AccountId: 011433970860
ContactId: 77f37dc5-1e64-43e5-a2b2-abb68d25c28b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1015059 ms
Total Talk Time (AGENT): 467496 ms
Total Talk Time (CUSTOMER): 661731 ms
Interruptions: 34
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/77f37dc5-1e64-43e5-a2b2-abb68d25c28b_20250127T19:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi. So, um, I called on Friday and I spoke about two of my claims that were sent to you. And, um, you know, uh, they explained to me that, uh, um, the providers never uh attached to the explanation of benefits. Um, and I do have the documents now. Uh, I explained to the other, uh, agent on Friday that it's like all together. It's on one PDF.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, they told me that I need to create a portal and that I, I can upload it there. When I tried to create uh a portal though, I couldn't, I couldn't create it.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I tried with all the information, social security, everything, everything that I have, and I I couldn't create it. So I have a question.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, uh huh.
[CUSTOMER][NEUTRAL] Before, before, because uh the thing is that I don't have my computer in front of me now, so I cannot create the portal right now. Um, my question is, can I send you a, um, the, can I send you the document, uh, the benefit, uh, explanation of benefits? Can I fax it to you?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You can absolutely fax that to us um we can also go ahead and check the information that you have um most of the time the reason why uh you would get an error when trying to create an account is the information that you input does have to match what we have in our system. um, most of the time it's going to be that the email is different, so we can go through and check all of that really quick, um, and if anything needs to be changed we can go ahead and change it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] um.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And then of course I will give you that fax number as well just in case um really quick though I'm sorry what was your name?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, my name is, uh, [PII]. So I wanna, I wanna, um, ask you, the fax number is listed on the card, right? It's [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] Yeah, OK, OK. Um, so I, I have to like, do I have to say something in the file that it's coming from me or you're gonna obviously see it?
[AGENT][NEUTRAL] Um, honestly, I like, I tell most anyone if you could at least put your policy number on there, um, it would be better if you could attach the claim number that it was in regard to as well, um, so that we could kind of piece it together, um, it's just be that much faster for you.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] So the thing is that the so I have United Healthcare, um, and when I opened the the PDFs for every claim, they all come at the same, they all come up in the same in the same place, all the claims. So I only need, for now, I only need two of them because the rest of them are paid. So I only need 2.
[AGENT][NEUTRAL] And I can get that information if you don't have it, go ahead, I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And uh the lady that I spoke with on Friday, she said that just highlight them, because I also spoke with United Healthcare and they said, yeah, don't worry, we're gonna send you a document, documents only for those two claims. They send it to me and I
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh my gosh, they sent you everything?
[CUSTOMER][NEUTRAL] And and guess what, it's exactly the same thing. It's, it's all together.
[AGENT][NEGATIVE] Oh my goodness, what a mess. Yeah, that's perfectly fine like what you were told you can highlight that that's perfectly fine yeah sure OK I'm sorry, that's just kind of an extra mess for you but that's perfectly fine, um.
[CUSTOMER][NEUTRAL] So I'm gonna highlight it. I'm gonna highlight it and I'm gonna send it. OK. OK.
[CUSTOMER][NEUTRAL] Yeah, because Friday, Friday, I spent like the whole afternoon on the phone with, uh, you know, with APL with United, with APL with United, and it's like, you know, I also have a job and I can't do that all the time, you know? And then I, I try to create a portal like with, I, you know, try everything possible change this change that, nothing worked. So I'm, I'm gonna, OK.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Yeah, I, yeah, exactly. You are, yes, absolutely.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well we can definitely take a look at that and make sure we'll see what we have in our system, make sure all of that is correct um before we go any further.
[CUSTOMER][NEUTRAL] OK. So what I'm gonna do,
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] I, I just wanna tell you like, I'm gonna, I'm at this point, at this point, I'm gonna fax it to you. Um, and I'm gonna highlight the claim number and I'm gonna highlight the amount, and I'm gonna fax that to you. And I'm gonna, uh, say, I'm gonna state in the fact that is, uh, what is exactly the, like the payer ID? Is that what you need?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Payer ID and my name. Is that, is that, is that enough?
[AGENT][NEUTRAL] Oh, not the payer ID, no, it would be the your policy number, um, OK, so if you're looking at your card.
[CUSTOMER][NEUTRAL] What, what do you need? Is the policy number, the group, the group number?
[AGENT][NEUTRAL] If you're looking at your card, it would be on the bottom I believe where it'll say um outpatient uh certificate or outpatient benefit number do you see that?
[CUSTOMER][NEUTRAL] The group number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh. Yes.
[AGENT][NEUTRAL] That would be, that is your policy number.
[CUSTOMER][NEUTRAL] I see the outpatient benefit. OK, so the outpatient not in hospital.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It could be either one, to be completely honest with you, either one is perfectly fine we'll be able to determine if it's inpatient or outpatient benefits so that's perfectly fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK. Can you give me, can you give me just a second, please? Just a second.
[AGENT][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] Hey [PII], I'm still here.
[CUSTOMER][NEUTRAL] No, no, no, I'm, uh, you remember what I told you like in like where, um, pinstripes are. There are like a few restaurants around. I'm waiting for you here. Uh-huh.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][POSITIVE] No, no, no worries. I'm here. I'm waiting for you. I already went to like a few of them. So, um, yeah, mhm. All right. See you soon. Bye.
[CUSTOMER][POSITIVE] I'm sorry about that.
[AGENT][POSITIVE] No, you're perfectly fine. OK, um, before we go any further, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Alright, I appreciate it and then if you would, can you give me that uh outpatient uh certification number?
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] Yes. It's um 02557.
[CUSTOMER][NEUTRAL] 860
[CUSTOMER][NEUTRAL] M
[CUSTOMER][NEUTRAL] L. 8.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what was your last name? I'm sorry.
[CUSTOMER][NEUTRAL] Um, part of the [PII].
[AGENT][NEUTRAL] Got you. Alright, I'm just gonna verify some information really quick, uh, [PII], can I get your, uh, date of birth please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII] um
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the zip code is [PII], that's [PII].
[AGENT][NEUTRAL] Perfect. OK, last thing I need is the email address we've got on file for you. uh, this one does look like it's through an organization.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, yeah, it's [PII].
[AGENT][NEUTRAL] OK, yes, that is exactly what we've got now is that the information that you were putting in to create the account or we're using a different email?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No, that one, that one I'm putting in my account.
[AGENT][NEUTRAL] You were using that one, OK, so the other other thing I will say um in the spot where you enter in it'll ask for a member ID or a social security number um are you putting in your social?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEGATIVE] I tried with the social. I tried with the, yeah, I didn't, didn't work.
[AGENT][NEUTRAL] Yeah, you did.
[AGENT][NEUTRAL] OK. Let me verify. I know it sounds.
[CUSTOMER][NEUTRAL] I tried with the social. I tried with the, the, the payer ID number. I try with the group number. I try with the outpatient benefit with all, all of them, you know, that's what I'm saying.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah it would be.
[AGENT][NEUTRAL] Sure, yeah, so for this, this kind of policy it would just take your social so it wouldn't do anything else. This policy doesn't have a member ID. OK, so let me verify that we have your social correct in our system. Um, I have your social as [PII] is that right?
[CUSTOMER][NEGATIVE] Yeah, it didn't work, it didn't work with the social.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] That's correct. Yes. Mhm. Yes. [PII].
[AGENT][NEUTRAL] It is. OK, OK. The only other thing, mhm.
[AGENT][POSITIVE] Yes ma'am. OK, that is exactly what we've got. Alright, so everything else looks exactly right so what I would recommend um and you said you were doing this on a laptop correct? when you were?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] No, uh, yeah, the laptop. Yes, yes. The laptop, yeah.
[AGENT][NEUTRAL] You are OK um do you remember what browser you were using?
[CUSTOMER][NEUTRAL] Um, I believe I, I use Chrome.
[AGENT][NEUTRAL] OK, um, so Chrome is the one that we have the best support for is why I ask it doesn't have support for certain browsers like um Firefox or ones like that so I would give it just a little bit, um, get when you get back or when you're able to give it another try, um, again make sure you're using this email the at my GA.org and that your social.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Give me, give me just a second again. I'm sorry. Sorry.
[AGENT][NEUTRAL] Oh no, you're fine.
[CUSTOMER][NEUTRAL] Hey, [PII].
[CUSTOMER][NEUTRAL] Uh, you're on the other side of the mall, yeah, yeah, um, do you want me to send you a location?
[CUSTOMER][POSITIVE] Or you wanna, or you wanna like, you wanna, there are plenty of fucking food here where I'm not, but we can meet somewhere in, we can meet somewhere in the moon inside if you want because you're.
[CUSTOMER][NEUTRAL] Yeah, yeah, there are plenty of parking spots. OK, OK, I'm gonna send you my location, OK?
[CUSTOMER][NEUTRAL] Yeah, but today's, uh, today's, uh, Monday shouldn't be a problem to park anywhere, to be honest with you.
[CUSTOMER][NEUTRAL] You see there
[CUSTOMER][POSITIVE] You see, if you, if you see a parking park there and we can meet somewhere, you know, it's not a problem.
[CUSTOMER][NEUTRAL] Just, just let me know so I, I can, you know, I can go inside because I'm outside now. uh, I mean there are businesses that businesses that I told you about before, but I, I already went, I already went around here.
[CUSTOMER][POSITIVE] Mhm. Yes. Yeah. Mhm. So we can meet if you want to park somewhere, let me know where you are, and we can meet somewhere.
[CUSTOMER][NEUTRAL] OK. OK. OK, Macy's. So you wanna meet.
[CUSTOMER][NEUTRAL] Um, when you went, when you go inside, there is a Rosetta bakery, you wanna meet there maybe?
[CUSTOMER][NEUTRAL] Do you know Rosetta Ba correct?
[CUSTOMER][NEUTRAL] Do you see, do you see Apple store? Do you see a big Apple store?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, park somewhere and let me, let me know where you are if you want, and I'll I'll meet you. I'll, I'll come there because I'm familiar more with the more than, you know.
[CUSTOMER][NEUTRAL] Because I don't know which part, like the, if you, I don't know if you're buy is the ladies' park, the women's part, or the men's part, they are like quite opposite of each other.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That you're the men's part. OK, I'll meet you in front just park there and go inside the men's part and, and exit to the mall and I'm gonna wait for you, uh, right there. I'm gonna be there.
[CUSTOMER][NEUTRAL] OK, all right, fine.
[CUSTOMER][POSITIVE] I am really sorry about that.
[AGENT][NEUTRAL] No, you are perfectly fine. You got a lot going on, um, OK, so I'm just gonna verify one more thing with you and then you know I can let you go um I do wanna verify the spelling we have for your last name, um, because of course when it does ask for that information again just wanting to make sure that it's matching so what we've got is [PII]
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Oh, no.
[AGENT][NEGATIVE] That's not correct.
[CUSTOMER][NEUTRAL] You have SDFA, that's it?
[AGENT][NEUTRAL] No, so it's the [PII] or [PII], sorry.
[CUSTOMER][NEUTRAL] Yes, possible it's OK, so it's gonna be.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It, it's gonna be the one that's possible, you got to try, and then it's gonna be uh [PII], [PII] [PII] [PII] [PII]
[AGENT][NEUTRAL] Ah, that's gonna be it. So we've got it as [PII] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Um, my, on the card, on the card says [PII] as the first name and then [PII]
[CUSTOMER][NEUTRAL] And then says [PII]
[AGENT][NEUTRAL] OK, is that correct?
[CUSTOMER][NEUTRAL] No, it's not. It's uh it's uh [PII], it's missing from the card. But, you know, because my, because I have two last names, that's, that often, often happens on, on cards. But then, uh, they have my full name when, you know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, but that's why I wanted to make sure because in here it's uh [PII], so not [PII].
[CUSTOMER][NEUTRAL] In the system.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, [PII], but, but the thing is that I also tried the exactly like it's on the card, you know what I mean? I did, because, because, because I did pass the [PII], and then I'm like, you know, 100, yeah, I'm like, I am, I'm gonna try everything to avoid calling you, you know what I mean? And
[AGENT][NEUTRAL] Oh, you did. Oh, yes.
[AGENT][NEUTRAL] You really thought of everything, yeah.
[AGENT][NEUTRAL] OK, yes, all right.
[AGENT][NEUTRAL] You did. Well, I, that's exactly how I am. I understand, but you know sometimes it somebody just says, hey, did you try this? Like, no, I didn't, so I don't know. All right, well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So OK, the way that we have.
[CUSTOMER][NEUTRAL] Yeah, I tried everything and.
[AGENT][NEUTRAL] OK, so the two last names we do have it, the two last names separated only by a space, not a hyphen or anything like that. It's just a space, um, otherwise the only thing that is incorrect is just missing that V or the VA Nova.
[CUSTOMER][NEGATIVE] And it didn't, it didn't work.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I, uh.
[CUSTOMER][NEUTRAL] The VA, the VA, but I try with the VA I try without the VA, and you only, you, you also have only Stefano, right? You have Stefano only without the VA. That's what you have.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, with the weather the way, OK, OK.
[AGENT][NEGATIVE] Not no.
[AGENT][NEUTRAL] Well, yeah, it's Stefano only um but we do have the um Spasova in front of it so we do have Spasova Stefano is how we have it in our system. OK, well let's do this um, you of course we were able to verify all this information is right um you do have our fax number when you're able to um go ahead and try it again, um, I would, you know, make sure your computer's restarted, clear cache and history if you're able to.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, and then give it another shot if it's still not working for you, give us a call while you're on the computer so we could try to walk you through and just do like, you know, one step at a time if we're able to.
[AGENT][NEUTRAL] Um, we are open from [PII] Central Time Monday through Friday, so any time you're able to within that window, um, try to give us a call so we can help you out with that because while you can still get that claim information to us through fax, obviously I still like for you to be able to have access to your account be much easier in the future and you could look at the claim status and everything as well through our portal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. OK. I'm gonna, I'm gonna try again, but, you know, if it doesn't work this time, yeah, I am gonna.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, we'll see fingers crossed, yeah, you just give us another call back, um, when you're able to, we can do it all together like at the same time, um, alrighty, well, I'm sorry that was like information overload, um, but did you have any other questions for me?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, that's gonna be all. I, you know, I'm gonna try again later today and if not,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, if I have the time, if not, uh, tomorrow, and I'm gonna just text you, I mean, I'm gonna fax you the, the thing because I don't know at this point, you know.
[AGENT][POSITIVE] That's perfectly fine.
[AGENT][POSITIVE] That's yes, that's perfectly fine. Sure. All right.
[CUSTOMER][NEUTRAL] It's a lot of, it's a lot of back and forth and I, I, I wanna like see, you know.
[AGENT][NEUTRAL] I understand you need to breathe.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][POSITIVE] Alright, well, thanks for giving us a call. I hope you have a great rest of your day. Yes, ma'am.
[CUSTOMER][POSITIVE] All right. Thank you so much. Yes.
[CUSTOMER][NEUTRAL] And and that's the best fax number, the one that I verified with you before, right?
[AGENT][NEUTRAL] That is correct, yes, that is our claims tax number.
[CUSTOMER][NEUTRAL] Yeah, OK. OK.
[CUSTOMER][POSITIVE] OK, perfect, perfect. Thank you so much. Have a good day. Bye-bye.
[AGENT][POSITIVE] All right. Thank you. You too. Bye-bye.