AccountId: 011433970860
ContactId: bf5705b3-141a-4fa9-8039-42f14f54f181
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 957270 ms
Total Talk Time (AGENT): 158643 ms
Total Talk Time (CUSTOMER): 423737 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/bf5705b3-141a-4fa9-8039-42f14f54f181_20250610T13:50_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] And what was the name again? I'm sorry.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII], OK. [PII], this is [PII] and I.
[CUSTOMER][NEGATIVE] Not sure what is happening. Um, I'm trying to find out about a claim that I sent in January. I have been in contact with someone, uh, every month since then and they keep saying, well, I'm not sure what's, what's going on. uh I've not ever been able to reach back my agent.
[CUSTOMER][NEGATIVE] Uh, so I just now called customer service about something else and they gave me this number, so I'm, I'm just trying to find out we've actually sent two claims in and have not heard anything uh back from either one so just trying to find out what's going on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is your policy number?
[CUSTOMER][NEUTRAL] Uh, policy, uh, my member number is M as in Mary.
[CUSTOMER][NEUTRAL] 47421009
[AGENT][NEUTRAL] Um, that is not our policy number with APL that may be with your other carrier.
[CUSTOMER][NEUTRAL] OK, uh, hold on just a moment. I've got another one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] Sorry I got all of this is confusing. Insurance, let me say it that way. Insurance is confusing to me.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Now I have a
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I have an ABA association membership is that?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] That's the only cards that I have.
[AGENT][NEUTRAL] Um, let's see here. I can look you up by, by name, but just to make certain, um, Ms. Ms. [PII], you're calling APL Insurance Company, is that correct? Just wanna make sure.
[CUSTOMER][NEUTRAL] Well, that's what they that's from my customer service with the PHCS this is the number they gave me for claims.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What is your last name again? I'm sorry.
[CUSTOMER][NEUTRAL] No, you're fine. [PII]
[AGENT][NEUTRAL] OK. And your first name is [PII], is that [PII]? OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII], hm, I don't have a [PII] in our system.
[CUSTOMER][NEGATIVE] OK, that may be why I'm having problems.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Uh, who is your employer, Ms. [PII]?
[CUSTOMER][NEUTRAL] Uh, oh, I'm retired.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I'm like tired.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you spoke to customer service and what company was that with customer service that you spoke with?
[CUSTOMER][NEUTRAL] Uh, the, the PHCS.
[CUSTOMER][NEUTRAL] Uh, limited benefit plan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have anything that has that says policy certificate number on it, um, by any chance?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Probably on the computer. Let me get over there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if we disconnected, miss, no, you don't have to apologize. What is your callback number for we disconnected?
[CUSTOMER][POSITIVE] I'm sorry about all this.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Give me just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Get
[CUSTOMER][NEUTRAL] Yeah, we've, we uh.
[CUSTOMER][NEGATIVE] Have sent a claim over and I was assuming because everything went through and then to be reimbursed we haven't heard anything and this is since January and February and uh.
[AGENT][NEUTRAL] OK. And
[AGENT][NEUTRAL] And did you send the claim to APL or who did you send the claim or who was this claim sent to?
[CUSTOMER][NEUTRAL] Well, we thought it was um now I'm confused at at uh what we did um we were given a number I guess customer let me see.
[CUSTOMER][NEUTRAL] We have a email fax or mail claims.
[CUSTOMER][NEUTRAL] Uh, to medical bill.
[AGENT][NEUTRAL] OK, what, what is the fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what is that mailing address?
[CUSTOMER][NEUTRAL] And, and
[CUSTOMER][NEUTRAL] Um, the email.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII], OK, that is.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And it's MBR in the care and I've got a PO box number.
[CUSTOMER][NEUTRAL] Obvious, let me
[CUSTOMER][NEUTRAL] Uh, my computer's being a little slow. I apologize.
[AGENT][NEUTRAL] Uh, no apologies. I understand. I understand that.
[CUSTOMER][NEUTRAL] It's it's acting like a Monday.
[AGENT][NEUTRAL] I understand
[AGENT][NEUTRAL] Yes, ma'am, I understand.
[AGENT][NEUTRAL] Now you say you were retired, what company did you work for?
[CUSTOMER][NEUTRAL] Um, I, I'm a housewife. My husband worked for Texas Eastman, a chemical company.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So with being a housewife, I'm actually not retired.
[AGENT][NEUTRAL] Moment.
[CUSTOMER][NEUTRAL] That is a continual.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Let's see in the here I'm just trying to see if I can still find you in our system.
[AGENT][NEUTRAL] OK, so you're under your husband's insurance. So what is your husband's first name? Let me try that way.
[CUSTOMER][NEUTRAL] Um, well, he's, he's on Medicare, so this is strictly for me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, strictly for you, OK.
[CUSTOMER][NEGATIVE] He's not on this one at all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Well, I'm having a little issue pulling this up.
[AGENT][NEUTRAL] And who gave you our phone number, Miss [PII]? What company gave you our phone number?
[CUSTOMER][NEUTRAL] Um, it was the customer service with P.
[CUSTOMER][NEGATIVE] The phone with them and they said with claims I should have been talking with [PII] and gave me your number uh the lady's name that I've been dealing with today was [PII], uh, who I have been dealing with is [PII], and I've not been able to actually reach him per se, uh, for the last two weeks and I've had the insurance since November with them.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I've not been able to since we got the insurance to reach my agent, so it's kind of been you know and when I go into.
[CUSTOMER][NEUTRAL] Uh, like I had a doctor's visit yesterday, they boom, they pull up the PHCS, there's no problem. They have everything in the system and, uh, but I'm just now having some issues since January about.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] My claims so.
[AGENT][NEUTRAL] PHCS OK.
[AGENT][NEUTRAL] that
[CUSTOMER][POSITIVE] Uh, OK, I'm almost there. It's finally trying to work.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] And if you're, if you can also again give me the the company that you worked for again please.
[CUSTOMER][NEUTRAL] Uh, my husband worked for Texas Eastman Chemical Company.
[AGENT][NEUTRAL] OK, and so that's who you have the insurance with PHCS limited benefit plan with, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I still don't show anything in our system as of yet.
[CUSTOMER][POSITIVE] And I'm, I'm trying to get there. I am so sorry for this.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] OK, here we go.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said OK I have.
[CUSTOMER][NEUTRAL] OK, my, the products I have and your, your APL, let me see.
[CUSTOMER][NEUTRAL] OK, it's I got key protector AMA I mean AME.
[CUSTOMER][NEUTRAL] AD&D ABA membership, ABA Good Life Eli and BWA urgent 365, but I'm not showing an APL.
[CUSTOMER][NEUTRAL] Let me go in each of these.
[CUSTOMER][NEUTRAL] AMA, the claims, OK, that's not it.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] I guess I need to call uh back my customer service.
[CUSTOMER][NEUTRAL] And because I'm not finding an APL on any of my.
[CUSTOMER][NEUTRAL] Things that I have here insurance benefits and everything.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me make sure I have your name spelled correctly. I'm so sorry, can you spell your last name just to make sure I have it spelled correctly.
[CUSTOMER][NEUTRAL] Let me, I've got
[CUSTOMER][NEUTRAL] No, that's fine. [PII]
[AGENT][NEUTRAL] OK, I just wanna make sure I had it spelled correctly.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah, my, my claims.
[CUSTOMER][NEUTRAL] Went to
[CUSTOMER][NEUTRAL] Medical repressor.
[CUSTOMER][NEUTRAL] At [PII], so let me call.
[CUSTOMER][NEUTRAL] Let me call them back.
[CUSTOMER][NEUTRAL] Who I actually just BWA hold on just a moment.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] And I'm sorry I'm having you.
[AGENT][POSITIVE] Oh, no problem.
[CUSTOMER][NEUTRAL] Look up everything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me call my customer service again.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Because I don't, I don't have on any of this.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] An APL.
[CUSTOMER][NEGATIVE] That might be why I'm not getting anything.
[CUSTOMER][NEUTRAL] Uh, it's not funny, but
[CUSTOMER][NEUTRAL] Well, let me call, let me call the customer service again and try to see what's going on there, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because uh what I have is not y'all's initials, the American Public Life APL at all, and we have sent, um, we've got the email here I've got the mailing address, uh, customer service billing, you know, I mean I've got all of this, but none of it has the APL, um, initials or whatever so let me, let me call back on this end and see what's what's going on.
[AGENT][NEUTRAL] Yes it is.
[AGENT][POSITIVE] OK, yes, ma'am. I'm so sorry.
[CUSTOMER][POSITIVE] I no you're fine. I appreciate your time thank you very much and you have a great day.
[AGENT][POSITIVE] You as well. You as well, Ms. [PII]. Thank you.
[CUSTOMER][NEUTRAL] OK, OK, bye bye.
[AGENT][NEUTRAL] Yes ma'am bye bye.