AccountId: 011433970860
ContactId: 8a5b6445-7d99-4b26-bb3d-a500f51c698e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 920809 ms
Total Talk Time (AGENT): 356613 ms
Total Talk Time (CUSTOMER): 629164 ms
Interruptions: 10
Overall Sentiment: AGENT=1.5, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/8a5b6445-7d99-4b26-bb3d-a500f51c698e_20250122T20:46_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling. Um, I had, um, filed some claims last week and I logged back into my account just now to follow up on them, and I see it looks like they have been like completed or confirmed and I just wanted to know like a very stupid question, but um I just wanted to know like what happens next like how does that work with the um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] With the claim like I have a claim number now and it says like you know date completed and then um how does that work with the paying out or the the um.
[CUSTOMER][NEUTRAL] The coverage I guess I'm trying to say.
[AGENT][POSITIVE] I got you, Mill. You don't have to. I've got you. And that's not a, it's not a stupid question or anything. I can, that is a good question.
[CUSTOMER][POSITIVE] Oh thank you. I'm like trying to figure I'm looking at this and I'm like looking at and like OK, what happens next? Yeah, yeah.
[AGENT][POSITIVE] And I can help you.
[AGENT][NEUTRAL] And you're just going, what, what, what? Yeah, I got you.
[AGENT][POSITIVE] Not a problem. Do you have your policy number available so I can pull up your coverage?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, um, let's see here I have um.
[CUSTOMER][NEUTRAL] A number here I have 048 0077 ML 8.
[AGENT][NEUTRAL] And you said 048 or is it 014?
[CUSTOMER][NEUTRAL] 0
[CUSTOMER][NEUTRAL] I'm sorry, 01480077 ML 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Perfect, thank you. And do you, I just need to verify your information. Your last name is [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] My date of birth is [PII]. Mailing address is [PII].
[AGENT][NEUTRAL] All right, thank you. Did, now did you get to know where you are?
[CUSTOMER][NEUTRAL] Uh, no, we've been talking about all day. It's, it's up in the panhandle and I'm down in, um, more of like, uh, I'm like maybe an hour and a half or 1 hour north of [PII], so I'm, I'm in, um, sort of southern [PII], so it's just cold and rainy here.
[AGENT][NEUTRAL] Oh, got you.
[AGENT][NEUTRAL] Gotcha. So, um, yeah, y'all aren't used to that cold though, are you?
[CUSTOMER][NEUTRAL] Not really. I mean, it's not too bad right now. It's, I think it's gonna be colder tomorrow, um, but it's just weird to see like the news everywhere where the top of the state's getting all these these inches of snow. I'm like, what the heck is going on here?
[AGENT][NEUTRAL] Oh, I know.
[AGENT][NEUTRAL] I know in [PII], I'm like, uh, mm mm.
[CUSTOMER][NEUTRAL] Yes, yeah, I know it's crazy. I don't what, what, what state are you in, may I ask?
[AGENT][NEUTRAL] Like, really?
[AGENT][NEUTRAL] I'm actually in [PII] and we're just above where the all that snow hit in [PII], so.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh, so you guys you skipped over you, you missed it, huh?
[AGENT][MIXED] Skipped over us. Mhm. But that's OK, yeah.
[CUSTOMER][POSITIVE] Oh, that's too funny, huh.
[CUSTOMER][POSITIVE] Yeah, you're you're OK with that.
[AGENT][NEUTRAL] I mean, I, I'm kinda like, uh, if it's gonna be this cold, I would like to at least to see some snow, at least falling, even if it doesn't stay on the ground.
[CUSTOMER][POSITIVE] Uh, right, exactly right.
[AGENT][NEUTRAL] But
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] We just got
[CUSTOMER][NEUTRAL] It would be nice.
[AGENT][NEUTRAL] Super cold, but that's OK, whatever. I'm ready for the sunshine.
[CUSTOMER][POSITIVE] Yeah, you're like it's all right.
[CUSTOMER][NEUTRAL] Yeah, I know it's really out.
[AGENT][NEUTRAL] Warmer temperatures. I like flip flops. What can I say?
[CUSTOMER][NEUTRAL] I know I, I'm in them as we speak so.
[AGENT][POSITIVE] These, these shoes with close toes. Oh, I'm ready to get out of them.
[CUSTOMER][POSITIVE] Yeah, I know, I hear you I hear you I'm a true [PII] girl.
[AGENT][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] Uh, I'm a beach girl, so.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, I don't blame you.
[AGENT][NEUTRAL] One of these days I'm gonna be a [PII] girl, but that's OK when my time will come.
[CUSTOMER][NEUTRAL] There you go, there you go.
[AGENT][NEUTRAL] So, so I do I've got your policy pulled up and I do see that we did process two claims yesterday.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you clicked on the claim number, I'm just, I mean I'm gonna tell you everything but and you see that there were payments?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I, I did.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] You should be able to see those payments.
[CUSTOMER][NEUTRAL] OK, so I just pulled up I just pulled up a um invoice looking thing with with the claim and then it shows um.
[CUSTOMER][NEUTRAL] And it shows at the bottom like total benefits paid 859 10.
[AGENT][NEUTRAL] Mhm. And that is coming to you.
[CUSTOMER][NEUTRAL] On one, so we're
[CUSTOMER][NEUTRAL] OK, so that means that's coming like via check to me?
[AGENT][NEUTRAL] It will be coming via check, um, and if you have to submit a claim in the future, there is a direct deposit option.
[AGENT][NEUTRAL] But because that direct deposit was not activated, you will be getting those checks by mail to your address on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's fine. And then when I get it I can pay out to um that bill um OK so I see that was the you said there was 2 on the 1 on the [PII] 0 yeah OK I I see the.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, there were 2.
[CUSTOMER][NEUTRAL] OK, and then the other ones that are sitting there um and it says no files next to them, what does that mean?
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] Uh, yes, I do have a claim number, um 355-069-4.
[AGENT][NEUTRAL] So that one was paid to the provider that was for Jupiter Imaging Associate Associates for data service 1123 24 and we paid the $344.74 to them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] OK, so that one basically that's a closed case then that's done deal.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Got it. OK, so that's what that means. OK, I think I have a better understanding. I was trying to figure out why there was a difference in, in how they looked, um, and then I saw like the, the claim or you know I was like I think it's a done deal, so, um, I think that makes better sense now. So, OK, that that's good, um, and then generally I'm assuming it takes maybe like a week or two for the check to get to me.
[AGENT][NEUTRAL] Yeah, so the process date was the [PII]. Our checks generate overnight.
[AGENT][NEUTRAL] So they will be going out in the mail today.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And did you sign up for the text messaging as well to notification?
[CUSTOMER][NEUTRAL] I think I did, yeah, I haven't gotten anything yet, so when do I start getting texts?
[AGENT][NEUTRAL] So it
[AGENT][NEUTRAL] Well you if it's if you're signed up for the text messaging you should have received a text yesterday.
[CUSTOMER][NEUTRAL] I did that's weird. I did I did um when I got this set up on Friday I did opt in for that um hm I wonder.
[AGENT][NEUTRAL] What's your phone number? Let's verify the phone number we have on file.
[CUSTOMER][NEUTRAL] Sure, I have um it's [PII].
[AGENT][NEGATIVE] Yeah, you should have gotten a text.
[CUSTOMER][NEUTRAL] I'm looking through my.
[CUSTOMER][NEUTRAL] I don't see anything on here unless my phone somehow blocked it as spam, but I mean I get other stuff in.
[CUSTOMER][NEUTRAL] Um, hmm.
[CUSTOMER][NEUTRAL] The only thing I have from APL on my text messages is like a a verification code for getting logged in.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] But that's it.
[CUSTOMER][NEUTRAL] That's weird.
[CUSTOMER][NEUTRAL] Wonder
[AGENT][NEUTRAL] I'm letting my supervisor know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's not the end of the world, but if it, if it can be done great if, if it's, you know, something on my end that I'm not aware of if it's blocking it then.
[CUSTOMER][NEUTRAL] I'm not sure. I can't say, but I don't see anything on here.
[AGENT][NEUTRAL] OK, I'm just letting them know.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Because I've not heard of any issues, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] But yeah, those have been processed and paid and also if you have to.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Submit another claim we do have the direct deposit option.
[CUSTOMER][NEUTRAL] Yeah, I will, um, I'll probably do that moving forward if I have to submit anything else, um, just so that it's quicker.
[AGENT][POSITIVE] Hopefully your providers will take care of that for you. It's just a lot easier because they don't have, you don't have to gather all the documents and they've got the documents needed.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Right, right, yeah, so yeah, I will, I will do that, um, but at least I know now like the, the big, um, expenditures least covered so I'm really happy about that, um, that makes me feel a lot better so I.
[AGENT][POSITIVE] Yeah, this is a good policy. I do have one other quick question for you. You do know that on the portal you can click on your policy number and view what's covered under your plan?
[CUSTOMER][NEUTRAL] Yeah, seriously.
[CUSTOMER][NEUTRAL] Yeah mhm.
[AGENT][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] Yeah, I, I figured that out on Friday at the last minute. I was like I'm not sure, so now I have a better understanding.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] Well, you know, it's
[AGENT][NEUTRAL] It's, it's easier to, yeah, it's easier to to know how to use when you know what's covered and what's not covered and
[CUSTOMER][POSITIVE] Right, exactly, yeah, I know that's my stupid mistake and lesson learned this time around, um, so I will definitely be, you know, using this card more when I go to my anywhere pretty much for anything medical and just give it to them as a, you know, just by default, so lesson learned like I said.
[AGENT][NEUTRAL] Well, it's
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] Mhm. And
[AGENT][NEUTRAL] And your policy has been active since [PII].
[AGENT][NEUTRAL] So here's a, here's a, here's a little tidbit for you. If you
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Had any charges that
[AGENT][NEUTRAL] You know that your primary applied to your deductible or co-pay or co-insurance during that time frame the claims were not submitted for, you can still file that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For reimbursement
[CUSTOMER][NEUTRAL] Yeah, if
[AGENT][NEUTRAL] And catch up
[CUSTOMER][NEUTRAL] So even yeah I would have to I guess the only problem with that is like my insurance has changed through my company since [PII] so I'd have to probably go back to our previous insurance and try to figure out if I could get a hold of, you know, like my statements and stuff that would be the only problem with that, um, because I did I actually did break my foot in [PII] so I, I had to pay.
[AGENT][NEUTRAL] The EOB, yeah.
[AGENT][POSITIVE] Oh, we need to get, yeah, that would help.
[CUSTOMER][NEUTRAL] Yeah I know so if I can try to track that down um then I will and see because I mean the only other thing I can think of is to go through my doctor and maybe see if they have like statements that they can somehow give me um but otherwise I'll have to find out from my employer if they still have like access to that other insurance we're under to see if I can get those statements so because that would help.
[AGENT][NEUTRAL] When did y'all change to [PII] Blue?
[CUSTOMER][POSITIVE] You know that's a good question. I think we've been on it for, I wanna say like 2 years now, maybe 3 tops.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I will be glad you've got [PII] Blue and I'll, I'm gonna tell you another little tidbit, um, when, if you have to submit a claim, you only have to submit the Florida Blue health statement.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, I, um, I, I figured that I talked to someone else on Friday and she said that and I was like, oh my god, that's a that's a huge life saver because I I just logged into my Florida Blue account and I was able to pull those statements from there and just download them so that was like a a huge um like time saver for me because I wasn't sure how I was gonna do that so I'm actually very glad.
[AGENT][POSITIVE] Good.
[AGENT][NEUTRAL] It is so.
[AGENT][NEUTRAL] Do you know who you talk to Friday?
[CUSTOMER][NEUTRAL] Oh God, I wanna say um was it you? Why did I think it was, why did I think [PII]?
[AGENT][NEUTRAL] Me, me.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] [PII] was in customer service and she transferred the call and I answered.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] That's what it was. OK, I, OK, I thought you sounded familiar. I'm like, well, maybe.
[AGENT][NEUTRAL] I know. I kept looking at this going, wait a minute. Let me just check.
[CUSTOMER][NEUTRAL] Oh my [PII].
[CUSTOMER][POSITIVE] That's right, yes, because you're a sweetheart, and I know, OK, that is that's all adding up now, so that makes sense. Yeah, you saved me a lot of hassle on Friday, so I appreciate that very much. Thank you, thank you, thank you for all of that.
[AGENT][NEUTRAL] Oh well.
[AGENT][NEUTRAL] It was me.
[AGENT][POSITIVE] I'm so glad you got the Florida Blue. That, I wish every insurance was like Florida Blue on there, you know, had something that you could just submit like that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, seriously, because that that was a big help that it was quick and easy for me to find it and then just submit it and then you guys are very quick too so I'm happy about that so I appreciate that.
[AGENT][POSITIVE] Now, the mail can just be quick for you.
[CUSTOMER][NEUTRAL] Yeah, now if the mail can just be quick then that that'll be done and dusted and then I can move on with my life for the time being.
[AGENT][POSITIVE] That's right. That's right.
[CUSTOMER][POSITIVE] So, I appreciate it.
[AGENT][NEUTRAL] But check on
[AGENT][NEUTRAL] Yeah, check on that information for [PII] when you broke your foot because you've got these benefits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I know if I can get some money back, heck, I need, I need everything, every penny I can get right now. I'm um going through my husband and I are going through trying to get, um, his parent sponsored, uh, like immigration processing and it's been costing us like hundreds and hundreds and hundreds of dollars and um I'm like any yeah any penny I can save right now or get back is a blessing. So, um, yeah, so I'm trying to, you know, I'm trying to get this sorted so that I don't have to keep paying out of pocket for these medical expenses.
[AGENT][POSITIVE] Oh good.
[AGENT][NEUTRAL] Oh, I wish I could help.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, I, uh, is there, is, is it looking good for that?
[CUSTOMER][NEUTRAL] No, um, we actually just got a letter back yesterday from the immigration department that they declined his dad, so we're now trying to, um, scramble to fight to find out what's going on and how we can get like resubmitted stuff and it looks like somebody in in the immigration department didn't do their job and actually look through our paperwork they were just like something's missing and it's not missing so now we have to um.
[CUSTOMER][NEGATIVE] We're trying to scramble to either go through an attorney or our like local representative to help us out um we might have to go before a judge and have it um reviewed or you know something like that so it's like all uncharted territory for me but it's just so frustrating because we've been doing this for like months now and.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Um, his parents have been here already for like 2 years and they don't have, they're from South Africa, so they don't, they don't have a home to go back to if they have to get deported and we're trying to do everything, you know, the legal right way and it's, it's just, it's been really a lot of red tape, a lot of red tape, so it's frustrating it's, it's.
[AGENT][NEUTRAL] Right.
[AGENT][NEGATIVE] Probably so frustrated, yeah, that's what I was fixing to say.
[CUSTOMER][POSITIVE] It's so it's, it's just it's a nightmare. Thank you, yes, amen. I'm praying my, my butt off and I I do believe the Lord has got a plan for them and I'm trusting that he's gonna make a way somehow so that's what I'm leaning on right now is I know the Lord's gotta make a way and that's what I'm going with, so.
[AGENT][POSITIVE] Well, I'll just say a little prayer that that, that goes through easily and smoothly.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] I'll be praying for that with you as well.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate that. God bless you and I thank you so much for your time today and if I need anything else, I'll call you back.
[AGENT][POSITIVE] Absolutely. Just ask for me if I'm available. I'll be happy to assist you. My name is [PII], so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Wonderful.
[AGENT][NEUTRAL] And I
[CUSTOMER][POSITIVE] Yeah, I got it. Thank you, [PII].
[AGENT][POSITIVE] I'm glad we got those claims processed for you and you call us if you need anything else, OK?
[CUSTOMER][POSITIVE] I will thank you. God bless and have a good day.
[AGENT][POSITIVE] You too, [PII]. Thank you for calling ATL. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um bye bye.