AccountId: 011433970860 ContactId: c2b48b4e-3c79-4482-a5ba-d9382dda480f Channel: VOICE LanguageCode: en-US Total Conversation Duration: 1515020 ms Total Talk Time (AGENT): 555897 ms Total Talk Time (CUSTOMER): 552887 ms Interruptions: 3 Overall Sentiment: AGENT=0.8, CUSTOMER=0.1 Redaction Types: PII Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/c2b48b4e-3c79-4482-a5ba-d9382dda480f_20250121T18:45_UTC.wav -------------------------------------------- [AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you? [CUSTOMER][NEUTRAL] Well, I'm trying to upload files and and do a kind of a wellness mammogram, you know, to get the $50 check or whatever you call that I don't know. Uh, so I'm having trouble, um, I filled out. I called earlier, she told me I had to go through a wellness form. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] And uh. [CUSTOMER][NEGATIVE] Download that and I did, and I went through it all and I couldn't find it, wouldn't let me do any of that kind of stuff. So anyway, I was just stuck as to what to do. [AGENT][POSITIVE] Sure, I'd be happy to help you figure that out. OK, so you are in the portal now, correct? OK, do you have your policy number handy? [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Yes, I, I am. [CUSTOMER][NEUTRAL] I do, it's 255-9225. [AGENT][NEUTRAL] 255-9225 and your phone number please, can you provide me your phone number? [CUSTOMER][NEUTRAL] [PII] [AGENT][POSITIVE] OK, thank you. [AGENT][NEUTRAL] And bear with me for just a moment while I pull that policy up. [CUSTOMER][NEUTRAL] Sure. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] And can you verify uh name and date of birth please? [CUSTOMER][NEUTRAL] [PII] uh [PII]. [AGENT][NEUTRAL] Thank you, and go ahead and verify your mailing address please. [CUSTOMER][NEUTRAL] [PII] [AGENT][NEUTRAL] Thank you and the last piece of verification, your email address please. [CUSTOMER][NEUTRAL] [PII]. [AGENT][POSITIVE] OK, thank you. [AGENT][NEUTRAL] OK, so let me just check some information so you're in the what kind of error are you getting? Are you getting an error or is it just kind of spinning or what's going on? Can you tell me that? [CUSTOMER][NEUTRAL] Well, uh, the lady told me to go, uh, download the file for the wellness claim. [CUSTOMER][NEUTRAL] And when I download that and I go through and answer all that stuff. [CUSTOMER][NEGATIVE] Uh, get down to the bottom and I can't find it, and I'm just stuck. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] So he said I had to do the claim first. I can upload my files I think uh that's been. [CUSTOMER][NEUTRAL] Maybe OK. I hadn't gone all the way through it, but anyway, I'm just uh [AGENT][NEUTRAL] OK [AGENT][NEUTRAL] So [AGENT][NEUTRAL] Let me just take a look here. [CUSTOMER][NEUTRAL] I just need to file a 24 memo and a 25 memo 2025. [AGENT][NEUTRAL] OK, got you. [AGENT][NEUTRAL] OK, so when you're in the portal and you first sign in you're able to get to that main page where it's we call it the dashboard and it should have your name, uh your information at the top and it should list your policies. [AGENT][NEUTRAL] Um, that you have with us, so down a little bit underneath that you should see, do you need to file a wellness claim? [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Sure. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] And you did that part, uh, you click that. [CUSTOMER][NEUTRAL] Click that. [CUSTOMER][NEUTRAL] Well, that's where, that's where I get stuck because it comes up, I fill out the information, but [CUSTOMER][NEUTRAL] You know, it doesn't let me go anywhere else, so I don't know. Anyway, I'm gonna. [AGENT][NEUTRAL] OK, you answered the four questions? [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] You did OK and then it should just allow you to go ahead and complete it, um. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Well that's the problem and you're supposed to sign it at the end and I can't so let me go ahead while I got you on the phone if you don't mind I'll fill it out. [CUSTOMER][NEGATIVE] I've done it 2 or 3 times and I don't know, it just, it, it won't let me do anything. I don't know what I'm doing wrong. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Uh [CUSTOMER][NEUTRAL] Uh, let me, uh, fill this thing out real quick. Uh. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] If you don't mind, while I got you on the phone, yeah. [AGENT][POSITIVE] Sure, absolutely. [CUSTOMER][NEUTRAL] Do you have yesterday off? [AGENT][NEUTRAL] We did, yes. [CUSTOMER][POSITIVE] Well, good. [CUSTOMER][NEUTRAL] clients. [CUSTOMER][NEUTRAL] See if I can [CUSTOMER][NEUTRAL] Mm [CUSTOMER][NEUTRAL] OK, um. [AGENT][NEUTRAL] And you are using a laptop or desktop computer, is that right? [CUSTOMER][NEUTRAL] Yeah, laptop. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] And um can you tell me which browser you're using? are you using like a Google Chrome browser or Internet Explorer? [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] I think it's Google Chrome. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] A number now should have all this memorized me because I've done this thing. [AGENT][NEUTRAL] Yeah [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] I've been busy. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] Imagine having yesterday off everybody runs to the phone then. [AGENT][NEUTRAL] Yeah. [AGENT][NEUTRAL] Yeah [CUSTOMER][NEUTRAL] Yeah [CUSTOMER][NEUTRAL] Uh, I would like to test. [AGENT][NEUTRAL] It's been a little busy this morning for sure. [CUSTOMER][NEUTRAL] Oh, I gotta select here. Let me see. [CUSTOMER][NEUTRAL] Uh, I guess it's all kinda. [CUSTOMER][NEUTRAL] What did I choose last time, last time. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Uh [CUSTOMER][NEUTRAL] Um [CUSTOMER][NEUTRAL] I want to get paid faster. No, I just send me the check what I just continue or close or. [AGENT][NEUTRAL] Yeah, just it should allow you when you get to the end um it just asks you those four questions usually you just do that drop down that it's for you and then like I said it will ask you what service and then that date and then you add the provider, um. [AGENT][NEUTRAL] Did you, were you able to get to that? [CUSTOMER][NEUTRAL] OK, now, [CUSTOMER][NEUTRAL] Well, I guess my question is I'm enroll in direct deposit. I don't wanna do that. I need to go back or continue or close. If I close, I don't know what if that closes the whole thing or what. [CUSTOMER][NEGATIVE] I don't wanna continue with rolling in the direct deposit so but I don't wanna go back because there's gonna send me I, I, I'm just stuck here. [AGENT][NEUTRAL] Um, [AGENT][NEUTRAL] Yeah, and it doesn't so it asks you to just there's an option to continue correct? [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] And you said that you didn't want to sign up for direct deposit, but you said when you close it, then it just disappears, is that right? [CUSTOMER][NEUTRAL] No. [CUSTOMER][NEGATIVE] Well, I, I don't know. I haven't done anything. I'm stuck. I don't know which one should I, I don't wanna do direct deposit. [CUSTOMER][NEUTRAL] So I, if it, I got it, I can close it, which I don't know if it closes everything, or I can go back, which I don't really want to go back because it's probably gonna ask me the same question. So I just wonder where do I go from here? [AGENT][NEGATIVE] I think you can just continue and and you tried to continue before and it just doesn't do anything or? [CUSTOMER][NEUTRAL] Well, I hit continue. Let me see what happens. [CUSTOMER][NEUTRAL] Uh, [CUSTOMER][NEGATIVE] I didn't get all this last time. [CUSTOMER][NEUTRAL] Now wants me please sign below using your mouse. [AGENT][NEUTRAL] Yeah, and then that should be the end of the claim and then once you complete that I should be able to see it in a couple of, it'll take a a couple of a minute or so, but I should be able to see it and then I can view it for you if you'd like. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] So [CUSTOMER][NEUTRAL] Alright, let me see. [CUSTOMER][NEGATIVE] They didn't let me finish signing my name and [CUSTOMER][NEUTRAL] Now, [CUSTOMER][NEUTRAL] Let me see, maybe. [CUSTOMER][NEUTRAL] Here we go. I came back. [CUSTOMER][NEUTRAL] OK, well. [CUSTOMER][NEUTRAL] I don't know, uh. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] Um, uh, I'm back to the page where I could file a wellness claim or upload files, so I don't know where I'm at in process. [AGENT][NEUTRAL] Did, did you happen to see a little pop up that said, once you uh submitted it or once you finished it, there might have been a little pop up that kind of, it gives you like a series of numbers that tells you it's been accepted. Did you get any of that? [CUSTOMER][NEUTRAL] No. [AGENT][NEUTRAL] You didn't. [CUSTOMER][NEUTRAL] Mm. [CUSTOMER][NEUTRAL] Mm. [CUSTOMER][NEUTRAL] I signed my name and then I said continue and then I'm back here at this page we started uh upload files, file a wellness claim. [AGENT][NEUTRAL] Hm. [CUSTOMER][NEGATIVE] But the bar below is like I'm almost complete, but no, it's just slides it back and forth. I don't know. I it just all went away and I'm back at this page, so. [CUSTOMER][NEGATIVE] I have to start over now do another wellness claim form. [AGENT][NEUTRAL] Well, I'm gonna see if it kind of shows up here for us um so far it hasn't, but it does the process does take a a minute or so so it's gotta kinda make its way through the system but you said you didn't receive any kind of uh pop up that indicated that it was an authorization number, OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Mhm [CUSTOMER][NEUTRAL] No. [CUSTOMER][NEUTRAL] No. [CUSTOMER][NEUTRAL] Mm. [CUSTOMER][NEGATIVE] It's not a user friendly app y'all have here. [AGENT][NEUTRAL] Well they're continuing to improve on it they're working on it um but we did simplify the wellness process so I'm not sure it should not be giving you that much trouble it usually moves through pretty quickly like I said we made it a a kind of a straight through process where you just answer those questions and then you can just upload um. [CUSTOMER][NEUTRAL] Mm [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] I'll do it again. Let me, I'll try it again. [CUSTOMER][NEUTRAL] If you want me to. [AGENT][NEUTRAL] Uh, yeah, I'm not, I'm still not seeing it, so do me a favor before you do that, um, go ahead and, and do you know how to clear your cookies, clear your claim, you know, your browsing history. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] OK [CUSTOMER][NEUTRAL] I think so. Let me see. History. [AGENT][NEUTRAL] Go ahead and clear that and these are just kind of like housekeeping tips that we um you know provide for you to kinda help you navigate if you're having issues so we already established that you are using a laptop or desktop computer. [CUSTOMER][NEUTRAL] Uh [AGENT][NEUTRAL] Um, and that you're using the latest version of your browser, which that's also an, uh, uh, a big one too. So if you're using Google Chrome, um, do you know when's the last time it's been updated? Do you have a latest version? [CUSTOMER][NEUTRAL] I, I don't know. I've had, I hadn't had any problems with doing anything and not normally kind of do. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Then I cleared my cookies and the history. I cleared it all. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. So let me go. [AGENT][POSITIVE] So let's try it again and see if that maybe helps. [CUSTOMER][NEUTRAL] Oh. [CUSTOMER][POSITIVE] Yeah, alright, that'd be good. [AGENT][NEUTRAL] I'm not aware that we're having any issues so I don't, I don't know that there's anything um on our end I've not uh been advised of that so hopefully like I said this will. [CUSTOMER][NEUTRAL] Yeah [AGENT][NEUTRAL] Help. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] All right. [CUSTOMER][NEUTRAL] Let's get his number again here. [CUSTOMER][NEUTRAL] I continue. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Acknowledge. [CUSTOMER][NEUTRAL] OK, I'm gonna try to find this thing again. [CUSTOMER][NEUTRAL] I say so. [CUSTOMER][NEUTRAL] Uh, about my claim. [CUSTOMER][NEUTRAL] They submitting data, please wait. [AGENT][NEUTRAL] OK. [AGENT][POSITIVE] Well that's a good sign. [CUSTOMER][NEUTRAL] Yeah, progress. [CUSTOMER][NEUTRAL] Successful entry, add another claim. I do have to. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Um, so, I hadn't uploaded. [CUSTOMER][NEUTRAL] The information [CUSTOMER][NEUTRAL] So on either one, whoops, it just switched back. [AGENT][NEUTRAL] I think I got I've got something here so let me pull it up and take a look at it so bear with me for just a moment. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] OK, I see it. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Right now it just asked me to close, file a wellness claim, temporary ID went all the way to end. [CUSTOMER][NEUTRAL] So do I close [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Clothes. [AGENT][NEUTRAL] Yeah, you're gonna submit an additional claim just do it the same way. Go ahead and close it and then I would just go ahead and unless you wanna try to uh just submit it that way. I see it this one I I have is your mammogram. [AGENT][NEUTRAL] And it says it was done on [PII]. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] At Regional Hospital. [CUSTOMER][NEUTRAL] Yes, now that. [AGENT][NEUTRAL] OK, so I have, I have all I have all those pages. [CUSTOMER][NEUTRAL] Now I understand I have to send the itemized statement. [CUSTOMER][NEUTRAL] Correct? [AGENT][NEGATIVE] No, you do not. [AGENT][NEUTRAL] Not for the wellness, so that's why I was telling you we kind of simplify that process for the wellness claim. So we just ask that you go ahead and complete that statement of insured, which you did that you gave us the information about the patient and then what type of test it was and then where uh the provider or where the services were rendered your claim form is signed and I have your authorization page as well. [CUSTOMER][NEUTRAL] Oh. [AGENT][NEUTRAL] You do not have to uh submit any kind of documentation. Like I said, we tried to simplify it for these wellness uh benefits that you know are just for a screening um and we just like I said, we have you fill out that claim form and then that should be sufficient information. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK, let me ask you now, now I gotta do this again. It asked me if I want to do another one, but then it didn't last very long but anyway I'm at uh claims and forms. [AGENT][NEUTRAL] Uh-huh. [CUSTOMER][NEUTRAL] And this is a little different. This is where I went to the first time, the lady told me the claims and forms and then she said, go down. [CUSTOMER][NEUTRAL] To, uh, the, uh, [CUSTOMER][NEUTRAL] Wellness, they say page 3, she said, go to page 3 and it says download form and that was different. Wellness and screening benefits claim form. [CUSTOMER][NEUTRAL] And that, I guess that's where I went last time, but she took me to another place. [AGENT][NEUTRAL] Yeah you can just do it on that dashboard when you first sign in and it lists where your policy is at then you like I said, you just go down the page a little bit I think it's just kind of midway almost midway and then that's where you just start the the wellness claim and like I said we tried to simplify it, yeah, so it wasn't too um like so when you're filing a regular claim you have to download the form. [CUSTOMER][NEUTRAL] Yeah [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Oh right, so. [CUSTOMER][NEUTRAL] Yeah [AGENT][NEUTRAL] Then you have to um kind of fill it out and then save it as a file and then you have to include your additional documents that's a different um process like I said, we try to simplify the wellness just to make it a little bit easier for our customers to be able to just go in and simply answer those four questions and upload the document right to us. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] Or that claim form. [CUSTOMER][POSITIVE] Yeah, that, that it was better, so kudos to y'all for, you know. [AGENT][NEUTRAL] Yeah. [AGENT][POSITIVE] Oh good. [AGENT][POSITIVE] Thank you. [CUSTOMER][NEUTRAL] Doing that, so I, I think. [AGENT][POSITIVE] Yeah, we try to, yeah, we try to make it a little bit simpler. [CUSTOMER][POSITIVE] Yeah, OK, I think hopefully I can do the second one, [CUSTOMER][NEUTRAL] We'll see, but I'll just call y'all back if I can't, but it should just go through. Now I told it to save my uh signature, so that ought to be easier even, huh. [AGENT][NEUTRAL] Yeah, that should make it simpler, right, mhm, yeah, and now I see, let me see. [CUSTOMER][NEUTRAL] OK. Oh. [AGENT][NEUTRAL] I see something else here. Did you already file that one, the second one? [CUSTOMER][NEUTRAL] I'm, I'm fixing to send it now if you want, if you're not in a big hurry, maybe I could. [AGENT][POSITIVE] Just make sure certainly I'd be yeah I'd be happy to do that. [CUSTOMER][NEUTRAL] Uh, it, yeah. [CUSTOMER][NEUTRAL] Alright, thank you. I, I gotta find my dates the only thing I gotta do. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] Which I think [AGENT][NEUTRAL] So I'm not sure what happened um the first time but it looks like I got it twice for the mammogram, which is fine too. Like I said, we can just put those together and and go ahead and keep processing um it's the same information so it's just kind of like a duplicate. So I'm not sure what, maybe it was maybe it was a little bit hung up and then when you cleared those cookies and then resubmitted it, it went ahead and sent it to us again. [CUSTOMER][NEUTRAL] OK, so they won't. [CUSTOMER][NEUTRAL] Where [CUSTOMER][NEUTRAL] OK, OK. I'll uh. [CUSTOMER][NEUTRAL] Let me see the other one. [CUSTOMER][NEUTRAL] Uh [CUSTOMER][NEUTRAL] Uh, [CUSTOMER][NEUTRAL] Let me see if I can [CUSTOMER][NEUTRAL] Real quick, like, if I can just find the. [CUSTOMER][NEUTRAL] Uh, find that lady, and. [CUSTOMER][NEUTRAL] [PII], here she is. [CUSTOMER][NEUTRAL] Uh [CUSTOMER][NEUTRAL] We all want to go in there. [CUSTOMER][NEUTRAL] I know if I can find it here here here. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] And I get this date here it comes. [CUSTOMER][NEUTRAL] Uh, [CUSTOMER][NEUTRAL] Yeah this one was [PII], OK. [CUSTOMER][NEUTRAL] How many years do y'all go back on this? [AGENT][NEUTRAL] Um, well, we don't have a filing limit, so if, um, if you have, uh. [AGENT][NEUTRAL] Services that aren't in this calendar year we will go back as far as you have coverage for so in other words, like say I so now this policy um it looks like uh. [CUSTOMER][NEUTRAL] Oh, OK. [AGENT][NEUTRAL] Let me take a look here. [AGENT][NEUTRAL] But we will go back like I said we don't have any filing limitations so if you had a mammogram and say even in [PII] and your policy was active, you're more than welcome to file a claim for that, um, data service, you know, so we don't have, like I said, we don't have any um filing limit. There's no, um, where you have to get that claim in by a certain date. [CUSTOMER][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] OK [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Well, I, uh, [CUSTOMER][NEUTRAL] I changed him while I retired, that's what happened and [CUSTOMER][NEUTRAL] So, I've signed it, file my claim. OK. I didn't, it, I told it to save my signature, but I still had to put it in. It's OK. [CUSTOMER][NEUTRAL] But I submitting now. [CUSTOMER][NEUTRAL] So anyway, I guess that's when I [CUSTOMER][NEUTRAL] You know, all that changing. [CUSTOMER][NEUTRAL] took place because I had to [CUSTOMER][NEUTRAL] Switch over it direct deposit and then I had to, you know, do something about it. OK, said successful. [AGENT][POSITIVE] OK, great. [CUSTOMER][NEUTRAL] And I guess maybe you got it, hopefully. [AGENT][NEUTRAL] Um, checking now. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Like I said, it does take a minute or so to. [AGENT][NEUTRAL] Think about what it wants to do. [CUSTOMER][NEUTRAL] Yeah, [CUSTOMER][NEUTRAL] Uh, I get it. I have to. I have to think about stuff. [CUSTOMER][POSITIVE] I appreciate your help. [AGENT][POSITIVE] Oh, certainly, you are so welcome. I was, I'm glad I was able to assist you. [CUSTOMER][POSITIVE] Well, thank you. [AGENT][NEUTRAL] No. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Alright, I see it here let me take a gander at it real quick, just make sure. [CUSTOMER][NEUTRAL] No, that's a one-time deal a year, right? Because I got to go for a colonoscopy. I don't guess that counts a different category or anything. [AGENT][NEUTRAL] Um, well, if it's a screening like a wellness screening, you could submit that service, sure, um, I'm not sure on your policy if it's once per year. I believe it's once per year. OK, so I do see the, um, the additional claim for the 12 5 2024 mammogram as well. [CUSTOMER][NEUTRAL] OK, alright, thank you. So just go ahead and file the colonoscopy and see what happens, huh? [AGENT][NEUTRAL] I would sure you can you're more than welcome to do that and like I said, if, if there's uh a payable benefit, the benefit will be paid otherwise it will you'll get an explanation of benefits letting you know um if it was declined and the reason why. [CUSTOMER][NEUTRAL] And [CUSTOMER][POSITIVE] OK, well thank you so much. [AGENT][NEUTRAL] You're welcome, Ms. [PII]. Did you have any other questions? [CUSTOMER][POSITIVE] No, you did a great job for me thank you, thank you. [AGENT][POSITIVE] You're so welcome. Glad we were able to solve that for you. You have a great day and thank you. [CUSTOMER][POSITIVE] You have a blessed [CUSTOMER][NEUTRAL] You too. Bye-bye. [AGENT][POSITIVE] Thank you so much for calling APL and thank you for being a customer bye bye. [CUSTOMER][POSITIVE] Thank you. [CUSTOMER][NEUTRAL] But