment to look you up.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Can I get you to verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're having trouble logging into your OSC account?
[CUSTOMER][NEUTRAL] No, so I'm in my account and I'm filing the claim. I've gone through like the steps and as it gets to claimant details, it says enter the information about the claimant, and then it says no claims available, claimant or coverage types not listed and to contact you guys.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh you just on a building.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Bro, I can't believe it. I can't eat it.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so, um, if you would please just walk me through it. So you went to the secure.in public, you click start your claim.
[CUSTOMER][NEUTRAL] How the
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And you file, you're filing a traditional claim, correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, well, do the hospital indemnity.
[AGENT][NEUTRAL] Yes, that, that would be a traditional.
[CUSTOMER][NEUTRAL] So I pushed on traditional claims.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I put next step and then it talks about what I'll need to expedite it, so I push next step.
[CUSTOMER][NEUTRAL] And then, were they supposed to do something at that point?
[AGENT][NEUTRAL] Um, no, it should have said select claim it and you would have sent yourself.
[CUSTOMER][NEUTRAL] What now?
[AGENT][NEUTRAL] Or you would have uh clicked yourself and it didn't let you?
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEGATIVE] No, so after telling me what I need to expedite everything, I push next step and then it says claimant details, enter the information about the claimant and it says no claimants available, claimant or coverage type not listed to contact you.
[CUSTOMER][NEUTRAL] Well it's for me.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] You should be able to click in that box and click the claimant.
[AGENT][NEUTRAL] And it's not letting you click it at all?
[CUSTOMER][NEUTRAL] I see that.
[CUSTOMER][NEUTRAL] No, there's nothing.
[AGENT][NEGATIVE] You can't, so I'm just trying to uh get in here. So you can't click it, you can't type anything in or anything like that?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK. Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] And it won't even let me press next step so.
[AGENT][NEUTRAL] OK, I won't even let you do that. OK, let me look here.
[CUSTOMER][NEGATIVE] Are afraid of anything.
[CUSTOMER][NEUTRAL] Did she eat all that?
[CUSTOMER][NEGATIVE] Yeah, but like she wasn't like really like.
[AGENT][NEUTRAL] Alright, so we'll probably need to troubleshoot this so if you would please go up um to the top right of your browser.
[AGENT][NEUTRAL] And click the 3 dots and I would delete all of your browser history um you, I'm gonna put it up there you will have to log back in again, um, so just keep that in mind. Let's delete all of your browser history and clear your uh your cache and let's see if that works.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, at what? 3 dots?
[AGENT][NEUTRAL] And so if you go, are you on edge or Chrome?
[CUSTOMER][NEUTRAL] Um, Firefox.
[AGENT][NEUTRAL] Firefox, OK.
[AGENT][NEUTRAL] Um, that could be.
[CUSTOMER][NEUTRAL] But just so you know, I, I did do it from my phone and it didn't let me, it stopped me at that same point too. But if I need to try to get onto Google Chrome, I can do it from there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Try Google Chrome or Edge um I haven't heard anyone using Firefox on on this before, so um.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] I'd have to look up how to clear your browse your delete history anyways, um, but try it on Google Chrome or Edge.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] Um, log out of what you're in now so that it doesn't think that you're.
[AGENT][NEUTRAL] You're already logged in. Mhm.
[CUSTOMER][NEUTRAL] In 2
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm gonna send the verification code real quick.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so it took me to the dashboard and from the dashboard it it says um need to file a wellness or traditional claim. I'm gonna push start claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Click on this one. Next step, it's telling me what I'll need and then I'm pressing next step and it still says the same thing. Claimant details enter the information about the claimant, but it doesn't give me a place to enter and it says no claimants available.
[CUSTOMER][NEUTRAL] Being the first time like I'm ever doing this, is there like a place where I need to go set up something?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Well, if you were able to set up your account I'm not showing any claims on file for you, but you should be able to set one up.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] It's not letting you click on claimant details or claimant under select claimant it's not letting you click anything at all.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, where we did do.
[AGENT][NEUTRAL] Let me put in a ticket so we can get in.
[AGENT][NEUTRAL] So we can have someone from IT look into it. I, I'm showing that your policy is active.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You should be able to file a claim, so um let me see what's going on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 54.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] And should our IT need to reach out to you, would you prefer to be emailed or um.
[AGENT][NEUTRAL] Have us call you.
[CUSTOMER][NEUTRAL] Um, call, please.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] At the number ending in [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I put that help desk ticket in. Um, I would give it about 24 hours.
[CUSTOMER][NEUTRAL] OK. And there's no like.
[AGENT][NEUTRAL] OK, in the meantime, mhm.
[CUSTOMER][NEUTRAL] Like date as to when this like will expire like if it's been almost a month ago now.
[AGENT][NEUTRAL] Right, we don't have timely filing limits, so as long as your policy was active at the time of service, you can file the claim.
[CUSTOMER][NEUTRAL] OK, I'm just saying because I tried to, it took a while to get all the paperwork that I needed and then I tried getting on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And it took a while because every time I would try it wouldn't let me file it, so I just needed to remember to call you guys to see if y'all can help me.
[AGENT][NEUTRAL] Right, and if um and if nothing else we can always try mailing it in as well or faxing it whichever works um but I did put that IT ticket in so hopefully someone will be reaching out to you soon.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate it.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, just the paperwork that I needed was just the claim form. It was the itemized bills. Is there anything else?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, itemized bill with codes if you had any receipts, if you had to pay anything out of pocket, um, we'll need an itemized receipt as well showing what you paid. Um, if you have major medical and major medical was billed for this and they paid part of this claim, you'll want to send in um.
[CUSTOMER][POSITIVE] Just pretty
[AGENT][NEUTRAL] What they give you is called an explanation of benefits. So anytime your primary insurance or any insurance, uh, pays or denies the claim, they send you a an explanation of benefits, um, obviously if it was denied it says why if it was paid it shows what was paid and how much so um if they sent you one of those you'll wanna send one of those in as well.
[CUSTOMER][NEUTRAL] OK, um, and you said the itemized bill with what code on it?
[AGENT][NEUTRAL] If it has any procedure codes or diagnosis codes, which, if it's an itemized bill, it should have some of that on there.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I got all that. I appreciate it.
[AGENT][POSITIVE] Great, thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thanks. You too. Bye.