AccountId: 011433970860
ContactId: ccdcf2c5-cb7f-4149-a7d6-fc2f470b72ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 723049 ms
Total Talk Time (AGENT): 206562 ms
Total Talk Time (CUSTOMER): 233946 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/ccdcf2c5-cb7f-4149-a7d6-fc2f470b72ab_20250611T18:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Hi, um, I'm trying to log into my account online and it's giving me an error and it says no user was found with this information that was entered. Please try again. Um, I've tried multiple times and it's.
[CUSTOMER][NEGATIVE] Still not letting me access my account I've previously been able to.
[AGENT][NEUTRAL] Yes, about 2 weeks ago, we launched a new website, so all of the users have to create a new um OSC account using the email address that you used previously, and the two accounts will sync, um.
[CUSTOMER][NEUTRAL] I tried to do that.
[AGENT][NEUTRAL] And you still receive
[CUSTOMER][NEGATIVE] Yeah and it said it gave me that error too, yeah.
[AGENT][NEUTRAL] The no user found error?
[CUSTOMER][NEGATIVE] Yeah, it's giving me that um error and I used all my full social and everything and it's still saying that I have there and I tried every email that I know I've ever had associated with this discount and it's not processing anything because I needed to look up a claim to see if my one of my doctors had actually ran it through you guys or not.
[AGENT][NEUTRAL] OK, uh, well, I can help you with the claim, but yes, um, this is one of the, the errors that are the, yeah, the errors that we're receiving. Um, I believe it was fixed, but I will go ahead and um let them know I'll work, I'll go through it as well with you. But 1st may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, my name is [PII], and then it's [PII] and my phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Um, is that the same thing as the, yeah, OK, 02473091.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Um, it's [PII]. Um, I live at [PII], and I think the email I have on file is [PII].
[AGENT][NEUTRAL] So actually, the
[CUSTOMER][NEUTRAL] Or it might be Cva Moo at
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] So actually there is no email on file, which is why you're probably receiving that error. So let me go ahead and add which one you like and then you should be able to get in.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] OK. So you should be able to um log in now. I'm, I'm trying to do the steps on my end as well just to make sure everything's OK.
[CUSTOMER][NEUTRAL] So we have to go through the, the thing where I create my uh account?
[AGENT][NEUTRAL] Yes, so you'll click on create um OSC.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Account and then insured?
[AGENT][NEUTRAL] In the system, there is a space in between bass and minnow.
[CUSTOMER][NEUTRAL] Yes, there should be a space.
[CUSTOMER][NEUTRAL] Uh, it took me to a thing that said verification is necessary. Please click send, put in your email and click send button.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I think.
[CUSTOMER][POSITIVE] OK, it looks like I was able to create an account. Thank you so much. I was freaking out for a minute. I'm like, did my my employer drop this benefit and not tell anybody?
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] No, we apologize for the inconvenience.
[CUSTOMER][NEGATIVE] And I'm like, it's still showing that it's taking it out of my paycheck. That would be just like them to do something like that.
[AGENT][POSITIVE] Oh my gosh.
[AGENT][NEUTRAL] No, ma'am. Well, was there anything else I, well, did you still want me to look up and see if a claim has been received?
[CUSTOMER][NEUTRAL] Um, yes, so I got.
[CUSTOMER][NEUTRAL] An MRI, I think it was an MRI or it was something to do with ultrasound, I think, or something with my boobs. Um, I got it on [PII]. And I've been fighting with the doc the doctor's office cause they aren't running it through you guys, but I was going on there to see if maybe it had been, and I just, you know, missed.
[CUSTOMER][NEGATIVE] Um, they're just not portraying it correctly on this form because they're not showing that it's been, um, sent to you guys, so.
[AGENT][NEUTRAL] OK, um, what's the total bills on that, on that bill that you have or the paperwork you have?
[CUSTOMER][NEUTRAL] Um, the total bill was for $6,839. Um, I didn't know if there was like, because I know sometimes when I have something radiology done, um, there'll be a bill for one service and a bill for another, and like one will get billed to you, but then the other one obviously you don't cover two services in the same day, but I don't know if there was two services in that same.
[AGENT][NEUTRAL] Which one
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Cause um I've had like MRI's and X-rays where like there's a radiologist.
[CUSTOMER][NEUTRAL] Payment and then there's like the actual facilities payment and I just wanted to make sure that this didn't have two payments and that's the reason why it's not showing on here or if there was you know something else going on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, hold on one moment. And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So it looks like the original claim that we received was denied because the policy provides no benefits for the treatment or conditions other than sickness or injury as defined by the policy. Um, so what, hold on one moment.
[CUSTOMER][NEUTRAL] Cause it's always covered it in the past. Um, I get it.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Do you mind if I take, if I place you on just a brief hold, I'm just gonna look at the claim.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, hello, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, thank you so much for holding. So for this one, I'm going to send this back to the claims department to take a look at the claim, um, because MRIs, um,
[CUSTOMER][NEUTRAL] F
[AGENT][NEUTRAL] Or diagnostic testing in a hospital outpatient facility or MRI facility is covered under the policy under outpatient up to $300 per calendar day. So I'm not sure if this is an error or if this is in fact the correct um decision. If it is, they will not, they'll give you a call back um just explaining as to why it was correct. If not, we'll go ahead and reprocess and get a new decision for you.
[CUSTOMER][POSITIVE] OK, thank you. Cause yeah, I've got this covered in, I've had a lot of MRI's and they've all been covered. So I was really surprised why this one wasn't going through.
[AGENT][NEUTRAL] Yes, I'm not sure why either. So I definitely do apologize for the inconvenience, um, but they will um give you a call back just to talk about it some more for you.
[CUSTOMER][POSITIVE] All right, thank you. I really appreciate your help.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Um, no, I'm, I'm waiting for it to like let me log into the portal and it's still not like it's still like loading is that just because it's still new and you guys are working out bugs?
[AGENT][NEUTRAL] Yes, it does take a, um, it takes a little while to load. Um, I'm not really sure of the, the cause of it, but yes, that, that is something I've been hearing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright then I'll just keep waiting thank you so much for your help I really appreciate it.
[AGENT][POSITIVE] You're welcome. Well, thank you so much for calling APL Crystal. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you. Bye bye.