AccountId: 011433970860
ContactId: cfe9723e-ebaa-4d25-8d67-da05dcf22007
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531710 ms
Total Talk Time (AGENT): 186521 ms
Total Talk Time (CUSTOMER): 323256 ms
Interruptions: 8
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/cfe9723e-ebaa-4d25-8d67-da05dcf22007_20250619T20:36_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So my name is uh [PII]. I need help and I can get in your claims, but I don't know how to find the claim. So I, I'm trying to get some help with that.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, sure, Ms. [PII]. I can assist you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] Thank you. May I have the policy number?
[CUSTOMER][NEUTRAL] It is um 00640053.
[AGENT][NEUTRAL] OK. And Ms. [PII], for security, may I have your date of birth and mailing address on file?
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII]. I didn't give you my zip code. I'm sorry.
[AGENT][NEUTRAL] Um, yes, OK.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] OK, and you say you are um so you can submit claims but you're not able to see your claim?
[CUSTOMER][NEUTRAL] Um, uh
[CUSTOMER][NEUTRAL] I, I just don't know how to see it. I'm, I'm in your file where, you know, it says dashboard, my policy resource center and help. And it says, you know, would you like to review your coverage on your policy or do you need to see your access your ID cards? I mean, uh, well, and then do I go to the resource center or no? Where do I go?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, it should be under my policy. When you go to my policy, it says my details and right beside it should be your claims.
[CUSTOMER][NEUTRAL] That says
[CUSTOMER][NEUTRAL] OK, wait a minute. Right.
[CUSTOMER][NEUTRAL] Alright, I'm, when I sign on, it takes me to your dashboard and the options I have, uh, go in my policy, is that what you said? I, I have that I go in my policy. OK. I write this that my policy.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now,
[CUSTOMER][NEUTRAL] Then it says, do you want to review your coverage details or do you need to access your ID card? I don't need any of that. So I, I need to see my claim.
[AGENT][NEUTRAL] OK, on right beside, right beside it, you should be, you should have a, a place where it says claims.
[CUSTOMER][NEUTRAL] Uh, I, I see a place where it says, you need to file a wellness or traditional claim and start your claim. The claim's already out there. I just wanna see what, you know, I want to see what it looks like or, or I don't, I don't see any other options.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Yeah, OK, yeah, I understand, uh.
[AGENT][NEUTRAL] OK, when you go to my details, my details, you're gonna see all your information. There's another tab right beside it that says claims.
[CUSTOMER][NEUTRAL] Wait a minute. My details, I don't even see that.
[AGENT][NEUTRAL] OK, when you click on my.
[CUSTOMER][NEUTRAL] I'm on the dashboard. Is that where I'm supposed to be?
[AGENT][NEUTRAL] OK. You're supposed to be on my policy. Mhm.
[CUSTOMER][NEUTRAL] Um, am I supposed to be at the dashboard?
[CUSTOMER][NEUTRAL] My policy, OK. Alright, alright, I'm, I've got in the wrong place again, right, right, I met my right, so go to claims.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] On my detail claims, OK.
[CUSTOMER][NEUTRAL] OK. All right, I see it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It has the claim number, the date and everything, and that it's uploaded.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I don't see how I look. Is there something, is that all I get to see?
[AGENT][NEUTRAL] No, go ahead and click on the download documents.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK. I'm trying to see where, where, uh.
[CUSTOMER][NEUTRAL] It's, I guess it's a bunch of them out there. No. um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I don't see where it says to download the documents so.
[AGENT][NEUTRAL] It's on the corner right, it's in blue.
[CUSTOMER][NEUTRAL] Uh, it's
[AGENT][NEUTRAL] Right beside the claim number, claim number and then you see a blue it says download documents.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right, bye.
[CUSTOMER][NEUTRAL] Where I see it says pending undefined, and it gives the claim number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The date you got it, that it's been uploaded and the amount paid is, and that's all I, and it's just spinning. So I don't know if mine is not, if it's, if it's.
[CUSTOMER][NEUTRAL] If it hadn't got to where it's got to get to.
[AGENT][NEUTRAL] OK, if, if it's spinning, it means it's.
[CUSTOMER][NEUTRAL] Do I go, um, am I supposed to go to the download file of it?
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] I know where the download file is, but then, but I hadn't put, told it to download anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you click on download documents it's gonna give you that EOB.
[CUSTOMER][NEGATIVE] But I don't have an option that says download documents.
[AGENT][NEUTRAL] OK. When you have under
[CUSTOMER][NEUTRAL] There, there, I can.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Alright, there's a file that says start your claim, but the claim is already, you know, I, I don't need to start one. I just want to see it says all open.
[AGENT][NEGATIVE] Mm mm mm, no.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] and processed and searched.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK. So under process.
[CUSTOMER][NEUTRAL] Open claims is under
[AGENT][NEUTRAL] OK, under process, what options do you have right beside the claim number?
[CUSTOMER][NEUTRAL] Download. OK, now, OK, I see, go to the process.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then download documents.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, download documents.
[CUSTOMER][NEUTRAL] And then I can go to the download file up there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And there's one, there's a document.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] That's what I couldn't.
[CUSTOMER][NEUTRAL] Get, I couldn't figure out how to get to that. So, um,
[AGENT][NEUTRAL] OK, yeah. OK.
[CUSTOMER][NEUTRAL] But that claim
[CUSTOMER][NEUTRAL] That's out there. That's one, that's been there a long time. That is the new.
[CUSTOMER][NEUTRAL] That's an old claim.
[CUSTOMER][NEUTRAL] I already, I already had that one. That was, that's not what was just done, the latest one.
[AGENT][NEUTRAL] If you're talking about, if you're looking at the one that you just sent in, which is the ones that there's 10 of them under the open claims there's 10, uh about 10 of them are a little bit more. Those are not been processed yet on [PII], those have not been processed yet, so they're in like to be processed once they process, they'll go ahead and be on the process side and you can see um the decision after we process them.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So there
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK. So they're not, they're, there's nothing I can see on that yet cause they haven't, haven't been processed. Is that, that's the way I understand what you just said, right? OK, cause this one that I, OK.
[AGENT][NEUTRAL] Correct. Yes. Mhm. Yes, yes, the one we received on the [PII]. Mhm. They're not processed yet.
[CUSTOMER][NEUTRAL] OK. All right. OK. All right. I think I understand now. I just couldn't figure out, you know, I thought once it was there, there was something that you could see, but until they're actually processed, that's all I'm gonna see for right now then. OK. All right. So I'll just watch for, and I should get an email telling me that it's processed as I would think, because I signed up for emails about my.
[AGENT][POSITIVE] Correct, yeah.
[AGENT][NEUTRAL] Well, if you signed up for emails or for text message, you will get a text message or an email once it's processed, yes, mhm.
[CUSTOMER][NEUTRAL] Take me.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] OK, OK. OK, thank you. You've helped me and I just, I, I just was confused. I thought there was something that I would see now on those 10 claims that you said or whatever that were out there then. OK, I'll be, I, I know kind of how to understand what I'm doing now then. Thank you very much.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah. You're welcome, Ms. [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] No, ma'am. That was, that was all I was just trying to get to that point so I could understand that part of it then. OK. Uh, uh, I appreciate your help.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yeah, have a good afternoon.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] Yes, ma'am. Bye.