AccountId: 011433970860
ContactId: d91db7a9-1443-4a47-809c-e40e8ef07330
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 907739 ms
Total Talk Time (AGENT): 181087 ms
Total Talk Time (CUSTOMER): 661247 ms
Interruptions: 6
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/d91db7a9-1443-4a47-809c-e40e8ef07330_20250513T16:29_UTC.wav
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[AGENT][NEUTRAL] I just hearing.
[CUSTOMER][POSITIVE] Hi good afternoon how are you doing today?
[AGENT][POSITIVE] Hey, I'm doing fine.
[CUSTOMER][POSITIVE] Good, good, good, good. My name is [PII] and I am a new broker with you guys, um, just had a wonderful case go through, um, and I have some claims coming in.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um I I know that um I received an email from care team which was very helpful um but I just wonder what I'm doing is this group is a decent sized group um and what I'm doing is I'm putting together um an email for them with some attachments um on the different options and how they can file their claims uh my goal is for them to upload them to, you know, secured. [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, versus faxing them or coming through me most importantly.
[CUSTOMER][NEUTRAL] I, I really don't want that. Um, so my question is this, this is, I've been doing insurance for 21 years and I
[AGENT][NEUTRAL] Really, they should probably send them to the claims department.
[CUSTOMER][NEUTRAL] OK, so, so, OK, so what is that? Because I thought that.
[CUSTOMER][NEUTRAL] Who's this email come from? My email came from.
[CUSTOMER][NEUTRAL] Care team at [PII]. And then this, this email initiated because I was advised, I had a claim I submitted for somebody. And I was advised.
[CUSTOMER][NEUTRAL] To send it via email to [PII].
[CUSTOMER][NEGATIVE] And when I did that her team reached out to me and said yeah we don't like that this is how we prefer you do claims upload them or fax them.
[CUSTOMER][NEGATIVE] To a fax number, the claims fax department number or mail them, which I never want anybody to mail anything anymore.
[CUSTOMER][NEUTRAL] So, so what, what's what, how should I direct my clients?
[AGENT][NEUTRAL] OK, so I work in [PII] and I've always just told, I've always given out the claims email and fax number, um, but if they're telling you because I've never used [PII] so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Never dealt with their email. I usually do.
[CUSTOMER][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Quite bad.
[AGENT][NEUTRAL] Uh, [PII]. I've never.
[CUSTOMER][NEUTRAL] Yeah, see, and that's what I did and they ended up forwarding it.
[CUSTOMER][NEGATIVE] To get processed, but they're like yeah we don't, it's not secure enough I guess sending it via email um.
[AGENT][NEUTRAL] Do you think your clients would be, would that be too much to ask them to go to the uh APO website directly and just fill out the claims forms on there and upload them, or you think that would kind of be too much?
[CUSTOMER][NEUTRAL] That's what I want them to do, um, and, and that is, and that is the [PII], right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, that's what I want them to do. I'm trying to train all of them with all of the carriers I work with to do that just because if I get hit by a bus tomorrow, I'm not in the office all day long, you know, so I, I've really, yeah, I tried to train my clients that, you know what y'all need to learn how to file your claims, you know, there's a fax number, um, you know.
[AGENT][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] All that good stuff. So, you know, they need, they need to do it on their own just because I'm just at that point in my career where, you know, I don't have time to service. So, um.
[AGENT][NEUTRAL] Well, yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, so I, um, definitely want, you know, them to be self-sufficient. And I understand there are gonna be some that are just like, I don't wanna do that, and that's fine. But the majority of them, I want them to, to do it. So go online, register.
[CUSTOMER][POSITIVE] An account it's, it looks super easy.
[AGENT][NEUTRAL] And you don't even have to register. You can clearly there's options where I could just be a regular person that's still an APO and at the top right it says claims and then it says claims forms and it still lets you download even if you don't have an account.
[CUSTOMER][POSITIVE] Yeah, well, and I'll even tell them that just go to secure. you know, [PII] and you don't even have to register an account. That's good to know so don't.
[AGENT][NEUTRAL] How many products do they have? Cause would it just be easier if I
[CUSTOMER][NEUTRAL] They just have 2.
[AGENT][NEUTRAL] Just sent you the claim forms for those two products and you just and that way they just have the forms already.
[CUSTOMER][NEUTRAL] Yeah, they just have 2.
[CUSTOMER][NEUTRAL] That's what I'm doing, yeah, so in my email to them that's exactly what I'm doing. I'm putting their plans in there again. I mean they've gotten like 5 emails with their plans, but yet they still call and they're like, I don't know what my plan is, um, [PII] love them, but, um, and then I'm putting in the accident claim form because they have an indemnity plan, so there's no wellness benefits or anything in there so I don't need to include that one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And this is another question for you. um I'm putting in the hospital indemnity claim form obviously if they're admitted or anything like that, the big thing about this form is the ER benefit. We were we customize a plan for them for an ER benefit because that's what the group wanted.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And, um, the group ended up paying for this benefit. We wrote $80,000 in premium. So it's, it's, it's a nice group. Yeah, very nice group. So I definitely want to make sure that they are always informed and that we get their claims paid. So, um, so, so having said that,
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] There, there's a physician benefit in that hospital indemnity or indemnity plan. They get $50 once a year for going to the doctor.
[CUSTOMER][NEUTRAL] I don't think that's considered the wellness benefit, right? The wellness benefit is a completely different thing, correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] On the hospital plan.
[AGENT][NEUTRAL] What, what, what is the, let's just look at it. What is your, what's the group number by chance?
[CUSTOMER][NEUTRAL] Oh sure, yeah, the group number is hold on one second, it's group number 26999.
[AGENT][NEUTRAL] 26195.
[CUSTOMER][NEUTRAL] Ohio Heartland.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And we're talking about the HI 721 with the extra.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Because I, I was like, well, I don't think I attached the hospital wellness.
[AGENT][NEUTRAL] And what was it that you wanted me to ask, OK, so you said that is the hospital wellness on.
[CUSTOMER][NEUTRAL] Oh yeah, if you look, yeah, if you look at the hospital plan.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's a pretty simple plan. We stripped it down. So, you know, you've got your hospital admission, you've got your surgical benefit, you know, your ER urgent care. I think I assume all of those benefits would be filed under just the normal hospital indemnity claim form.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, we were just all right, and then when they pull this account up, they'll notice that they have all those extra additional writers and things like that.
[CUSTOMER][NEUTRAL] OK great so so I don't need because the physician office benefit to me that is not a wellness benefit. I don't need to send them the wellness form, correct? OK, perfect. That's what I thought. I just want to make sure that I'm attaching.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] But yeah, that's exactly what I'm doing in my in my message to them. I'm attaching their plans. I'm attaching the two claim forms, which is great. We only have 2 and I'm telling them, look, here's the deal, but here's here's my big question for you. So this is a good one. This is the main question actually, um, you know, I'm telling them because this is the first you guys are the first carrier that has ever sent cards to the clients.
[CUSTOMER][NEUTRAL] And I'm like, holy crap, that's new. And I've been told by um Morgan and by my, the, you know, my, um, the, the manager that I work with that helped me sell the case, um, his name is [PII] as well, that with these cards, they have the option. So when they go to the ER,
[CUSTOMER][NEUTRAL] To, to give them, I think that's called, I, I think the cards, do they say AM first? Do you know off the top of your head what our cards look like?
[AGENT][NEUTRAL] Uh, let me, I can, I actually sit right by Morgan. Uh, give me two seconds.
[CUSTOMER][NEUTRAL] I think somebody referenced in their email they say Am first so and I just wanna make sure because I've never seen a card, it's the first time.
[CUSTOMER][NEUTRAL] And, and what I've been told is if they show their card, like they go to the ER they check in, they give their health insurance card, then they show them their APL, I'll call it the APL card, supposedly,
[CUSTOMER][NEUTRAL] When they run that card.
[CUSTOMER][NEUTRAL] That deduction for that benefit will be taken off of their insurance somehow.
[CUSTOMER][NEUTRAL] Their insurance bill?
[CUSTOMER][NEUTRAL] That's what I want to clarify.
[AGENT][NEUTRAL] OK, so hold on, let me, I'm gonna actually let you say that out loud, so [PII] can kind of hear you too. Um, OK, she's here, and you, what were you saying about the ID cards?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh hi. Oh, who? Hi, who is this [PII] did you say [PII]?
[AGENT][NEUTRAL] Sorry to hear the morning still here. I.
[CUSTOMER][NEUTRAL] Is this my Morgan that I work with? This is [PII].
[AGENT][NEUTRAL] Oh yeah, it's me. Hi [PII].
[CUSTOMER][NEUTRAL] Hey [PII].
[CUSTOMER][POSITIVE] Oh [PII]'s my girl.
[AGENT][NEUTRAL] How are you?
[CUSTOMER][POSITIVE] She's been very helpful. No, [PII], it's so great to hear from you. I'm glad you're on the call. So I was just calling in because here's what I'm doing. I'm getting some claims coming in for my group. So I'm putting together a master email that I can send off and then when anybody comes to me.
[CUSTOMER][NEUTRAL] This email's going to have their two plans. So, you know, the hospital indemnity plan and the accident plan. It's going to have the claim forms, so the accident claim form and the hospital indemnity claim form. And what I want to do is give them the options on what they can do to file, all right?
[CUSTOMER][NEUTRAL] So, um, the, and the first thing I want to tell them is the whole concept of, this is the first time my team, they've ever received cards. And you and I talked about that. I'm like, oh my God, they're getting cards. What does this mean? What happens with this? So I want to explain this to them properly. And this is my understanding is, say they go to the ER.
[CUSTOMER][NEUTRAL] All right. And then their hospital plan, you probably remember, if they get that $750 benefit for going to the ER. That was the big selling point of the plan.
[CUSTOMER][NEUTRAL] Um, they, they're gonna show their medical card, and then they're gonna show their card with us, which is it called AM first? What is the name of our card? I, somebody put an email AM first card. Is that what it's called?
[CUSTOMER][NEUTRAL] Do you know?
[CUSTOMER][NEUTRAL] Did I lose you guys?
[CUSTOMER][NEUTRAL] I can't hear anybody.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh there you go there I thought I lost you guys. So do you know what the card is we issue what it's called is it called AM first or is it AM public or what is it called?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] It's AM public. I don't think it's AM first.
[CUSTOMER][NEUTRAL] OK, so, so I'm so I'm gonna call it that in my email so your AM public card. OK, great, that's good. Let me fix that. So, so my understanding, and correct me if I'm wrong, is when they go to the ER they'll show their health insurance card, they can show their AM public card and that difference, so let's use that ER visit benefit. That 750 then should be deducted, deducted from.
[CUSTOMER][NEUTRAL] Their health insurance bill or however they do it, correct?
[AGENT][NEUTRAL] Um, I don't, I would.
[AGENT][NEUTRAL] I would have to look at it again for that question, we would probably have to get you over to the claims department for them to explain that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That is perfect. That's what I need because I want to put this in an email and say, all right, guys, you got this option. Number one, you can show them your AM public card, boom, you're not going to get paid cash, but this will be deducted somehow or whatever. Number 2 is go to our secure portal, you know, um, the, the secured [PII], file your claim online. I'm really gonna push that, OK?
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And the 3rd option is, you can fax it. And then 4th option, if they have to send it to me, fine. But I'm trying to get them to be independent and know how to file claims in case I get hit by, by a bus tomorrow. So, um,
[AGENT][NEUTRAL] OK. Sure.
[CUSTOMER][POSITIVE] And I, and I'm doing that with all of my clients. I mean, I have thousands of clients with all state benefits from all of the years I've worked with them and I'm really done a great job transitioning everybody over to like look this is how you file a claim, so I wanna get started right off the bat with you guys with that process, but I want.
[CUSTOMER][POSITIVE] Like a master email for all of my groups that kind of explains these are your options. So yeah, yeah, if I, I mean yeah if I can talk to claims that would be great so I can get some clarification because yeah this is the first time I've ever dealt with a card for supplemental insurance. It's a cool concept I love it. I just need to know how it works.
[CUSTOMER][NEUTRAL] Oops, are you guys there?
[CUSTOMER][NEUTRAL] I can't hear you again.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Can you hear?
[CUSTOMER][NEUTRAL] Oh, I can barely hear you.
[CUSTOMER][NEUTRAL] So how, so how can I talk to claims?
[AGENT][NEUTRAL] Can I transfer you.
[CUSTOMER][POSITIVE] OK, no, that is, that is, that is great. If I get disconnected, is there a number I can call?
[AGENT][NEUTRAL] Um, just the [PII] number and then you just have to follow the prompts to speak to claims, but we shouldn't get disconnected. We'll get, we'll give claimsc hold on. We'll give claims your number in case something happens.
[CUSTOMER][NEUTRAL] Let me see
[CUSTOMER][POSITIVE] OK, alright, no that's perfect.
[CUSTOMER][POSITIVE] OK well I appreciate your help, yeah, and if you can transfer me to claims that would be wonderful.
[AGENT][NEUTRAL] OK, 1 2nd.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] And they go down there. Is there, OK, you taught me something. I always have to type in the number. I'm like, where the hell is clean.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Family
[CUSTOMER][POSITIVE] Thank you for calling APL. My name is [PII]. How can I assist you today?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEGATIVE] Yeah. You are on hold.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hey, I have.
[CUSTOMER][NEUTRAL] Oh hi um is this the claims department?
[CUSTOMER][NEUTRAL] Yes. Oh, hi, my name.
[AGENT][NEUTRAL] Yeah