AccountId: 011433970860
ContactId: d5a2510d-75e1-48db-9764-28757a0feda6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1332540 ms
Total Talk Time (AGENT): 412900 ms
Total Talk Time (CUSTOMER): 563021 ms
Interruptions: 4
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/d5a2510d-75e1-48db-9764-28757a0feda6_20250626T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. Um, I'm under my husband's, um, policy.
[CUSTOMER][NEUTRAL] And I can give you the number.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. Um
[AGENT][NEUTRAL] OK, Ms. [PII], what, what is the policy number?
[CUSTOMER][NEUTRAL] Um, just a second. I got it right here.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I just had it pulled to the right page.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] Uh, OK, here we go. So policy number says 14774.
[AGENT][NEUTRAL] OK, and Ms. [PII], what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And let me look up this policy.
[AGENT][NEUTRAL] OK, do you see an inpatient or an outpatient certificate number?
[AGENT][NEUTRAL] On that card or what's it look?
[CUSTOMER][NEUTRAL] Uh, I see.
[CUSTOMER][NEUTRAL] Certificate number it says 02560623.
[AGENT][NEUTRAL] OK, that's gonna be your policy number. I think the number that you gave me is your group number, but I've got you pulled up now, Miss [PII].
[AGENT][NEUTRAL] Uh, what is your day?
[CUSTOMER][NEGATIVE] OK, then they must have a, they must have wrote wrong on our pamphlet that they sent us then.
[AGENT][NEUTRAL] Oh, yeah, they probably just wrote your group number on there. Um, can you please verify some information for me? Can you give me your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number, and email address that's on the policy?
[CUSTOMER][NEUTRAL] Um, address is [PII]. And what was the other thing you asked?
[AGENT][NEUTRAL] Um, the email address and phone number that's on the policy?
[CUSTOMER][NEUTRAL] Um, that would be.
[CUSTOMER][NEUTRAL] Uh, the email is probably [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And then uh.
[AGENT][NEUTRAL] And then the self.
[AGENT][NEUTRAL] Cell phone number.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you very much for verifying the policy for me. All right, and how can I help you today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Well, I've tried several times to um file a claim and I've had trouble and I got to the point where I was downloading the information, but I was wondering if you could check and see if it shows that it went through.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, on this, this is a dental policy, and you can't file your own claims on dental, but let me see if there's another, um, was it for medical that you were trying to file the claim for?
[CUSTOMER][NEUTRAL] OK, cause I
[CUSTOMER][NEUTRAL] Uh, actually, I just sent everything I had and I do have dental.
[CUSTOMER][NEUTRAL] Uh, a second.
[CUSTOMER][NEUTRAL] Trying to
[CUSTOMER][POSITIVE] Do everything with just very minimal space here and my doggy wants to snuggle.
[AGENT][NEUTRAL] Yes, I've got one in a playpen right next to me, so I understand.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] OK. So, um,
[CUSTOMER][NEUTRAL] Yeah, this one's snoozing right along, so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And is the claim for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me look and see if I've got anything on either policy.
[CUSTOMER][NEUTRAL] Yeah, um, OK, so.
[CUSTOMER][NEUTRAL] Alright. This one is medical.
[CUSTOMER][NEUTRAL] This one is dental and this one is
[CUSTOMER][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] Your son's medical.
[CUSTOMER][NEUTRAL] And this one is medical.
[CUSTOMER][NEUTRAL] OK. I've got.
[CUSTOMER][NEUTRAL] I think one dental here.
[CUSTOMER][NEUTRAL] I do have another paper for dental, but I gotta look for that again cause I keep putting that where I won't forget it.
[CUSTOMER][NEGATIVE] Yeah, that doesn't work very well for me.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, what do I do with the dental right now?
[AGENT][NEUTRAL] I'm not showing that.
[AGENT][NEUTRAL] The dental will need to be if you can get the dental office to file the claim for you.
[AGENT][NEUTRAL] Let me give you um.
[AGENT][NEUTRAL] Our payer ID numbers so they have that information because that's what they'll need to do the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I can't do it myself.
[AGENT][NEUTRAL] It's 60.
[AGENT][NEUTRAL] No, the dental claims will have to be done. We don't have a claim form for dental.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean you can send the information in without a claim form.
[AGENT][NEUTRAL] But the office will need to send it so we can give them that payer ID number so that they can file the claim for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So what's the number 60?
[AGENT][NEUTRAL] Yes, 60801.
[AGENT][NEUTRAL] And tell him that's the payer ID number to file it electronically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, just a second, just a second. I gotta.
[AGENT][NEUTRAL] Right there from the computer.
[CUSTOMER][NEUTRAL] Gotta redo this. um, to file.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Dental.
[CUSTOMER][NEUTRAL] Electronically.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] OK. Um, now that is 60.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What else did you say?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right, I got that, so.
[AGENT][NEUTRAL] And then for your.
[AGENT][NEUTRAL] For your medical claim, is it a wellness claim or like did you just have a wellness check or did you actually have medical services?
[CUSTOMER][NEUTRAL] Um, OK, so this one here is physical therapy.
[AGENT][NEUTRAL] OK, OK, so that when you, when you file this claim, you're gonna click on traditional claim, you're gonna file a traditional claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna file it under your hospital indemnity plan?
[AGENT][NEUTRAL] And it'll take you to claims and forms you'll click on that.
[CUSTOMER][NEUTRAL] OK. I think I'm gonna do it right while you're on the phone here so I don't get all goofed up.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I was trying to write it down and remember it and I'm like, you know, as well just try to do it.
[CUSTOMER][NEUTRAL] Then it's done.
[CUSTOMER][NEUTRAL] puppy, you gotta, it's still.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Waiting for my computer to come up.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And when you get to claims and forms, you'll click on that hospital indemnity claim form.
[CUSTOMER][NEUTRAL] OK, a second, um.
[CUSTOMER][NEUTRAL] So I am looking for the website again here.
[AGENT][NEUTRAL] OK, have you signed up?
[CUSTOMER][NEUTRAL] Cause apparently I got.
[CUSTOMER][NEUTRAL] Yeah, I did all that last night.
[AGENT][POSITIVE] Have you signed up for the new one? Oh, good. You're, you're on a roll then.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I'm trying. OK, so I went to [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] Now, I'm on the dashboard and
[CUSTOMER][NEUTRAL] All is still all coming up on, on here, OK.
[CUSTOMER][NEUTRAL] So, that's another thing. Um, if I could
[CUSTOMER][NEGATIVE] somehow switch it over so I can not constantly
[CUSTOMER][NEUTRAL] Call my husband about
[CUSTOMER][NEUTRAL] You know, security codes and all that stuff. Is there a way to do that?
[AGENT][NEUTRAL] Uh, there's a form that you can fill out, uh, when you go to claims and forms, you're gonna, uh, you'll need the hospital indemnity claim form, but there's also an authorization, uh, third party release authorization that will need to be filled out and sent in so that we can add you in so that you don't have to, we don't have to verify with him every time.
[CUSTOMER][NEUTRAL] OK. So that I need to.
[AGENT][NEUTRAL] Authorization to this.
[AGENT][NEUTRAL] Information form.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Alright, cause right now it says secondary insurance. Let's see, it says you can receive claim status updates, text message, and your 10 digit phone number. So I guess I'll do that again. Is that right?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Oh, it says I can skip that one, because I already did that. I did that last time.
[AGENT][NEUTRAL] Yeah, you can
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Now,
[CUSTOMER][NEUTRAL] I go to my policy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yeah, I was on here last night and I was like, oh my God, driving me nuts now.
[CUSTOMER][NEUTRAL] OK. So then,
[CUSTOMER][NEUTRAL] Fla
[AGENT][NEUTRAL] Yes, and you're gonna choose traditional claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] It doesn't show that. I know what you're talking about. I've seen it last night, but I'm under
[CUSTOMER][NEUTRAL] My policy and it has.
[CUSTOMER][NEUTRAL] OK. Oh, [PII].
[AGENT][NEUTRAL] The hospital indemnity is the one that you need to choose.
[CUSTOMER][NEUTRAL] Hospital indemnity got it.
[CUSTOMER][NEUTRAL] OK, on that.
[CUSTOMER][NEUTRAL] Not letting me click on it.
[CUSTOMER][NEUTRAL] So how do I choose it?
[AGENT][NEUTRAL] Um, do you see where it says file a claim?
[CUSTOMER][NEUTRAL] Um, no, it usually says that.
[AGENT][NEUTRAL] Or claims and forms.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I went under my policy.
[CUSTOMER][NEUTRAL] And then it's giving me
[CUSTOMER][NEUTRAL] Um, the prices he pays.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I need to go, if I go to claims, it doesn't show a collection.
[AGENT][NEUTRAL] Do you see
[AGENT][NEUTRAL] Do you see a box?
[AGENT][NEUTRAL] A blue box that has a green start.
[AGENT][NEUTRAL] My claim
[CUSTOMER][NEUTRAL] Oh yeah, it just came back up.
[AGENT][POSITIVE] OK, good. That's what you need to. OK, good.
[CUSTOMER][NEUTRAL] Yeah, it just came back up. It was something.
[CUSTOMER][NEUTRAL] OK. So I need to go to hospital.
[CUSTOMER][NEUTRAL] OK, it says traditional first.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then next step.
[CUSTOMER][NEUTRAL] And then it says.
[CUSTOMER][NEUTRAL] claim and I go to masks.
[CUSTOMER][NEUTRAL] Select claimant name.
[CUSTOMER][NEUTRAL] My name?
[CUSTOMER][NEUTRAL] Alright, and then it says coverage policy.
[CUSTOMER][NEUTRAL] I think it's the one that ends in 623.
[AGENT][NEUTRAL] Uh, the hospital indemnity is 256-070-6.
[CUSTOMER][NEUTRAL] Yep, OK, just 6.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got that. OK.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] OK, right here, um.
[CUSTOMER][NEUTRAL] To put the files in.
[AGENT][NEUTRAL] Yes, you'll need to upload your information.
[CUSTOMER][NEUTRAL] OK. I did that and I have it on my CAM scan.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Click on that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] there's a PDF.
[CUSTOMER][NEUTRAL] OK, it says insurance one. That's the one that I did, but I filed like 3 different spots.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I don't know how to take
[CUSTOMER][NEUTRAL] One's out, the dental one's out.
[CUSTOMER][NEUTRAL] Can you tell me?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do I have to start all over.
[AGENT][NEGATIVE] If the dental goes through, it'll just, I mean, if those, if, if that information goes through, they'll just ignore it for, because it's not for this policy.
[AGENT][NEUTRAL] And they may put it on your other policy for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm not gonna guarantee that, but, but sometimes they do that.
[CUSTOMER][NEUTRAL] I don't know that'd be sweet.
[CUSTOMER][NEUTRAL] OK. Now I've got uh
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, file.
[CUSTOMER][NEUTRAL] OK so lets me click on it yeah.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Alright, submit.
[AGENT][POSITIVE] Yes, submit that should be your final step.
[CUSTOMER][NEUTRAL] Still think there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So that one was for the health insurance?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That, that one was for my physical therapy and then I've got a printout from my doctor's visit from my family doctor.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that you would do those.
[CUSTOMER][NEUTRAL] And that's on there too.
[AGENT][POSITIVE] OK. That's good. You got it all together.
[CUSTOMER][NEUTRAL] And then, so I
[CUSTOMER][NEUTRAL] Can I submit the same group of um documents that says claim successfully submitted details for your records.
[AGENT][POSITIVE] Good.
[CUSTOMER][NEUTRAL] OK, so, um, let me take a snap picture of it, so I've got it.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] All right. So then, that one was for medical, so do I go to the dental one now?
[AGENT][NEUTRAL] Um, you can file the dental one, but you would have to do it without a claim form.
[CUSTOMER][NEUTRAL] Oh, that's right. I got to tell them to do it. That's right. OK. So I do medical and they do the dental.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Got you. OK.
[CUSTOMER][NEUTRAL] Uh, what other information do I need to give them? Because there's a lot of people that haven't even heard of this company.
[AGENT][NEUTRAL] Uh, you just give them your, here, let me get to your, um, policy again real quick.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Well, come on, let me get over there.
[AGENT][NEUTRAL] OK, you're gonna give them your policy number which is 256.
[AGENT][NEUTRAL] 0623.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You've already got the payer ID number. You'll give them your group number which is 14774.
[CUSTOMER][NEUTRAL] OK. Policy number, group number, and what did you say the other thing was?
[AGENT][NEUTRAL] And then the
[AGENT][NEUTRAL] The effective date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, which is [PII].
[CUSTOMER][NEUTRAL] I will see effective date on mine it says [PII].
[CUSTOMER][NEUTRAL] Boy, they got all these mixed up, don't they?
[AGENT][NEUTRAL] Yeah, it's [PII] was when this policy started.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, that's a certificate effective date, is that what it, what it's called?
[AGENT][NEUTRAL] Right. Your policy certificate, effective date.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, um, and then what website, the one that I did?
[AGENT][NEUTRAL] Yes, the same one.
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That sounds good. Yeah. Um, now, can there be, like my dental, I'm in the process of getting a lot of dental work done.
[AGENT][POSITIVE] Awesome.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Is there any way that can I file for that before or does it have to be after?
[AGENT][NEUTRAL] It has to be after because they'll have to have the actual charges.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Because they got
[CUSTOMER][NEUTRAL] There's some things that were done, but not.
[CUSTOMER][NEUTRAL] Not everything.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you'll need actual charges.
[CUSTOMER][NEUTRAL] Cause I'm, I'm getting ready.
[CUSTOMER][NEUTRAL] OK, cause I'm getting ready to do an implant and I think I have the charges. That one there is
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well there should have because you, I got two different dentists going on, one's a um
[CUSTOMER][NEUTRAL] Specialist, you know.
[AGENT][NEUTRAL] Right, right. And they'll have the ADA codes on there for you um after the charges, which are, which is what we need to be able to know what actual charges will be and they'll send that, you know, they'll have the ADA codes. That's why it's easier for the dentist to be able to file for you because they have all those codes and everything in their computers and they can just boop, send it on over.
[CUSTOMER][NEUTRAL] This one
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] That works for me.
[CUSTOMER][NEUTRAL] So I guess we're all set then. Can you open up what I sent and make sure it's on there and you can read it?
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Uh, let me look real. I can't, I'm not in the claims department, so I'm not able to see that information, but if you got the confirmation, that means that the claims department has received it. If there's anything that's missing or they need additional information, they'll reach out to you through the online service center and let you know what they need, but it does take 7 to 10 business days to process the claim.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sounds good. Thank you.
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful rest of your day.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have some
[CUSTOMER][NEUTRAL] Thank you. My husband keeps saying, you gotta see if this is gonna work for us because if I'm paying more than we're getting back, then we should cancel it, you know.
[AGENT][NEUTRAL] Oh yeah, yeah.
[CUSTOMER][NEUTRAL] And I understand what he's saying, but
[CUSTOMER][NEUTRAL] Cause we've had it now for every month, so.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][POSITIVE] All right, well thank you I appreciate everything.
[AGENT][POSITIVE] You're welcome. You're very welcome. You have a wonderful day. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Mm bye-bye.