AccountId: 011433970860
ContactId: ad2df609-637b-4a97-a9cd-c26fa0d215cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 676880 ms
Total Talk Time (AGENT): 346096 ms
Total Talk Time (CUSTOMER): 173451 ms
Interruptions: 2
Overall Sentiment: AGENT=1.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/ad2df609-637b-4a97-a9cd-c26fa0d215cb_20250619T14:20_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you? Um, I want to know how can I go about, um, because I've been going to see a specialist and I've been having to pay an $80 co-payment, but normally with the APL card, it covers it, but they said I have to do it myself.
[AGENT][NEUTRAL] OK, so you're wanting to find out how to file a claim for yourself. Is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] I'm sorry, [PII], there's some background noise where you're located that's making it hard for me to hear you. What is your last name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is your policy number with APO?
[CUSTOMER][NEUTRAL] My policy number, 1 2nd.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Uh, is it the one that says outpatient benefit certification number? OK, 1294221 M like Mary, L like Lucy, 8.
[AGENT][NEUTRAL] Yes ma'am. Uh-huh.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, Lucy, I will need to verify several things with you for security and also any information that's provided would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] and events.
[CUSTOMER][NEUTRAL] find your.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and then also your home mailing address.
[CUSTOMER][NEUTRAL] I'm not sure what address um I have on file. You can try [PII].
[AGENT][NEUTRAL] Uh, let's see, no, ma'am, that is not the one we have on file for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] City tadings up.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. And is that still, is that your address?
[AGENT][NEUTRAL] Is that your address?
[CUSTOMER][NEUTRAL] No, I, I moved from.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. What is your current mailing address, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, [PII].
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, wait, [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that we should have on file for you is that the [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then what is an email address? Because I do need to add an email for you.
[CUSTOMER][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm gonna repeat that back. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so first off, [PII], have you, oh, OK. It did not retain this. Give me just a minute. We're gonna have to do all of that again. So just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm so sorry. OK, so what is your address again?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the zip code?
[CUSTOMER][NEUTRAL] No, yeah, [PII].
[AGENT][NEUTRAL] OK,
[AGENT][NEUTRAL] And your email one more time, please.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Mhm, uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] ya yeah.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I have gotten your information updated now have you updated your address with your employer, [PII]?
[CUSTOMER][NEUTRAL] I have not
[AGENT][NEUTRAL] OK, so you do need to do that because it could over if they still have your old 2741 address on file that could override my change.
[AGENT][NEUTRAL] In my system that I've done, so you do need to get that updated with them as well, OK? And then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I will.
[AGENT][NEUTRAL] On your policy number, the policy number you gave me is an old policy that's actually no longer active. You have a different policy number.
[AGENT][NEUTRAL] For your current active policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I can provide you that policy number.
[CUSTOMER][NEUTRAL] OK, let me write that down. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, it is
[AGENT][NEUTRAL] 0246.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 66.
[AGENT][NEUTRAL] 62.
[CUSTOMER][NEUTRAL] OK, 02466662.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, thank you for that information.
[AGENT][POSITIVE] Yes, ma'am. You're welcome. And so give me a second.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me double check one thing on your group.
[CUSTOMER][NEUTRAL] that
[AGENT][NEUTRAL] So I can also request, [PII] that um these ID cards, if you did not receive them, because they would have been mailed to that other address before, you know, it was updated. So I've requested that new ID cards be mailed to your updated address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] As well, yes, ma'am, now, um.
[AGENT][NEUTRAL] A couple of things I'm going to send you an email, [PII] that will have instructions on how to set up your profile in our portal called the online service center.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] When you set up your profile, you will have access to your policy information, you will have access to your ID cards and you can also upload claims information into the portal for our review and it gives you the instructions on how to do all of that, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you can
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Also, um, I can include a copy of the claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That you will need to complete in addition to submitting the other required documentation for claims review and the instructions are on page one of the claim form at the top it tells you.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It does say instructions and then it tells you the other documents that you will need to provide along with the claim form, OK?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So once you have all of that information together, you can send that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] Like.
[AGENT][NEUTRAL] Either via mail, fax or the quickest way to get something in line for review is to upload it directly into that portal.
[CUSTOMER][POSITIVE] I do yeah.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] OK, so give me just a moment to send you this email.
[CUSTOMER][NEUTRAL] Just.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Just give me just a second to get your claim form.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And also for future reference, [PII], uh, the claim form that I'm sending you is actually on our main website at [PII].
[AGENT][NEUTRAL] Under claims and forms and the type of plan that you have with APL is it shows you on your ID card is called Medlink.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But that is the claim form that I'm gonna be sending to you.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so I have uh.
[AGENT][NEUTRAL] OK, so I have just sent that to you, [PII], and the email that you're going to be receiving from me is coming from [PII].
[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] And I did put APL in the subject line as well so that that's easy to recognize.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] OK. Well, you're certainly very welcome. So is there anything else um that I can help you with at the moment?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] OK, well, you're welcome and thank you again for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you, bye bye.