AccountId: 011433970860
ContactId: b52acec7-f6d5-4d30-a0c2-f547eee4ada6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 745440 ms
Total Talk Time (AGENT): 357624 ms
Total Talk Time (CUSTOMER): 295821 ms
Interruptions: 8
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/b52acec7-f6d5-4d30-a0c2-f547eee4ada6_20250625T17:35_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], um, I just, uh, I don't think I've used your uh.
[CUSTOMER][NEUTRAL] The my benefits yet and I have a uh.
[CUSTOMER][NEGATIVE] A bill from a, a doctor that my insurance didn't cover all of it and uh they say they won't do it, so I have to do it myself.
[AGENT][NEUTRAL] OK, so you're needing, you're the, OK, so you're the insured and you're needing to find out how to go about filing your own claim with APL is that correct?
[CUSTOMER][NEUTRAL] Uh, submit the claim.
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat that again?
[AGENT][NEUTRAL] I said that you were needing to find out how to go about filing your own claim with us for review, is that correct? Yes, sir. I can help you with that. And who am I speaking with?
[CUSTOMER][POSITIVE] Oh yes, please. Mhm. Yes.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, can you please spell your last name for me, [PII].
[CUSTOMER][NEUTRAL] [PII] A.
[AGENT][POSITIVE] Thank you, and a good callback number for you, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number?
[CUSTOMER][NEUTRAL] The which number?
[AGENT][NEUTRAL] Your policy number for APL?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm, I have a payer ID.
[AGENT][NEUTRAL] No, sir. That's all.
[CUSTOMER][NEUTRAL] I have a in hospital benefits certificate now, huh?
[AGENT][NEUTRAL] OK. So yes, on your ID card, where you see the inhospital and the outpatient number, just for your knowledge, your policy number is the first part of those numbers that is identical. If you'll notice on the in-hospital and outpatient, the first part of the number prior to ML.
[CUSTOMER][NEUTRAL] Oh, the 01299855.
[AGENT][NEUTRAL] OK, so say that one more time for me, please.
[CUSTOMER][NEUTRAL] 01299855
[AGENT][NEUTRAL] OK, thank you. One moment while I get your information pulled up. What I do, I will have to verify several things with you first, [PII] for security, so one moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] You ask about the pain.
[CUSTOMER][NEUTRAL] Yeah, she said there's not a designated card it's just come up and ask.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] This is our time
[CUSTOMER][NEUTRAL] You know.
[AGENT][NEUTRAL] OK, so first off, any information that's provided would be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] So if you could first please verify the primary policy holder's name and date of birth and then your date of birth.
[CUSTOMER][NEUTRAL] So it's my wife [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh her birthday is uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And my birthday is [PII].
[AGENT][NEUTRAL] OK, thank you also your home mailing address please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. The phone number that we would have on file for your wife.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, no, uh, you have your business, I think it's uh [PII].
[AGENT][NEUTRAL] No, sir, that's not the number that we have for her.
[CUSTOMER][NEUTRAL] Hey what's your work number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you and then her email address for and this appears to be probably work.
[CUSTOMER][NEUTRAL] not.
[CUSTOMER][NEUTRAL] OK, can you give me your your work email?
[CUSTOMER][NEUTRAL] I working there?
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Hi, Ms. [PII].
[CUSTOMER][NEUTRAL] I don't know if I have my work email on phone. Hi there.
[AGENT][NEUTRAL] Hi, this is [PII] with APL so I was needing to verify some information first for security purposes. So your email that is on file appears to be your work email address, so I do need to verify that.
[CUSTOMER][NEUTRAL] Is it the old email, is it [PII] or is it [PII]? or can you tell me the last ending, so the [PII]?
[AGENT][NEUTRAL] The [PII].
[AGENT][NEUTRAL] This, it's the [PII]. Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, um, so [PII], or no, it's actually [PII] at um I think it's [PII]. Gosh, they, they keep changing it on me, hold [PII] or hold on.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Wasn't ready for this. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] Do I have to pay it myself and then I'm gonna get reimbursed?
[AGENT][NEUTRAL] Again, I can't provide any information until I can fully verify some things first for security.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You know, when I called for benefits last time I didn't have to jump through all the hoops.
[AGENT][POSITIVE] Yeah, so were you, yes, sir, you you were you should have, so I apologize.
[CUSTOMER][NEUTRAL] I don't.
[AGENT][NEUTRAL] But
[AGENT][NEGATIVE] This should have all been verified.
[CUSTOMER][NEUTRAL] She's looking it up. She's, she doesn't really use it. Health tech.com.
[AGENT][NEUTRAL] Oh, that's fine. Yeah, sure.
[AGENT][NEUTRAL] OK, thank you. Now, Ms. [PII], do you want to change your email to your personal email or do you want to leave this work email on file for you?
[CUSTOMER][NEUTRAL] That's the ending.
[CUSTOMER][NEUTRAL] Uh, you can leave it fine.
[AGENT][NEUTRAL] OK, and the reason that I'm asking you that is because I'm going to email you the user guide for how the in with the instructions for how to set up your profile in our online service center portal so that way you can have access to your ID cards policy information and you can actually submit claims to us and you will have access to your explanation of benefits as well for other claims that we have received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, can you add me and my email as well?
[AGENT][NEUTRAL] I can't. No, sir. I'm sorry, we can only have the primary policyholders.
[AGENT][NEUTRAL] Information on file so if.
[CUSTOMER][NEUTRAL] I mean I've had this account for probably over a over a decade now and I've never, I've never had access to anything.
[AGENT][NEUTRAL] OK, so you
[CUSTOMER][NEUTRAL] This is for the APL, right? Yeah, please put your email to your personal, please.
[AGENT][POSITIVE] That's correct. Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] Alright, we can switch it to my personal.
[AGENT][NEUTRAL] OK, it's entirely up to you.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK, so what is your personal email address that you would like to update to?
[CUSTOMER][NEUTRAL] Really
[CUSTOMER][NEUTRAL] So, the same, it's [PII] E.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, did you say [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] um
[AGENT][NEUTRAL] So yes ma'am, so um.
[AGENT][NEUTRAL] I'm going to email you the user guides to that email address and you'll be receiving them in just a few minutes. The email that you're going to get will come from [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And I will put APL in the subject line for you so that you can recognize that. I don't believe that it will go to your junk or spam folder, but in the event that you haven't seen that email in your inbox, you know, within several minutes you may want to check one of those other two folders to make sure it did not go there.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. Yes, ma'am. You're welcome. Now, would you like for me to speak back to your husband? He had a question on submitting a claim. And I'm also gonna go ahead and include the claim forms in this email as well. It will have the instructions on it for submitting a claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's fine. Thank you.
[AGENT][NEUTRAL] OK. Well, you're welcome. So does he need to speak back to me?
[CUSTOMER][NEUTRAL] I think, I think so. Do you need to speak to him? Yeah. OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So my question was, do I have to pay the doctors directly and then I get reimbursed or I submit it and you guys are gonna send the bill you guys gonna send the payment directly to them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so again I can't verify, I cannot guarantee payments on a claim. I can only verify the benefit information, so typically if you are filing the claim, if we are able to pay benefits they would be paid to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's typically to whoever files the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'll have to pay them first.
[AGENT][NEUTRAL] That would be a question that you would have to talk with that provider about. We can't dictate how that's handled.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now I'm going to email your wife the user guide so that she can create her profile online and then you all can actually submit claims through the portal once that's done and I will include a claim form.
[AGENT][NEUTRAL] That does have the instructions on the page one at the top.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Of the additional documentation that will also need to be submitted to us for review if you all are gonna be filing the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, is there any other question or anything else that I can help you with at the moment?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, have you sent the email yet? Can you send it so I can verify I will receive it?
[AGENT][NEUTRAL] I have not.
[AGENT][POSITIVE] If you can wait just a moment, I'll be happy to do that for you. So just a moment. Uh, you're welcome.
[CUSTOMER][POSITIVE] Sure, please. Thank you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Stop and.
[CUSTOMER][NEGATIVE] Yeah, I can put [PII], baby. You're gonna stop getting emails.
[CUSTOMER][NEUTRAL] I wasn't really I'm just saying yeah.
[CUSTOMER][NEUTRAL] Yes, 48,000 emails.
[CUSTOMER][NEUTRAL] If you want to know that.
[AGENT][NEUTRAL] OK, so I have just sent that, so it's gonna take probably a minute for it to come through.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] First sitting
[CUSTOMER][NEGATIVE] Not playing.
[AGENT][NEUTRAL] I hear little people.
[CUSTOMER][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I would have said.
[CUSTOMER][NEUTRAL] Let's see, nothing yet. It says I checked uh spam.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Well, give it just a minute. Yeah, but give it just a minute because it has to go through several security firewalls first.
[AGENT][NEUTRAL] But again, the email is coming from care team at [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] How you.
[CUSTOMER][NEUTRAL] You got 5 minutes left. Give you 10 minutes.
[AGENT][NEUTRAL] Yeah, it's, it's probably gonna take it a minute.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I got it. OK, thank you.
[AGENT][POSITIVE] OK. Well, you're very welcome. So again, is there anything else I can help you out with today?
[CUSTOMER][POSITIVE] Not right now thank you much. I'll I'll go through this appreciate it.
[AGENT][POSITIVE] Well, you're very welcome.
[AGENT][POSITIVE] Oh, OK. Well then, thank you for calling APL. Have a nice afternoon.
[CUSTOMER][NEUTRAL] OK, bye bye.
[CUSTOMER][NEUTRAL] Alright bye bye.