AccountId: 011433970860
ContactId: 8d54be75-7df1-42ae-8e2b-65cb821590d3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1586349 ms
Total Talk Time (AGENT): 466928 ms
Total Talk Time (CUSTOMER): 459248 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/8d54be75-7df1-42ae-8e2b-65cb821590d3_20250313T15:01_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] And I have recently filed claims um on our cancer policy just for our yearly uh skin cancer screenings. Uh, I, I thought I'd get $75 for each of us. That's what typically happens. And instead, I got one check.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For $61. I wonder if you can tell me what's going on.
[AGENT][POSITIVE] Ms. [PII], it would be my pleasure.
[CUSTOMER][NEUTRAL] If that
[CUSTOMER][NEUTRAL] Yeah, that might be an additional check and maybe the other 2 $75 ones are in the works. I don't know.
[AGENT][NEUTRAL] We
[AGENT][POSITIVE] Well, it would be my pleasure. We can take a look at that for you, Miss [PII]. What is your policy number?
[CUSTOMER][NEUTRAL] Oh, it's it.
[AGENT][NEUTRAL] If you don't have it available, I can look that up by your social.
[CUSTOMER][NEUTRAL] It's probably on here here we go. [PII].
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Ms. [PII], what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is your date of birth please, ma'am?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and if you don't mind, can we go ahead and verify your current mailing address and the email?
[CUSTOMER][NEUTRAL] [PII]. Well, it's, it's accurate because I just got this check, but [PII]. Email [PII].
[AGENT][NEUTRAL] Now we have a different address on file. Do we need to update that for you?
[CUSTOMER][NEUTRAL] Do you, you don't have do box.
[AGENT][NEUTRAL] We do.
[CUSTOMER][NEUTRAL] Well, how can you, because you just sent me a check to [PII]. How's that possible?
[CUSTOMER][POSITIVE] And we've been here 3 years and we've gotten at least 3 checks from y'all.
[AGENT][NEUTRAL] I'm gonna check on that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And we're gonna make sure that that is all updated as well.
[CUSTOMER][NEUTRAL] Yeah, because I did a change of address when we moved.
[CUSTOMER][NEUTRAL] We see how
[CUSTOMER][NEUTRAL] Don't know how
[AGENT][NEUTRAL] Yeah, I'm not sure how that if it got.
[AGENT][NEUTRAL] Accidentally changed back, but you know what? I'm gonna take care of that for you. Let's just go ahead and take care of that and get that new box address updated. Do you mind giving me that address?
[CUSTOMER][NEGATIVE] I hope the other, uh, I hope the other checks didn't go to that address.
[AGENT][POSITIVE] We're gonna take a look at that. Well, I'm gonna, we're gonna check into all that for you. We're gonna take care of you.
[CUSTOMER][NEUTRAL] Wouldn't that be something?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you. Cause I need, I need help.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Oh, well, I'm gonna help you the best I can.
[AGENT][NEUTRAL] And what is, give me that current address again and I'll go ahead and update that.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get this updated for you. [PII], which is where I'd like to live on a brief [PII], but.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know what you would if it was on a big front.
[AGENT][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] It's not
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] It's only 2 you sir.
[AGENT][NEGATIVE] Well, that's just not right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] It's not right.
[AGENT][NEUTRAL] So that's [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Just completing that.
[AGENT][NEUTRAL] Let's make sure that that update was completed and changed. You are now on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So we got you.
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] OK, so let's take a look at these claims and see what's going on. So the 6160.
[AGENT][NEUTRAL] That was for a surgery, a surgical procedure on [PII].
[AGENT][NEUTRAL] Do with [PII]. That's what that 6160 is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now let me take a look at that wellness claim.
[AGENT][NEUTRAL] That was also for that data service.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Now for [PII], they have not processed the claim.
[CUSTOMER][NEUTRAL] OK. That was the, that was the next question, you're reading my mind.
[AGENT][NEUTRAL] So that's
[AGENT][NEUTRAL] I told you I was gonna look at it for you.
[CUSTOMER][POSITIVE] Yeah, you know, it's interesting. I know it's whenever they get it, but it's interesting. I sent them in at the same time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And one of them I haven't even processed the client and one of them I have a check already.
[AGENT][NEUTRAL] Yeah, that's, um.
[AGENT][NEUTRAL] They do process it separate. I'm checking on this one that they paid the 6160. Let me check on that real quick.
[AGENT][NEUTRAL] Because it doesn't look like they processed that as a wellness.
[AGENT][NEUTRAL] And for your wellness screening it looks like it was the same data service for 5724.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] So did they do a procedure and a screening at the same time?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm just getting that pulled up. Let me check it real quick for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it looks like they processed it as an office visit, which just an office visit is not covered, but that's why I'm pulling it up to take a look and see.
[AGENT][NEUTRAL] If there's any wellness.
[AGENT][NEUTRAL] Information on that claim and you don't now um all you have to do to submit a wellness claim is to complete the wellness claim form.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Much easier. So any time, do you have that active online account with us?
[CUSTOMER][NEUTRAL] I don't. I need to set that up then.
[AGENT][POSITIVE] And I can help you do that.
[AGENT][POSITIVE] If you're at a computer, I can help walk you through it.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And show you
[AGENT][POSITIVE] The easiest is easy now they've updated everything to try to make it easier.
[CUSTOMER][POSITIVE] Good.
[AGENT][NEUTRAL] So if you want to go to our website, you can go to [PII] or you can go to [PII].
[CUSTOMER][POSITIVE] That's great.
[AGENT][NEUTRAL] You just tell me when you're there you're gonna go in as a new user.
[CUSTOMER][NEUTRAL] OK, let's say, am I looking for the app or I'm looking on Safari?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can use.
[AGENT][NEUTRAL] Safari or Chrome?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now I'm sorry [PII]?
[AGENT][NEUTRAL] Right, it's secured [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's funny. [PII]'s ice cream came up.
[CUSTOMER][NEUTRAL] Let's search again.
[CUSTOMER][NEUTRAL] Because it sounds so much alike, right?
[AGENT][NEUTRAL] Computers, right? Mhm.
[CUSTOMER][NEUTRAL] Yeah, love them or hate them, secure [PII].
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it's searching.
[CUSTOMER][NEGATIVE] This is ridiculous.
[AGENT][NEUTRAL] I know why they got that uh Dubo.
[CUSTOMER][NEUTRAL] Where?
[AGENT][NEUTRAL] Address, it was on the claim form.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, well, that's interesting because I've seen several, since we moved here with that form, but I guess this time they picked up on that. OK, well, that's, that's my bad, my bad. Um.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, that's OK. That, that answers that and, and that's good to know.
[CUSTOMER][NEUTRAL] My shop, OK.
[CUSTOMER][NEUTRAL] It says it gets OK what $2. Let me just try this again.
[CUSTOMER][NEUTRAL] OK, it's not lock in that. How about what's the, what was the other address I could look at?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And are you doing it on your phone or laptop or desktop?
[CUSTOMER][NEUTRAL] And this is on my iPad since it's bigger.
[AGENT][NEUTRAL] OK, so it should be fine, yeah. I have to do it on my iPad too for the same reason.
[AGENT][NEGATIVE] Those phones get so small.
[CUSTOMER][NEUTRAL] I mean, why not?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And it does actually work better on a laptop or desktop, so good.
[AGENT][NEUTRAL] Is that working?
[CUSTOMER][NEUTRAL] It's usually not so slow. It says searching and
[CUSTOMER][NEGATIVE] That's the little three dots lighting up and then no, no results found. OK, back to the, we'll go to the phone and see if that.
[CUSTOMER][NEUTRAL] I can't imagine that that would do any differently, but.
[AGENT][NEUTRAL] Yeah, the iPad, if you put in [PII], it should pull up APL.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And instead, it didn't find it. And that quickly, my phone pulled up APL, uh,
[CUSTOMER][NEUTRAL] OK. So,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To pull, pulled it up so now.
[AGENT][NEUTRAL] You're gonna go to log in and you're gonna choose that you're a new user.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] One sec
[AGENT][POSITIVE] Just take your time.
[CUSTOMER][NEUTRAL] OK, my choices.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] You're in you're gonna choose the top one, you're an individual with an APL policy.
[CUSTOMER][NEUTRAL] OK. Um, uh, my choices.
[CUSTOMER][POSITIVE] Without touching anything or workforce benefits that work for you, see how, click on that. Um, who we serve, brokers learn more groups, individuals.
[AGENT][NEUTRAL] OK, do you see a place to log in?
[CUSTOMER][NEUTRAL] No, but let's see these lines maybe these lines have it.
[CUSTOMER][NEUTRAL] About solutions products for brokers for groups contact claims and forms claim sign in.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] There you go.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK now log in OK.
[AGENT][NEUTRAL] As a new user.
[CUSTOMER][NEUTRAL] We
[AGENT][POSITIVE] And you're going, it's gonna ask you a question. That's right.
[CUSTOMER][NEUTRAL] OK, I'm an individual with a policy, OK.
[CUSTOMER][NEUTRAL] Well, let's see.
[AGENT][NEUTRAL] And then it's gonna ask for you to complete your information and you will use your complete social. It says social or medical ID you'll need your social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] With no hyphens probably.
[AGENT][POSITIVE] That's correct. No hyphens.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can put in the zip code for your beachfrontive address.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] It's the year of my birth, right?
[AGENT][NEUTRAL] And when you're creating that username that will never change.
[AGENT][NEUTRAL] Your password does need to have one lower case, one uppercase, one number, and one symbol.
[CUSTOMER][POSITIVE] Alrighty, let's see and do that.
[AGENT][POSITIVE] The fun part
[AGENT][NEUTRAL] Doing passwords.
[CUSTOMER][NEUTRAL] Yeah, yeah, it didn't, it didn't like my username. OK, let's keep going. Let's see.
[CUSTOMER][NEUTRAL] OK, still doesn't like it. Let me just start over.
[CUSTOMER][NEUTRAL] OK, we're stuck on the on the username which
[CUSTOMER][NEUTRAL] Must be 1 to 20 characters, check.
[CUSTOMER][NEUTRAL] Lowercase uppercase numbers.
[AGENT][NEUTRAL] And your password has to be a lowercase uppercase.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Symbol and number.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, and my password's OK but it doesn't like my user name maybe it doesn't like the symbols I use. OK, let's try.
[CUSTOMER][NEUTRAL] What it said.
[CUSTOMER][NEUTRAL] OK, let's see. Jump to home privacy notices. So I don't know if I signed in or not. Let me go back, sign in.
[AGENT][NEUTRAL] Looks like it's still creating the account.
[AGENT][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Did you get a because once it's created, you will get a notice that your account has been successfully created.
[CUSTOMER][NEUTRAL] No, that's what I thought, but I didn't get that. So instead, uh you know backing up.
[AGENT][NEUTRAL] And it could be, you know, sometimes it works a lot better on the laptop.
[AGENT][NEUTRAL] Or desktop.
[CUSTOMER][NEUTRAL] Yeah, well, you know, it's weird that I couldn't even get it to tell you what, let me try one more time on that.
[CUSTOMER][NEUTRAL] Which is the exact same thing I typed on my phone.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's see, to while it's searching, I'll be going on my phone.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, this is so fine.
[AGENT][NEUTRAL] The things we do for our computers these days, right?
[CUSTOMER][NEUTRAL] Nod.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] That are supposed to make our lives easier. Well,
[AGENT][NEUTRAL] I feel you because.
[AGENT][NEUTRAL] I'm the same way.
[CUSTOMER][NEUTRAL] And sometimes, sometimes, sometimes they do.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Sometimes they really do.
[AGENT][NEUTRAL] And on your laptop is it searching through Google Chrome or?
[CUSTOMER][NEUTRAL] Safari.
[AGENT][NEUTRAL] It should be compatible in Safari.
[CUSTOMER][NEUTRAL] Yeah, cause it's the same thing I'm using on my phone.
[CUSTOMER][NEGATIVE] I need to fix this uh program. When I'm putting in my primary phone and my text message phone, I put in the area code and it jumps to get my first three digits, and it goes back to the alphabet screen.
[CUSTOMER][NEUTRAL] So I type in the 1st 3 digits and it jumps to the last 4 digits of my phone number and it goes to the back to the alphabet screen.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So 12344 times, I have to push an extra key. Anyway, that's just, just a little programming thing.
[CUSTOMER][NEUTRAL] OK, you know what? I'm just gonna do this another time by myself. It doesn't like this username, which is exactly, I mean, I know it's got to be exact. It is 1 to 20 letters, it's got upper case, lower case, it's got numbers and it's got characters.
[AGENT][NEUTRAL] Now your user name you should be able to use anything.
[AGENT][NEUTRAL] But um yeah and that's fine so when you do create that and even if you don't create that account, if you create that account, you can always click on your policy number and view your policy certificate benefits.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, she's
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you can also if you just if you don't get that account created or.
[CUSTOMER][NEUTRAL] Oh, I, I'm going to.
[AGENT][POSITIVE] Good, good, good, because I think you'll like it because you can upload claims online too, but um.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] For the wellness claims there's a wellness claim form under the claims and form section, and that is on our website at [PII]. You don't have to sign in to get the claim form, but that's all that's needed now to submit a wellness claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I don't need to send a copy of a bill or an EOB or anything?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Mm. It's just completing that claim form.
[AGENT][NEUTRAL] No additional documentations are needed. Now you will have to.
[CUSTOMER][POSITIVE] Awesome. So
[CUSTOMER][POSITIVE] OK, I, I, well, I, I really, really, really I'm gonna love it. So, so [PII] is in the works.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am, it's in line to be processed now on yours.
[CUSTOMER][NEUTRAL] So you can't tell yet if you, you have what's needed for him, you can't tell yet.
[AGENT][NEUTRAL] I can't. The adjusters once they review it, um, we'll be able to tell that now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On yours, it looks like that it was submitted for an office visit. There's nothing.
[AGENT][NEGATIVE] Um, indicating that it was for a wellness office visit, so yours was denied.
[CUSTOMER][NEUTRAL] OK, so I'll just, I mean, I only go once a year and I have a wellness, so I'll go and uh
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Get that claim form and just submit the.
[CUSTOMER][NEUTRAL] I don't know if I've put in dates on the claim form.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I just tell the claim form uh that I had a mammogram, which I did. I'll just do something else.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, so on that claim form it'll ask you what your wellness screening was, and we will need the uh uh information for the provider that performed that screening.
[AGENT][NEUTRAL] You know, just the name and
[CUSTOMER][NEUTRAL] And would you need the date?
[AGENT][NEUTRAL] Mhm. There'll be a option, you'll put the date in and the test was performed that was performed.
[AGENT][NEUTRAL] If it's not listed in the list, it'll say other tests performed, but the mammogram is listed and you just check that box.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Much easier.
[CUSTOMER][POSITIVE] I'll do that. Thank you so much.
[AGENT][POSITIVE] It's been such a pleasure to assist you, Ms. [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yeah, you too.
[CUSTOMER][POSITIVE] No, thank you so much and have a wonderful day.
[AGENT][POSITIVE] I hope you do too and thank you for calling APL. Take care. Bye bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure. You too. Bye-bye.