AccountId: 011433970860
ContactId: 70f387d0-0b91-4436-ac06-f147836f3e55
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1040280 ms
Total Talk Time (AGENT): 306580 ms
Total Talk Time (CUSTOMER): 317195 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/70f387d0-0b91-4436-ac06-f147836f3e55_20250203T20:17_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I was just calling to check on the status of a claim.
[AGENT][NEUTRAL] I can help you. Your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], and are you the policy holder, [PII], or you're calling on behalf of a provider?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, and it's, it's me and it's [PII]
[AGENT][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] OK. And what's your policy number, [PII]?
[CUSTOMER][NEGATIVE] Oh gosh, let me, he doesn't have it on my letter. I don't think so.
[CUSTOMER][NEUTRAL] I'd have to go look it up unless it's on the bottom, 02481082. Would that be it?
[AGENT][NEUTRAL] Mhm. Give me that one more time.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02481082
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, that's it. What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Verify your date of birth and your mailing address for me?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you, and your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and you said that you're checking a claim status?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And what's the date of service in charge?
[CUSTOMER][NEUTRAL] Oh boy, I don't have that in front of me. I've just got the letter that you received it and it's been like 6 weeks, so I was just checking.
[AGENT][NEUTRAL] What did you receive?
[CUSTOMER][NEUTRAL] I just received a letter that says we've received a claim on your policy and a review of the claim has started and that was um [PII] and so I haven't heard anything else since, so I was just trying to.
[AGENT][NEUTRAL] So I'm showing a charge for [PII] and [PII]. It's an office visit at Boulder Medical Center.
[AGENT][NEUTRAL] And so this is basically a.
[CUSTOMER][NEUTRAL] Yes, but for 22976.
[AGENT][NEUTRAL] Mhm. A duplicate of a document that was previously submitted.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, they sent back one yeah because I couldn't remember if I had mailed one before [PII]. I had mailed one on the [PII] and didn't remember, so they did send back that I had duplicated it, so I just need on the one.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, and so we just need a copy of the itemized bill, not the balance due statement that you're receiving in the mail. Uh, you would need to contact this location of Boulder Medical and.
[CUSTOMER][NEUTRAL] Yeah, I did. I actually did, and that's what they sent me. I did it before I ever sent it in and this I said I need an itemized bill to send to my insurance and this is what they sent me.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so this was in a hospital?
[CUSTOMER][NEUTRAL] No, well, I was in a medical center, not a hospital, no.
[AGENT][NEUTRAL] I mean like it was an outpatient facility?
[AGENT][NEUTRAL] Or in an office.
[CUSTOMER][NEUTRAL] Outpatient, yeah, I just, an office, an office, yeah.
[AGENT][NEUTRAL] OK, give me one second. I'm gonna give you, I'm gonna look at what you said and I'm gonna give you the form name to ask.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, because I called them and asked for it before I ever sent anything in and this is what they gave me. I said I need to itemize this in my insurance and I'm like, OK, I've gone through all the steps.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] Yeah, this is a balance due statement.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So the phone number that's on there with billing questions I would dial that number.
[AGENT][NEUTRAL] And it looks like you had an outpatient visit in a hospital though.
[AGENT][NEUTRAL] Boulder Medical, no? OK, maybe this is how they build their claims. OK, I'm gonna give you the.
[CUSTOMER][NEUTRAL] I did not, I what?
[CUSTOMER][NEUTRAL] Yeah, I wasn't in the hospital.
[CUSTOMER][NEUTRAL] Yeah, I was in a hospital.
[AGENT][NEUTRAL] OK, I'm gonna give you the form uh name to request.
[AGENT][NEUTRAL] And they should probably um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Make it easier. It's an acronym C as in Charlie, Elm, Mary, S Sam.
[AGENT][NEUTRAL] 1500.
[AGENT][NEUTRAL] So you request the CMS 1500 itemized bill.
[CUSTOMER][NEGATIVE] OK, and then what do you want me to do when I get it? Because I don't wanna.
[AGENT][NEUTRAL] And so it looks
[AGENT][NEUTRAL] Yeah, it looks like to get it the quickest, I think you uploaded the original one online.
[AGENT][POSITIVE] Upload it online and we'll get it like pretty quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, and where do I upload it online because I might not remember how to do this.
[AGENT][NEUTRAL] Secured [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Say that again [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, OK, [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]. OK, secured at [PII]. OK, I will do that.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, and it looks, it looks like you you uploaded one at one point, but now it's showing that you don't have a file online.
[CUSTOMER][POSITIVE] All right, thanks.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] That's Interesting.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So, um, you could go and create a new account and you could also fax it over to us, you get that within 24 to 48 hours if it's faxed.
[CUSTOMER][NEUTRAL] Yeah, and I don't have a back, so I don't know how to do that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So do you want me to help you set up your account?
[CUSTOMER][NEUTRAL] Um, sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me know when you get to the site.
[CUSTOMER][NEUTRAL] So you get to
[CUSTOMER][NEUTRAL] And I need to go to um.
[CUSTOMER][POSITIVE] Secure, OK.
[AGENT][NEUTRAL] Put a D on the end, [PII] E C U R E D.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] Thank you for being helpful. I appreciate it.
[AGENT][POSITIVE] Oh, you're welcome, no worries at all.
[CUSTOMER][NEUTRAL] So go to new user.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] And then you'll select which role that best describes you.
[CUSTOMER][NEUTRAL] Huh, there's no user was found with that.
[AGENT][NEUTRAL] Which role which role did you select the best describe you?
[CUSTOMER][NEUTRAL] Um, an individual with an APL insurance policy.
[AGENT][NEUTRAL] And then when you click next what you enter has to match what we have in our system so your last name is [PII]?
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] And what did you enter in the next field?
[CUSTOMER][NEUTRAL] Uh, my social security number, should I do my member ID instead?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see, uh, so what do you have as your member ID number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I got to go get my, let me get my.
[AGENT][NEUTRAL] Yeah, I think that's the number it's looking for.
[CUSTOMER][NEGATIVE] Hard
[CUSTOMER][NEUTRAL] The group ID or?
[CUSTOMER][NEUTRAL] So what it would be it says a group ID.
[AGENT][NEUTRAL] Um, it's, it's
[AGENT][NEUTRAL] What what number is that?
[CUSTOMER][NEUTRAL] Oh here member number. I, I found the member number.
[AGENT][NEUTRAL] OK. OK. What is your member ID number?
[CUSTOMER][NEUTRAL] 682-251-388
[AGENT][POSITIVE] Perfect, that's what I show.
[CUSTOMER][NEUTRAL] OK, then that was my mistake.
[AGENT][NEUTRAL] And then you,
[CUSTOMER][NEUTRAL] No user phone.
[AGENT][NEUTRAL] OK, so you
[CUSTOMER][NEUTRAL] So I did [PII], my last name 682251-388.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] My zip code [PII] email [PII] unless it's [PII].
[AGENT][NEUTRAL] OK, I
[AGENT][NEUTRAL] I show a different email address on file. What's your work?
[CUSTOMER][NEUTRAL] OK, I'll do the I've got, I've got two of them, so I'll do the other one.
[AGENT][NEUTRAL] What's the other one?
[CUSTOMER][NEUTRAL] [PII] [PII] at Crux Point.
[AGENT][NEUTRAL] Now that's the one that's on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yep, you're right.
[AGENT][POSITIVE] Perfect. So it took you to to create a username and password?
[AGENT][NEUTRAL] Is it asking you to create a username and password?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] OK, my.
[CUSTOMER][NEGATIVE] Having in trouble with the password.
[AGENT][NEUTRAL] How's it going?
[CUSTOMER][NEGATIVE] I'm having trouble getting the password to go.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] So it should give you criteria to create it um you need to use one symbol and then one.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Number
[CUSTOMER][NEUTRAL] Oh, I see. I had the caps lock on and didn't notice it.
[AGENT][NEUTRAL] Oh, and everything was cap, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, that makes a difference.
[AGENT][NEUTRAL] OK, very good. Let me check on my end.
[AGENT][NEUTRAL] OK, so I do now show that it's active.
[CUSTOMER][NEUTRAL] Oh boy. Oh, OK. I can't type today.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And so then it probably took you back to the login page.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And then when you get there I'll show you where to go to upload.
[AGENT][NEUTRAL] The documents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you should see the filing a claim on my dashboard.
[CUSTOMER][NEUTRAL] I, I was, um.
[CUSTOMER][NEUTRAL] Verifying my account.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] Now it doesn't seem to work. 774,180.
[AGENT][NEUTRAL] What is it saying?
[CUSTOMER][NEUTRAL] Oh there it went. OK, your phone number's been verified. OK now it shows upload files, yep.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So yeah, it shows that I had, it shows that one was processed and then there's so it shows up that's weird.
[AGENT][NEUTRAL] So what
[AGENT][NEUTRAL] Yeah, it does.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So get us a copy of that itemized bill and then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We can take it from there.
[CUSTOMER][NEUTRAL] And then upload the file. OK, I'll do that.
[AGENT][NEUTRAL] That mhm yes ma'am. Oh, let me email you, let me email you a hospital indemnity claim form because we have to have that along with what you upload. Give me a second. I'll just.
[CUSTOMER][POSITIVE] Thanks thank you very much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Email this over to you real quick.
[AGENT][NEUTRAL] Alright, I just sent that over to you via.
[AGENT][NEUTRAL] Email?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's coming from [PII].
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] There it came in, got it.
[AGENT][POSITIVE] You got it? OK, good.
[CUSTOMER][POSITIVE] You thank you very much [PII].
[AGENT][NEUTRAL] You're welcome. So just send that and then the itemized bill just upload those two documents online and you're good to go.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right, I will get this person called yet again. Thank you for telling me what I need. OK. All right. All right. No, that's it. Thanks for your help. Bye-bye.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] You're welcome. Anything else?
[AGENT][POSITIVE] Uh, you're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thanks you too.