AccountId: 011433970860
ContactId: a52cefb3-12c0-4883-b859-f04ce65f45d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1231969 ms
Total Talk Time (AGENT): 354770 ms
Total Talk Time (CUSTOMER): 424228 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/a52cefb3-12c0-4883-b859-f04ce65f45d1_20250505T18:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, good afternoon, um, I thought, well, I, should I give you my name first so because I have uh an account.
[AGENT][NEUTRAL] Sure, um, your name and a good contact number in case we're disconnected.
[CUSTOMER][NEUTRAL] OK. My name is [PII]
[CUSTOMER][NEUTRAL] And the number is [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's uh 60801.
[AGENT][NEUTRAL] That's our payer ID. Do you have your ID card there with you?
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Uh, yes, I do. What is, so I'm supposed to give you where it says uh.
[AGENT][NEUTRAL] You're looking for the inpatient or outpatient policy er number?
[CUSTOMER][NEUTRAL] OK, so inhospital benefit card number, yes, 02.
[CUSTOMER][NEUTRAL] 161365
[CUSTOMER][NEUTRAL] M. like Mom. L like Light 7.
[AGENT][NEUTRAL] Thank you for that, and I have your policy here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] My um my email is uh [PII].
[AGENT][NEUTRAL] And your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And my birthday is [PII].
[AGENT][POSITIVE] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And how may I assist you today?
[CUSTOMER][NEUTRAL] Yes, uh, well, first of all, I, I was trying to go online. I haven't been there in a long, long time, so I guess it asked me to reset my password and I now I I've locked because for some reason it wasn't taking any of my passwords that I was making, so now it's, uh, my account is locked.
[AGENT][NEUTRAL] OK, let me look into that. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I just unlocked it. Um, so your username, do you have your username?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Or at least I think that that's what it is. It's [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, all together. And then, um, so if you put that in the username field and then click on the reset password link.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I did.
[AGENT][NEUTRAL] It should
[CUSTOMER][NEUTRAL] And then it's it's going to send me a a verification code.
[CUSTOMER][NEUTRAL] So it's quite.
[CUSTOMER][NEUTRAL] So I should type it in.
[CUSTOMER][NEUTRAL] Uh sorry, one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So I'm trying to have because I'm I'm using this um.
[CUSTOMER][NEUTRAL] Mac. So I'm trying to, to, to have it create its own password.
[CUSTOMER][NEGATIVE] But it was not working, so I tried to put my own password and it didn't work either, so what do you suggest I should do?
[AGENT][NEUTRAL] Well, it says, uh, it says password expired. Hold on one moment, let me reset it.
[AGENT][NEUTRAL] I mean, I would just do something generic. I mean, it's up to you, but usually, um,
[AGENT][NEUTRAL] I would just put like
[AGENT][NEUTRAL] First name, last name, 1234, just something that I remember um with the special character or it depends on what the specifications are.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right. OK.
[CUSTOMER][NEUTRAL] So, um, can you bear with me one second so I can create my my own password and so, you know, just to make sure it's working.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, I just
[CUSTOMER][NEUTRAL] I don't know, but why I don't know why you should keep saying uh.
[CUSTOMER][NEUTRAL] Invalid user or password, anytime I submit the new password.
[AGENT][NEUTRAL] Uh, what, what, can you spell what you're putting for the username just to make sure?
[CUSTOMER][NEUTRAL] For the username is um [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I mean, I can reset it on my end, but you would still need to go in and and yours to to reset it.
[CUSTOMER][NEUTRAL] Right. OK, so.
[CUSTOMER][NEUTRAL] Can you do it again, please?
[AGENT][NEUTRAL] Sure, hold on one moment.
[AGENT][NEUTRAL] OK, so it's getting ready to send a code to your
[AGENT][NEUTRAL] Um, mobile device.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so that's the code I'm supposed to use.
[AGENT][NEUTRAL] Yes, so enter that code in there.
[CUSTOMER][NEUTRAL] Oh, but it's OK, so when I put my pass my, my username, it, it takes me to.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] To choose, uh, you know, to, to choose to have them send, send me a verification code.
[CUSTOMER][NEGATIVE] It's not, you know, it, it doesn't give me the option for me to put the one you're sending.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So go ahead and um do for it to go to your cell.
[CUSTOMER][NEUTRAL] OK, so let me do this one.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK, just send me another one, so I'm gonna put the one I just, I just got.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, now, OK, so I, I'm going to create a new one, right?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So what does it, what does it say on, what is it saying, like it, after I gave you the code, it's just telling you to like create a new password?
[CUSTOMER][NEUTRAL] Or what do I do?
[CUSTOMER][NEUTRAL] No,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Well, yes, ma'am. You'll go ahead and um create a new one.
[CUSTOMER][NEUTRAL] Some.
[CUSTOMER][NEUTRAL] OK, because my username is already there. They're just asking me to to put a uh to create a new password so I'm gonna create it now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know why it's showing. OK, I, I put.
[CUSTOMER][NEUTRAL] So, I put a new password, like a different one, and I
[CUSTOMER][NEGATIVE] Reconfirm, you know, I write it again and then it, it says invalid user or password again.
[AGENT][NEUTRAL] OK, so I'm gonna, I'll just, let me see, hold on one moment.
[AGENT][POSITIVE] And one special character.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] You can reset it at a later time, but I, um, I just put your last name, so [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The [PII] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then [PII].
[CUSTOMER][NEUTRAL] Uh, then, is that you created one? Is that what you're saying?
[AGENT][NEUTRAL] I just reset the password for you so that you can get into the system and then you can, you know, work with the characters and everything at a later time to reset the password.
[CUSTOMER][NEUTRAL] OK, so I'm gonna, I'm gonna go in with my, with the same uh username, right?
[AGENT][NEUTRAL] Yes, so the username is [PII]
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So, now the password that you created is again?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Lowercase [PII]
[AGENT][NEUTRAL] The at sign
[CUSTOMER][NEUTRAL] The what? I'm sorry? [PII], OK.
[AGENT][NEUTRAL] The [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Lowercase
[AGENT][NEUTRAL] Yes, all lowercase.
[AGENT][NEUTRAL] And then [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, let me try and out that so just in case.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, sorry, but you're sending me the code again, so I have to do that all over again. I'm almost done.
[AGENT][NEUTRAL] It, you said it's sending you a code again?
[CUSTOMER][NEUTRAL] Yeah, it's always asking me to send it to, to, you know, to send me the code. Yeah, I'm putting the code and your new password.
[AGENT][NEUTRAL] No, no, no, no, no, no, no. So you shouldn't have to use the code anymore. You should just go to log in and put in your username and then the password.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because you're showing active in the system right now. If you, if you send another code and do another password, you're
[AGENT][NEUTRAL] Unless you're wanting to reset it right now.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, they
[AGENT][NEUTRAL] So all you need to do is cancel that.
[CUSTOMER][NEUTRAL] Yeah, they did I send.
[CUSTOMER][NEUTRAL] Yeah, but I got to the, to the point where I, where I did enter the the code.
[CUSTOMER][NEUTRAL] Does that matter?
[AGENT][NEUTRAL] Yeah, I would just I would just hit the cancel button.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me try it if it works like that, um.
[AGENT][NEUTRAL] And then go back to log in and put your.
[AGENT][NEUTRAL] Username and then the password that we reset it to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I went in finally. OK.
[CUSTOMER][NEUTRAL] All right, so later on, uh, to change it again, then I have to, uh, maybe later try to change it?
[AGENT][NEUTRAL] Yes, um, you'll be able to um change your password under settings.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, now, uh, now I'm in, OK. So now that I, that I, can I ask you something, um, how does it, I mean, I, I've been, you know, when I go to the emergency room or some other places like that, I show my, my regular insurance and also I show the APL, which is my secondary insurance.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So, how, I mean, what do I, how do we go by how much is it cover or like if uh, is it per, you know, I have my, my husband also under my insurance, so.
[CUSTOMER][NEUTRAL] Is it per person or how does it work? Because I, I use it, but I really don't know, you know, how does, I'm not sure how it works.
[AGENT][NEUTRAL] Alright, so we apply to your co-pays, your deductibles, and your co-insurance of covered charges after Blue Cross Blue Shield. So Blue Cross Blue Shield may charge you a co-pay to like go to your doctor's office or go to the emergency room, there may be a co-pay or deductible, we help pay that.
[AGENT][NEUTRAL] So whenever you give your Blue Cross Blue Shield card, just give your APL card as well, so that they can bill uh Blue Cross Blue Shield and then they'll automatically bill us after they receive everything back from Blue Cross.
[CUSTOMER][NEUTRAL] OK. So now, what is the maximum uh that they, the for the coverage?
[AGENT][NEUTRAL] So your policy is broken into um inpatient and outpatient benefits. So for inpatient benefits, the calendar year max is what oh well for both of them, um it's $1000 per calendar year. So inpatient is anything after admission to the hospital. Outpatient could be your emergency rooms, urgent care, um,
[AGENT][NEUTRAL] You have labs on here. So if you need to go to like Quest Diagnostic or Labor.
[AGENT][NEUTRAL] Um, any outpatient surgeries or diagnostic testing, that's all under outpatient.
[CUSTOMER][NEUTRAL] And uh sorry in patient is 1000.
[AGENT][NEUTRAL] Yes, you have $11,000 per calendar year for your inpatient and outpatient expenses.
[CUSTOMER][NEUTRAL] Oh, so it's for both. It's 1000 for, for, for inpatient and outpatient.
[AGENT][NEUTRAL] Right, 1000 for each.
[CUSTOMER][NEUTRAL] Oh, for 4 each. OK, sorry, I, I thought it was for both. It's 1000 for inpatient and 1000 for outpatient.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Now, um, how is, is this per person or how does it work?
[AGENT][NEUTRAL] Yes, it's $1000 per person per calendar year. So whoever um
[AGENT][NEUTRAL] Is going to the doctor or the hospital, we'll see their name on the claim that comes in and we'll know to process it under them. And as long as the policy is active, you can file the claim at any time.
[CUSTOMER][NEUTRAL] Alright, so let's say if, if, um, my husband goes, you know, to, and he meets up the $1000 then on my side, if I also go, uh, to, to, you know, if I need to use it, then it'll, that's separate. It's not, it doesn't go under the same.
[CUSTOMER][NEUTRAL] I, you know, the same $1000.
[AGENT][NEUTRAL] Right, he has $1000 that he'll use and you'll have yours and depending on who is being served, that's who the claim is filed under. So they'll be able to decipher between who received the services.
[CUSTOMER][NEUTRAL] OK, so it's per, per, per person. So, um,
[CUSTOMER][NEUTRAL] So how do I, uh, how do I know, you know, when are they covering something or not, I know, like.
[CUSTOMER][NEUTRAL] Is it like all co-pays or just some of them, or?
[AGENT][NEUTRAL] It's up to that $1000 max. So you'll receive explanation of benefits after we process each claim. So you'll be able to see if we're paying out on claims or if they were denied for any reason, um.
[AGENT][NEUTRAL] But once that claim is filed, they'll file it with Blue Cross first and then they'll file it with us.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All righty. Um, so, yes, I got it. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, I think that's it. Thank you.
[AGENT][POSITIVE] All right, well, thanks for calling APL. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] OK, bye-bye.