AccountId: 011433970860
ContactId: 942b55a4-15ac-4089-be82-c0915483d61b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1586189 ms
Total Talk Time (AGENT): 459573 ms
Total Talk Time (CUSTOMER): 701063 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/942b55a4-15ac-4089-be82-c0915483d61b_20250212T23:00_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] Hi, I'm on the website trying to find and file a claim, and I've been trying on and off for a few hours this afternoon, and it just keeps buffing. It doesn't ever go to the next step to say that it's accepted the claim. Are you having problems with your website?
[AGENT][NEUTRAL] Not that we know of, um.
[AGENT][NEUTRAL] Let me check and see, uh, is the file a picture or is it a small file?
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] What are you
[CUSTOMER][NEGATIVE] I was doing a wellness claim which is really just a quick claim online that they don't even ask for a lot of detailed information and I went in and out of it a few times I tried to log out, log back in thinking maybe something's hanging it up but it just didn't allow me to do anything.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Oh yeah, so mhm.
[CUSTOMER][NEUTRAL] I don't know if you would see anything on your end where it shows that it's hung up. I don't know.
[AGENT][NEUTRAL] I can check and see if we received anything, but yeah, um, the wellness claim form was having problems, so um I'm not sure if they have fixed it. I'll have to check on that one. let me see. Um, may I have.
[CUSTOMER][NEUTRAL] So I mean, go ahead, I'm sorry, go ahead.
[AGENT][NEUTRAL] It's OK. May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII]. Um, the number I'm calling from is [PII].
[AGENT][NEUTRAL] All right. And do you have the policy number?
[CUSTOMER][NEUTRAL] So I'm actually have two that I'm looking at because I work for a school and then on [PII] and went to the next year policy number. So the one that I was trying to file a claim for, let me give you that group cancer insurance first.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 241-188-5.
[AGENT][POSITIVE] OK, thank you and.
[CUSTOMER][NEUTRAL] And that would have been in effect on [PII].
[AGENT][NEUTRAL] Yes, thank you. OK, may I have your date of birth, mailing address and email address on file for verification?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] OK, I don't see anything on that one. Let me check on the other one. Let me pull that one up. One moment.
[CUSTOMER][NEUTRAL] Do you need that policy number because I have it if you do.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No, um, we haven't. I haven't. Thank you.
[CUSTOMER][NEUTRAL] 2256206
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mm, OK, so now it's not taking it. Let me check with that department and see if they fixed that problem with the um.
[AGENT][NEUTRAL] The wellness claims, OK? Yeah, one moment. You're welcome. You're welcome.
[CUSTOMER][POSITIVE] The online, OK, OK, thank you so much I appreciate it thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. OK, so it looks like, yeah, it was already um fixed um.
[AGENT][NEUTRAL] Yeah, no, oh, OK.
[AGENT][NEUTRAL] I'm telling you 6 and mine went off. OK, bear with me.
[CUSTOMER][NEUTRAL] OK, and I'm not understanding what you just said.
[AGENT][NEUTRAL] I'm so sorry. Yeah, I spoke to somebody in that department and they say they fixed the problem. Um, bear with me because mine just went off again, so I'm not sure.
[CUSTOMER][NEGATIVE] I just tried to go in and submitting data please wait wellness claim it's not fixed. I just did it again and it's just sitting there and going and going and going and it's not, it's not taking it.
[AGENT][NEUTRAL] Are you in a computer, desktop, laptop or your phone?
[CUSTOMER][NEUTRAL] I'm on my desktop.
[AGENT][NEUTRAL] Desktop, OK. Um, OK, uh, I'm just gonna report this because, yeah, I'm not sure what's going on, but OK, so desktop and um you're, you're just getting an error but you're not getting any red dots of missing information or anything like that. You are.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] It's not all it says is after you save the signature you can probably put this in your note when you do save signature.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And then it it allows you to go file my claim and then it says submitting data please wait wellness claim and then you're waiting and waiting and waiting and it doesn't take it.
[CUSTOMER][NEGATIVE] It's just, it's just like a a blue line moving, moving, moving like it wants to but it's, it never clears it to bring it to a confirmation page at all.
[AGENT][NEUTRAL] OK, but
[AGENT][NEUTRAL] OK. So, um, but you're able to click on the signature part of it.
[CUSTOMER][NEUTRAL] Yes, I put my signature in I hit save and then the next one it says file my claim right underneath save and that's where it says submitting data please wait wellness claim and it never goes through.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm. And you're using Crohn?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Are you um using Chrome or is it a different browser?
[CUSTOMER][POSITIVE] Oh that's a good question. That's a good question. I'm using Chrome, yes I am.
[AGENT][NEUTRAL] OK, so yeah, you should have no problem if you're using Chrome, um, mm, and if our website, yeah, you're able to find it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see what else they're gonna need.
[CUSTOMER][NEUTRAL] You know what, that's a good question because I went up to, I mean maybe you should hold up for a second. I did go up to the URL and I put in, I usually do use Chrome, but for this particular claim I referenced the website from the Ul using.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, let me try it through Chrome. Maybe that's the issue, you know, I used to work at USAA, and I remember we had the same problem with some stuff freezing up like that. So if we weren't in the right, yeah, uh, so let me look real quick.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And just X out of this again and I'll try to go through Chrome now when I go through Chrome, how am I gonna search you you guys just American Public Life or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You can go to [PII].
[CUSTOMER][NEUTRAL] Can you spell that for me? [PII] or what do I put it?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] No, it's gonna be [PII] like in the [PII], the letter, the letter [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, OK, let me try that thing.
[AGENT][NEUTRAL] And then you're gonna click on sign in.
[CUSTOMER][NEUTRAL] It actually comes up and says log in does that matter?
[AGENT][NEUTRAL] Yeah, that's fine.
[CUSTOMER][NEUTRAL] I'm probably not.
[CUSTOMER][NEUTRAL] OK, so, and then of course Google is gonna bring up APL secured.
[CUSTOMER][NEUTRAL] Let's see if that helps online service center.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And I'm in the claim it should just take a minute to type. Thank you for waiting.
[AGENT][POSITIVE] Sure. Yes, no problem. Take your time.
[CUSTOMER][NEGATIVE] And the other question I had while I'm typing here is it says, you know, oh for faster claim go to your dashboard and sign up for direct deposit but I couldn't find it anywhere.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Let me go to my dashboard and for the direct deposits under one more.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It should be where your information is um reflected like you can see your policy number, policy, effective date, and then in the bottom.
[AGENT][NEUTRAL] There's an option to register.
[AGENT][NEUTRAL] For the direct deposit, you don't see it.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I don't see that, um, so like if I'm looking under my coverage and this is, you know, I'm not.
[CUSTOMER][NEGATIVE] My policies have termed, meaning they, I was let go from my job.
[CUSTOMER][NEGATIVE] And um I'm filing claims while I was active with these policies but of course when I looked at cover dependent it shows lapsed so you know but I can still file the claims. I was told that's not a time period on that because I didn't get around to doing any of them, so I, I hope that's not holding me up. So when I go in here to file.
[AGENT][NEUTRAL] Oh, got you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that's probably it.
[CUSTOMER][NEUTRAL] You think so?
[AGENT][NEUTRAL] Yeah, yeah, now that you mentioned that and yeah, I, I saw that. No I didn't mention that, but yeah, um, yeah, whenever the policy is terminated, it usually lets you go in the policy to give your information, but the direct deposit, it will not let you because it's already terminated, so that's why you don't have that option. That's why you don't see that option now on the filing the claim, uh, I think you should still be able to do it because it's, it's for a past claim.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm, that is a good question. I never, OK, let me ask and see if, yeah.
[CUSTOMER][POSITIVE] Yeah, it's a great question. It's uh I'm only thinking about it.
[AGENT][NEUTRAL] Yeah, let me see if that will stop you from submitting the claim. Let me, let me go ahead and ask that question really quick.
[CUSTOMER][NEUTRAL] OK, and that's, it's OK if it does. I mean, I can mail it in it's a simple enough form, but I was like, oh, she told me it's so easy to do this and I was like, really? But it's making sense to me because it just seems like the system doesn't understand what's going on because I'm really not with an active policy that's what I'm thinking. I don't know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] Yeah, and I'm, I'm waiting for an answer right now, so let's see what they say.
[CUSTOMER][NEUTRAL] No problem and I'm gonna, you know what, I was in it and I typed my information and then it looked like it was gonna accept it and then it brought me back to the other screen. It wasn't even cycling anymore, so let's see if that.
[CUSTOMER][NEUTRAL] So anything that we send in by fax, does the fax automatically get scanned into your policy number or does somebody have to manually do that?
[AGENT][NEUTRAL] Somebody needs to manually do that. It goes to a fax line and then from there um there's somebody that pick it up and then they image it into your account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They image it OK and even though it's a lapsed account, it'll be OK as long as I have the policy number.
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Correct, yes, yes, because it's manually done, uh, it's not, it's not the system and they can go ahead and just put it in.
[AGENT][NEUTRAL] Override it. Mhm.
[CUSTOMER][NEUTRAL] I, you know, this nowadays with the way that our faxes are so electronic, I didn't know if it automatically went into a scanned um situation with you guys, but that's OK. And I would assume that anybody that's opening mail if I decide to mail it rather than fax it. um I have a, I have a large claim coming under the regular claim, not the wellness, but
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] When I do the, you know, the claim and all the riders that I have, there's gonna be a lot of documents sent because I have explanation of benefits. I mean, I was under treatment for over a year. So, um.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I didn't know whether to try to do that all at once or just send it in little by little. Does it really matter? I don't know.
[AGENT][NEUTRAL] It, it doesn't matter. Um, it is up to you. Um, it takes 7 to 10 business days to process the claim, so either you can wait to have it all done, you know, all sent one time, or you can send it little by little. Now if we don't have all the information and it's time for us to process, we'll go ahead and deny the claim asking for the information, um, so I don't know.
[CUSTOMER][NEUTRAL] Oh they're asking for more information tonight and you gotta do it again. OK, yeah, so I, that's why I'm being very careful, you know, to try to make sure, um.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] That you know you guys have everything but OK one more time I'm gonna try this.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, and always send copies. OK, yes, always send copies, never send original because we never know if it could get lost in the mail, OK, just in case.
[CUSTOMER][NEUTRAL] I know, I know.
[CUSTOMER][NEUTRAL] Yeah, now I hear you.
[CUSTOMER][NEUTRAL] Yeah, so there's that direct deposit problem which is not really a problem.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I was told that more than likely it's not gonna let you do it online, but you can try.
[CUSTOMER][NEUTRAL] Uh oh.
[CUSTOMER][NEUTRAL] No, it's not gonna let me keep cycling back so I'm not gonna worry about it so I'm just gonna go ahead and um.
[CUSTOMER][NEUTRAL] I can't get out of here now. Let me see.
[CUSTOMER][NEUTRAL] Yeah, I think the system's smart enough to because they're probably afraid of fraud, I'm sure so I don't know, but um, and do you think that's just for the wellness or it would be for both my claims and the wellness?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I believe it's gonna be just for the wellness because the wellness is electronic, everything is electronic and the system is reading that it is terminated and now to upload a claim, I don't think it's gonna be a trouble any trouble uploading a claim, but.
[AGENT][NEUTRAL] Um, to be in the same size since it is terminated. I will probably fax or mail it, um, because usually it will give you some time to be in the website and then sometimes it will kick you out because your labs, so.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah, it is safe to say it's better to send it by fax or mail.
[CUSTOMER][NEUTRAL] Yeah, that's.
[CUSTOMER][NEUTRAL] Yeah, so, um, one last question then.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because the direct deposit option wasn't available, more than likely if it's not available online, I don't, can I put something in writing that I want directly deposited and sign that or do I have to be an active member to have that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, no, no, we can manually do it if you send us the claim form, um, I'm sorry, the direct deposit form. There is a form under claims and form.
[CUSTOMER][NEUTRAL] Where?
[CUSTOMER][NEUTRAL] Under claims and forms for direct deposit? OK.
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] So and then I can print that, fill it out and send it. OK, that's fine. I'll do that then, alright, I think I'm just not gonna keep you any longer. I have a feeling that that's exactly what's going on after I've tried a few times today. I've already prepared an envelope with one of the claims to go off and I'll just go ahead and fix the other one and send it with it, so.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][POSITIVE] OK, totally fine.
[CUSTOMER][POSITIVE] At least get the wellness one done. Now, I was told that the wellness is one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Particular
[CUSTOMER][NEUTRAL] Um, procedure that was done for the year, but I couldn't do a mammogram and a biopsy in the same year, is that correct?
[AGENT][NEUTRAL] One minute.
[AGENT][NEUTRAL] Correct. It is gonna be only one diagnostic testing, one wellness exam. Mhm.
[CUSTOMER][NEUTRAL] OK, so what happened is I was.
[CUSTOMER][NEUTRAL] Um, even though school started already for the next school year, our benefits didn't start until [PII] again the next time. I was, I went for my mammogram on [PII].
[CUSTOMER][POSITIVE] And let me make sure that that's correct.
[AGENT][NEUTRAL] You too. Mm.
[CUSTOMER][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] It was [PII] so I would just reference that with a different number right that I see my last numbers are there. I'm just relying on that that information is still correct, right?
[AGENT][NEUTRAL] Uh, all your policies started on [PII]. So anything before that is not gonna pay, it has to be after [PII]. Mhm.
[CUSTOMER][NEUTRAL] No, that's fine, that's fine, but there's two different numbers though that I've noticed when I signed in. One was for [PII] and then the one from [PII]. That's probably gonna reference the claim that I had for my mammogram actually, you know.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They dated? Oh yeah, it's still [PII]. I don't know why I thought it was [PII] because it's not, but it falls within the [PII] time period. Because can you check those dates for me? That's the last thing I'll ask you to do. So I had a policy in effects, a group cancer policy on, I believe, [PII] that ran through probably [PII]. Is that correct?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Mhm. Correct, yes.
[CUSTOMER][NEUTRAL] OK, OK, so that one, even though it's in the same calendar year, that's considered the mammogram I can put under that one, APL number.
[CUSTOMER][NEUTRAL] That you see there and then I can do the maybe the uh biopsy which was then a few weeks later under the [PII], under the um [PII]. Would that be all right if I did one for that, that first group cancer policy date and then the second one. They're two different tests, the mammogram and then the biopsy.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, I cannot guarantee that one. that one needs to be reviewed by the examiner and see if he will be payable.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, yeah, because I don't know if they go with, they should go with the group effective term policy date which starts [PII]. So I'll just indicate. Right. And so, and the school years are always like that where other companies will start on [PII] and make it a lot more simple but not the schools. So um I'll just try to submit and see what happens and then I guess if I put something through the wellness claim area.
[AGENT][NEUTRAL] Mhm. Yeah, and I see that. Mhm. Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Cause she, she, I had talked to [PII] last week and she was saying, oh yeah, it's so easy. You don't even have to send any documentation or, or anything. You just have to write down the name of where you did it and the phone number. So, but if that particular um biopsy is covered under one of the writers, can I still use that for a writer as well?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, if it's uh um part of the cancer benefits not wellness, um, then we need the
[AGENT][NEUTRAL] Claim form for cancer. There are two claim forms. One is for cancer, one is for wellness. OK. So the wellness is only gonna pay wellness. If you put anything out that is not wellness, it's not gonna be payable under that one. It has to be, um, yeah, it needs to be sent with the cancer claim form. Um, and the cancer claim form does ask for an itemized bill. That's the difference between the wellness and the regular cancer claim form.
[CUSTOMER][NEUTRAL] Right, I know.
[CUSTOMER][NEUTRAL] Yeah, that's fine, that's fine.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Yes, no, I, I did ask for that. I called them today just in case I needed that for a different part of the claim on the cancer claim form. Yes, I do see the difference. OK, that's helpful. All right, thank you so much. I appreciate all your time. I guess we figured it out, didn't we.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Yes, we did. Wasn't a good turn, but yeah, we did. All right. Well thank you for calling ATL. You have a good afternoon, Ms. [PII]. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, thank you so much.
[CUSTOMER][NEUTRAL] And you as well ma'am bye bye.