AccountId: 011433970860
ContactId: 9a3a54a8-b83d-4529-96a1-9516902557b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 315279 ms
Total Talk Time (AGENT): 166949 ms
Total Talk Time (CUSTOMER): 146128 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9a3a54a8-b83d-4529-96a1-9516902557b8_20250527T17:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I have some questions about kind of how to use our APL coverage. We signed up through it or for it through my wife's employer, and so it was kind of like a not really a secondary insurance through our, uh, after our primary, but I just, I'm not really sure how to submit claims or anything like how that works.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 00, I can help you with that. Um, now, do you happen to have your policy number? I can just see what kind of policy you have.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] I sure do. you ready?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 02581652
[AGENT][POSITIVE] OK, thank you. Let's see.
[AGENT][NEUTRAL] And do you mind verifying your date of birth for me?
[CUSTOMER][NEUTRAL] Yeah, my date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And will you also verify um your home address for me please?
[CUSTOMER][NEUTRAL] Yes, it's um [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate that. And the policy, the primary policy holder is [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. Yes, ma'am. Let's see.
[AGENT][NEUTRAL] Now this is a midlink policy. It's a gap policy. So you will always use this as secondary to your major medical, anytime you provide your major medical providers also as secondary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, we've been doing that so far, but sometimes it doesn't come back. I think it's saying that like I I don't know if it's just because it hasn't processed through our primary insurance.
[AGENT][NEUTRAL] It's um
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] And are you saying that you owe after it comes through like the provider or?
[CUSTOMER][NEUTRAL] Yeah, that we've we've done that before where we've had APL listed as secondary but then it'll come back saying uh that this is denied um that it needs to go through another insurance sometimes it says different things different times we've only really had APL cover I think one of them.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, right. Um,
[AGENT][NEUTRAL] Now I can definitely let you speak to someone in our benefits department to see why it's being denied or has been denied um to see if it's possible as for a service possibly not covered. I don't know that. um, but they can definitely, they can look at details in our benefits department, you know, so that you know what's going on with it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Right, for sure.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] That would be great, but so it's good to know though that it should be working through as like a secondary insurance that we build the primary insurance and list as a secondary and it should be working that way.
[AGENT][POSITIVE] Definitely, yes, yes.
[CUSTOMER][NEUTRAL] OK, [PII], is there a phone number of that benefits department? I don't, I'm not able to contact them right now, but maybe I could give them a call a little bit later when I have all my claims stuff handy.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK, now it is the same [PII] number. Um, I'm so sorry. I always mess up our [PII] number unless I'm looking at it. Um, but if I.
[CUSTOMER][POSITIVE] You're good. Is it the [PII]?
[AGENT][NEUTRAL] That is it, yes, ma'am. And just um I'm not even sure what option it is, but it's for a claims and benefits department. It's all one, so that's for the department or someone on our care team.
[CUSTOMER][NEUTRAL] Claims and benefits
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Or a care team, OK.
[AGENT][NEUTRAL] Yes, I know.
[CUSTOMER][POSITIVE] That's good to know that I can, I can compile all of our claims that have previously not gone through and we can kind of go from there and then see that this is a great place to start. I really appreciate it.
[AGENT][NEUTRAL] You are welcome and also you can create an account online um at [PII] and in the upper right hand corner you know it's a box for you to um.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] Set up your account and but you would need to use [PII]'s um um.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] So sorry, social, birthday, you know, things like that. It would be hard because it's um she's the primary, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Makes sense.
[AGENT][NEUTRAL] And her email I was looking to see yes it would be her email just her information and you can get that set up and you can view your claims there also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] As well, uh, that'll be great. That'll actually, that'll be perfect. OK, cool. I will get started on that and then kind of review things and then give you guys a call back if, if, uh, if we see that things are something's going on weird.
[AGENT][POSITIVE] Yes, yes. Definitely. Yes, ma'am.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help today [PII] that is all I need for right now.
[AGENT][POSITIVE] OK, you are welcome and you have a good day, [PII], and thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks you have a good one as well bye bye.
[AGENT][POSITIVE] Thank you. Bye.