AccountId: 011433970860
ContactId: 80d17d63-545b-480f-a2c6-deea603af515
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 617000 ms
Total Talk Time (AGENT): 210443 ms
Total Talk Time (CUSTOMER): 243856 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/80d17d63-545b-480f-a2c6-deea603af515_20250410T18:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so I have um APL insurance, but I've never, I believe I misplaced the letter in the mail for my login to log into the portal. I'm trying to see if you can assist me with getting into the portal.
[AGENT][POSITIVE] Oh, sure. Yes, I can assist you with that. Um, may I have your name?
[CUSTOMER][NEUTRAL] Yeah, first name is [PII]. It's spelled [PII]
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And do you have the policy number or you don't have that number either?
[CUSTOMER][NEUTRAL] Oh, I don't think so. Let me see if I can find my summary.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I can give you my social, but I don't have the policy number.
[AGENT][NEUTRAL] OK. Yeah, that will work. Go ahead.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hold on real quick.
[AGENT][POSITIVE] Thank you. Mhm.
[CUSTOMER][NEUTRAL] That's not how it works? OK.
[CUSTOMER][NEUTRAL] OK, never mind. hello?
[AGENT][NEUTRAL] Yes, OK, and for security, I need your date of birth, mailing address and email address on file.
[CUSTOMER][NEUTRAL] Date of birth is [PII]. [PII]. No, [PII]. And then address is mailing address is [PII], three separate words.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's in what city and state?
[CUSTOMER][NEUTRAL] And they is.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's the city and state? Mhm.
[CUSTOMER][NEUTRAL] City is [PII], state is [PII], [PII] being [PII]
[AGENT][NEUTRAL] OK, thank you. What's the email address on file?
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] What's the email address on file?
[CUSTOMER][NEUTRAL] It should be [PII].
[AGENT][NEUTRAL] OK, we have a [PII].
[CUSTOMER][NEUTRAL] Oh, that's gonna be [PII].
[AGENT][NEUTRAL] OK, perfect. Um, now, the zip code for the address, is it [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, alright, so you can go to [PII].
[CUSTOMER][NEUTRAL] OK, I'm on it right now.
[AGENT][NEUTRAL] OK, click on sign in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna take you to another page and you're gonna click on new user.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You you're gonna choose the first option and click next.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you're gonna fill out the information.
[CUSTOMER][NEUTRAL] And then just
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's, it's gonna be your social security on the member's ID or Social Security, OK?
[AGENT][NEUTRAL] The email address is the one we have on file, which is gonna be the Marriott, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's probably why it didn't let me in.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, it's now prompting me to set up an account, correct?
[AGENT][POSITIVE] Perfect, yes. Mhm.
[CUSTOMER][NEUTRAL] So, um, what do I need to do to submit a claim?
[AGENT][NEUTRAL] OK, if you're trying to submit a claim online, you just click on upload files and you can upload the files. Now, um let me check something really quick, um.
[AGENT][NEUTRAL] Now this is.
[AGENT][NEUTRAL] OK, so this is a secondary policy. We're gonna need 3 documents for you to submit a full claim. The first one is the claim form that you can find through our website at [PII] on the first page it was at where it says claims and forms. You can click on that and you can get the Metin claim form.
[AGENT][NEUTRAL] And um the first page is gonna give you instructions that I can let you know that what we're gonna need out, out of the instructions is an itemized bill with the diagnosis codes and procedure codes.
[AGENT][NEUTRAL] And also a copy of the explanation of benefits from the primary insurance for that date of service.
[CUSTOMER][NEUTRAL] Um, you said I have that you said oh, that's the OK, OK, alright, sorry, I just double checking that I have all of those um.
[AGENT][NEUTRAL] OK, sure, it's OK. Yeah, once you have all three, then that is a full claim. You can go ahead and submit a claim through the website by uploading the documents.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] OK, um, so which claim, OK, let me, let me get through this new user part it's asking for an email.
[AGENT][NEUTRAL] OK, yeah, go ahead, yes, yeah, go ahead.
[CUSTOMER][NEUTRAL] Should I put an email you have on file or anyone that I want?
[AGENT][NEUTRAL] On which side?
[CUSTOMER][NEUTRAL] On the new user sign up it's asking me to create my account. It's asking for an email and to confirm my email. Should I put the email you guys have on file, or should I put the um email, any email that I want?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's best to use the one we have on file. You can try to use your personal one. Sometimes it takes it, but if it doesn't take it, you will have to go back to that uh Marriott email address.
[CUSTOMER][NEUTRAL] OK, let me try that now and see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I submitting.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, it's been created so let's see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] logging.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And do you know exactly which form would be best for me to use to submit for a colonoscopy that I had?
[AGENT][NEUTRAL] Um, well, you have a secondary policy, so it's gonna be always the same claim form, which is the Metlink claim form.
[CUSTOMER][NEUTRAL] Me that you came for? OK.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] Are you able to upgrade it for me?
[AGENT][NEUTRAL] Upgrade um the policy?
[CUSTOMER][NEUTRAL] I want to you can upgrade on uh so now you.
[AGENT][NEUTRAL] What type of upgrade?
[CUSTOMER][NEUTRAL] One second, sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry. Are you able to explain to me the differences between the three policies that I'm seeing on the enrollment?
[AGENT][NEUTRAL] OK, uh, we only handle the Metin, um, the other ones are through your employer.
[CUSTOMER][NEUTRAL] OK, OK, I understand. Um, give me one second. Why is it?
[AGENT][NEUTRAL] Yeah. Mhm mhm.
[CUSTOMER][NEUTRAL] So asking for a phone number verify.
[CUSTOMER][NEUTRAL] So what did you see that you have to up here the the the claim form and what else? Um, let me get a sticky note so I can write it all down. One second. So the three forms that I need to upload when I'm uploading it is the explanation of benefits.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] The, the what else.
[AGENT][NEUTRAL] The claim form.
[AGENT][NEUTRAL] And the itemized bill with diagnosis codes.
[CUSTOMER][NEUTRAL] The itemized bill with with which code? OK.
[AGENT][NEUTRAL] With diagnosis coin.
[CUSTOMER][POSITIVE] Yeah, OK, mhm. OK, perfect. Um, I think I got it and I think I'm all set.
[AGENT][NEUTRAL] OK, so once you go in in the top of the page, you're welcome. You're gonna see where it says claims and forms. Just click on that. It's gonna be on the top on the on the blue ribbon where it says APL contact us claim form. You can just click on that and it will take you to the page where the claim forms are, OK?
[CUSTOMER][POSITIVE] Thank you so
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it took me to another website for you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh you did? OK, yeah, it's right here. Oh, you have to fill it out outside it.
[CUSTOMER][POSITIVE] And then send it where do I submit it? OK, alright, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day, Miss.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Bye bye.