AccountId: 011433970860
ContactId: 9b6f2c6a-31fd-4899-8ee0-4937947d7670
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1649150 ms
Total Talk Time (AGENT): 399761 ms
Total Talk Time (CUSTOMER): 527069 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/9b6f2c6a-31fd-4899-8ee0-4937947d7670_20250304T14:46_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] Hi, I'm calling to check status on claims that I was told by BWS that you guys received.
[AGENT][NEUTRAL] OK, well, I can definitely help you with your claims. And are you the insured or you're calling with an employer or um provider?
[CUSTOMER][NEUTRAL] I was the insured.
[AGENT][NEUTRAL] OK, and may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII] and my phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Um, I don't have that. Um, I'm driving for work today.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, no worries. Um, I can also look the policy up with your social if you don't mind.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here we are.
[AGENT][NEUTRAL] And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and then just your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alrighty, and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. And so, um, you said that you were advised by Business Workers of America to give us a call to check on the claims that you have.
[CUSTOMER][NEGATIVE] Yeah, I sent in the paperwork to request a refund for some of my expenses that I incurred, and they're telling me that you would, I, I supposedly sent them directly to you. I don't know if that's true or whatever was on the front of the paper is where I sent them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] Do you remember, so was it like a PO box? Do you remember if it was like Jacks? Did you mail it?
[CUSTOMER][NEUTRAL] I do not remember. I believe I emailed it and faxed it.
[AGENT][NEUTRAL] OK, so this is what I'll do. Let me go ahead and give Business Workers of America a call. The reason I'm saying that is because we don't have any claims here. We've never processed a claim for you yet, like it's literally blank. So let me give them a call and see if I can get a representative. Um, they do help with claims and process claims also, so this, um, this has been coming up. So I can definitely reach out to them and try to get a resolution and see if we can get some clarity.
[CUSTOMER][POSITIVE] OK, I appreciate that.
[AGENT][POSITIVE] You're welcome. Um, do you mind if I place you on just a brief hold? I'm just gonna call on the other line and then I'll connect everybody together.
[CUSTOMER][POSITIVE] Yeah, no that'll be great thank you.
[AGENT][NEUTRAL] OK. You're welcome. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Why does this keep coming up?
[AGENT][NEUTRAL] This is new.
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance. Our hours of operation are Monday through Friday [PII] Central Standard Time. If you know your party's extension, please dial it now.
[CUSTOMER][NEUTRAL] For customer support, press 2. For agent support, press 3. For claim support, press 4 for provider support, press 5. Thank you.
[CUSTOMER][NEUTRAL] Thank you for holding. Unfortunately all of our customer agents are helping other customers. Please try your call again later or email us at customer support at.
[AGENT][NEUTRAL] Oh, come on, BWA.
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance. Our hours of operation are Monday through Friday [PII] Central Standard Time. If you know your party's extension, please dial it now.
[CUSTOMER][NEUTRAL] For customer support, press 2. For agent support, press 3. For claim support, press 4. For provider support, press 5. Thank you.
[CUSTOMER][NEGATIVE] We have not received a valid response. Please try again.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] You are currently caller number 25 waiting to speak with a representative. The estimated hold time is currently 12 minutes. Thank you for your patience.
[AGENT][NEUTRAL] What?
[CUSTOMER][NEUTRAL] You are currently caller number 23 waiting to speak with a. You are on hold.
[AGENT][NEUTRAL] Hello Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So I'm on hold on the other line. It's a twelve-minute wait. Do you want me to join the call, um, and then
[AGENT][NEUTRAL] Because I can't wait that long, but if you want me to join the call so that you're on the line, if y'all want to call us back or I can try to wait and see if hopefully.
[AGENT][POSITIVE] Let's just wait. Let's just get it done. I'll wait. I don't want you to have to go through that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I would rather get
[CUSTOMER][NEGATIVE] I don't wanna have to deal with this. I'm starting a new job soon and I don't want to do it while I'm working. Uh, also, I did look it up and it was on or around [PII], and I can't remember. I, I swear I emailed it and faxed it, but I'm driving so it's really hard for me to look.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEGATIVE] So I apologize. I know I'm, I'm, uh, certain that I, I faxed it and I'm almost certain that I emailed it, but because I honestly, I've been dealing with them off and on, and they every time I send in something for my uh one of my my my um doctor's office is sending something, they always say that they never received it.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] I put that it was emails and fax. I'm going to click back over and see what number I am. Hold on one second, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You are currently caller number 21, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 21, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 20 waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 19, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 17, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 16, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 15 waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 14, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 14, waiting to speak with a representative. Thank you for your patience.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You are currently caller number 12, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 11, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 7, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 6 waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm still here with you. Um, we were [PII], now we're [PII], so we're making progress. OK.
[CUSTOMER][NEUTRAL] No, yeah, that.
[AGENT][POSITIVE] Right, and it's way faster than I thought it was, um, so it'll be just a few more moments, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You are currently caller number 3, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently caller number 2 waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] You are currently caller #2, waiting to speak with a representative. Thank you for your patience.
[CUSTOMER][NEUTRAL] This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from APL. How are you?
[CUSTOMER][POSITIVE] I'm doing well how are you?
[AGENT][NEUTRAL] I'm doing well. Um, we have a, um, mutual insured, and I'm trying to locate where her claims are. Um, she said she's, she believes she's faxed them and emailed them, but we don't have any claims here with APL. Can you look and see if y'all do?
[CUSTOMER][POSITIVE] Yeah, absolutely. What is that member ID number?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, I don't have her member ID with y'all. I just have APL's information.
[CUSTOMER][NEUTRAL] OK, what is her first and last name?
[AGENT][NEUTRAL] Her first name is [PII]
[AGENT][NEUTRAL] Last name [PII]
[CUSTOMER][POSITIVE] Thank you, bear with me just a moment.
[AGENT][POSITIVE] You're welcome. OK.
[CUSTOMER][NEUTRAL] And do you have her date of birth by any chance?
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][POSITIVE] Bear with me for just a moment, I apologize.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate your help. No problem.
[CUSTOMER][NEUTRAL] Did she by chance she said she submitted claims or was this uh obviously or was this matters.
[CUSTOMER][POSITIVE] I, I emailed them and faxed them, I believe, around the [PII], um, they were for reimbursement for me. You guys had already processed my claims through the facilities that I went to which I had to call multiple times for and then you guys told me that they would um cover like you guys first a certain percentage.
[CUSTOMER][NEUTRAL] Bear with me for just a moment.
[CUSTOMER][NEUTRAL] Are you guys still there?
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK, I, I'm where I'm driving to for work I don't know if I have service down here so I'm a little worried.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Well, if anything happens, I'll call you back.
[AGENT][NEUTRAL] And if we can't get you, I'll just put some really good notes in your in your policy. So if you have to call back, they'll be there.
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][NEUTRAL] So you, you did receive the email with the claim form then correct?
[CUSTOMER][NEUTRAL] I received that and I printed everything out. It did. I didn't submit it right away, but um I did it around the [PII] [PII]ause I had emailed them from my work because I had to scan them at work and I faxed them from my work and then I emailed them to myself I believe and then sent them out so they could have came from like 3 different emails.
[CUSTOMER][NEUTRAL] Alright, bear with me just a moment.
[CUSTOMER][POSITIVE] Yeah no problem.
[CUSTOMER][NEUTRAL] There's a couple more I still have to submit. I couldn't get the itemized statements yet.
[CUSTOMER][NEGATIVE] It's probably about 20 pages long because it was multiple bills.
[CUSTOMER][NEUTRAL] I'm gonna have to put you guys on hold for just a second. My boss is calling me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is me. I'm the supervisor here. Who am I speaking with from APL?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK thank you um I did one of um my other CSRs spoke to the um member earlier we typically do submit claims for our members because this is a group policy. I, I checked, she said, um, earlier on the call I think that she emailed them and faxed them both. We did not submit claims for her, so on our of course on APL claim forms it has y'all's direct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Information we also put a cover photo on ours it it didn't come to us we assumed that she submitted it directly to y'all.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK. Well, then she may just have to resubmit it because we don't have anything here. OK. Well, I just wanted to um just check my bases and try to get a resolution, but that helps. So at least we know that y'all don't have it and it's not here, so she'll she'll have to resubmit it.
[CUSTOMER][NEUTRAL] Yes, that
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] We have to resubmit however she wants to do that, but I did. I checked, um, I'm personally who at this point submits all of our claims over to y'all. I don't have it. We haven't received it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alrighty. Well, thank you so much. And what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] [PII], mhm.
[AGENT][NEUTRAL] Me
[AGENT][POSITIVE] All right. Thank you, [PII]. I'll, she, um her boss was calling her, so she's on hold on the other line. So I'll let her know and thank you so much for helping me. Um, that helps a lot.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yes ma'am alright and have a good day.
[AGENT][POSITIVE] All right, have a good day.
[CUSTOMER][NEUTRAL] You too
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi, sorry.
[AGENT][NEUTRAL] Hey, um, no, it's OK. So the um supervisor [PII] came on the line and she let, she's the um representative that filed the claims with us for, I mean, files a claim for for them with APL, um, them beingus workers of America, and she said that she didn't have any claims, so she assumed we had it.
[AGENT][NEUTRAL] So it sounds like um you're gonna have to resubmit the claim because there's no, they don't have it and we don't have it, but you can resubmit it at any time. There's no deadline or anything.
[CUSTOMER][NEGATIVE] Yeah, no offense, but that's irritating because this has happened multiple times even with my regular claims. They kept saying they didn't have them miraculously they had them.
[CUSTOMER][NEGATIVE] So whenever you call, so I'll submit it again but I'm gonna call them whenever I do submit it because I want them to, I want proof that they got it because I'm tired of dealing with this. I even printed out the um the fax paperwork and I'll find all that at home and I'll, I'll send it in as well.
[AGENT][NEUTRAL] And you know what, if you want to, when you, when you, you know, once you're home and you're settled, when you look at the documents, if it says [PII], that's our old claims mailing address because I, I heard her say she sent y'all, um, she sent you a form. I don't know if she has, if they have up to-date forms. So I'm thinking maybe that might be also, um, if it, if it does.
[CUSTOMER][NEUTRAL] Well, that's the thing right, and the fax number?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] That wouldn't change the email and fax number, right?
[AGENT][NEUTRAL] Well, we don't even have an email to send claims to, so I, I'm assuming that's on their side. I we don't have, because the HIPAA laws we can't um accept email claims, but we do have fax, um, you can mail it in and then we have an online portal that you can like upload the documents to, um, but we don't have an email address. But if you look at the form and it says [PII], um, if that's where it was sent to.
[AGENT][NEUTRAL] Oh, but you said you emailed it and faxed it though you didn't mail it.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] No, I believe faxed it and emailed it. I did not mail it.
[AGENT][NEUTRAL] OK. So I'm wondering.
[AGENT][POSITIVE] So you can either do two things. If you want to, if you want to um give us a call [PII] when you're ready to file the claim, um, we can let you know, just go over everything and make sure you have everything you need. I'm the only [PII] here. I'll be more than happy to help um if you get someone else, they can get you to me.
[CUSTOMER][NEUTRAL] You're, you got, so you're the one I need to send it to?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] You can do either or. You can send the claim, you can send the claim to us yourself or BWA can send it on your behalf, whichever you prefer.
[CUSTOMER][NEUTRAL] I'd prefer to send it to you. Are you able to send me an email with your information and the proper.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Um, fax number and stuff so that I can make sure that I get it to you uh and your name again if I can that way I can send it to you directly.
[AGENT][NEUTRAL] OK, so we can't, um, so for your, when you send the claim stuff, we can't um accept it through email, but I'll put on the email and that's the one we verify, right? [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so I'll send you an email with the claim form, so you will know you have the up to-date claim form then and then I'll, in the email, it'll have the ways to file a claim.
[CUSTOMER][POSITIVE] OK, that's perfect.
[AGENT][NEUTRAL] OK, well, I'll go ahead and send this over to you now. I'm typing it up once we um get off, you know, get off the line and then give me about maybe 5, 10 minutes and I should have it to you.
[CUSTOMER][POSITIVE] OK great thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] All right. Well, thank you so much for calling APL. I'm sorry for all the confusion, but I do hope you have a good day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you. Bye bye.