AccountId: 011433970860
ContactId: de4b71e5-ae85-4447-a771-2e38b8db0f01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 687380 ms
Total Talk Time (AGENT): 320456 ms
Total Talk Time (CUSTOMER): 381187 ms
Interruptions: 8
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/de4b71e5-ae85-4447-a771-2e38b8db0f01_20250605T18:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, [PII]. Uh, this is [PII]. Um, I, I found out I needed to reset my account, which I did, um, on my policy, and I'm going through and it is not showing claims that um I filed that haven't been processed yet.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And, um, or I don't see them anywhere. Um, and it was, uh, I'm sure you need all my information, but I'm not sure exactly.
[AGENT][NEUTRAL] No, it's OK. Um.
[AGENT][NEUTRAL] Sure, OK, so just so that I understand, [PII], I'm sorry to interrupt, um, you're trying to see claims that you had submitted but they're not completed processing yet, is that correct?
[CUSTOMER][POSITIVE] Correct, correct.
[AGENT][NEUTRAL] OK, OK, so are we just needing to verify that they have been received?
[CUSTOMER][NEUTRAL] And the website shows, yeah.
[CUSTOMER][NEUTRAL] Um, yes, I mean, they were verified on the old site. I mean, I saw them all out there, but since it's updated to this new platform, they're not on there anymore. So I guess, yes, we need to verify.
[AGENT][NEUTRAL] Sure, OK, um.
[AGENT][NEUTRAL] Yes, OK, so we can go ahead and get all that pulled up, um, and of course make sure that they're there, um, can, can I first get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, 208-876-3.
[AGENT][NEUTRAL] OK. One moment, please.
[AGENT][NEUTRAL] Alrighty, just gonna verify some information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect, uh, last thing I need is the email address we've got on file for you. uh, looks like it's an [PII] account.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Perfect thank you so much for verifying all of that. OK, now the claim that we are looking for, um, because I'm looking and I don't see any claims. The last claim that we received was on [PII] for you. um, I don't see any pending, but I do see one for [PII] that is.
[CUSTOMER][NEUTRAL] OK. This would have been for my husband. Yes, yes. It would have been for him.
[AGENT][NEUTRAL] Yes, OK, I do see that for [PII], mhm, uh, [PII] it looks like that was when that was received and yes it is currently processing, um, so let's see, I know the.
[AGENT][NEUTRAL] It did change quite a bit at the website um but I do believe it's going to be separated by member of course so you may not be seeing it because you're seeing the claims for you give me just a moment.
[CUSTOMER][NEUTRAL] Well, OK, I don't know how to click on just me or just him because it says claims all claims, and then it says um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, from
[CUSTOMER][NEUTRAL] When I go to, to, to click just him.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, OK, if I try to click on him like it has covered individuals on under my details, OK, it doesn't let me click on either one of us.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I mean, there's nothing.
[AGENT][NEUTRAL] Are you under um.
[CUSTOMER][NEUTRAL] I mean, you would think maybe
[AGENT][NEUTRAL] I'm sorry, um, are you under the tab that says my policy?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] It has [PII] active.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'm looking under my details and then my thought is, OK, it shows us both covered and when I go to claims.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I do all, and it has
[CUSTOMER][NEUTRAL] One for him and then the rest are for me.
[CUSTOMER][NEGATIVE] And because I said, well, I'll just do all. But it, you know, there's nowhere where it lets me just pick him. And it doesn't show, it says all or open or processed. And so open, it shows there's nothing open.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the one that you are seeing for [PII], um, is that the claim number ending in 505?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK yeah so that is a bit different because again from what I'm seeing I do see that this other one has been received of course it's not completed processing so it doesn't have its own claim number just yet um I'm trying to see because again I'm.
[CUSTOMER][NEUTRAL] But you know what's funny because I filed that a long time ago, they just got, I've just got the information from the additional information from the hospital. So I'm, I'm wondering if I can go back and because it was, I'm pretty sure it was a, find the claim number, I'll have to go find all my papers, uh, an original claim number, um.
[AGENT][NEUTRAL] Oh, what we were missing?
[CUSTOMER][NEUTRAL] Let's see, under the old site, um, because they, I think they would have had to send me something saying they needed
[CUSTOMER][NEUTRAL] Additional information. I'm not sure that I
[AGENT][NEUTRAL] If it was for um OK so the only claims that I do see for Scotty are the one, the one ending in 505 and this one of course that was just still being processed. So if it was additional information needed for Scotty, it would have been that claim number, the 505.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, well, it's already paid on that one, so no, that one, I mean.
[CUSTOMER][NEUTRAL] Uh, let me see, because I had to have, I'm sorry, I've got like 40 different things, um, because some of them I didn't understand when I was following them. And
[AGENT][NEUTRAL] I can take a look at that too hang on no, you're fine.
[AGENT][NEUTRAL] I do see, yes.
[AGENT][NEUTRAL] OK, I do see I'm looking at this claim as well, the, uh, one for Scotty that did process, um, and I do see some spots where we were missing some information, um, let's see, like fully itemized um hospital or facility bill, uh, with all charges fully identified.
[CUSTOMER][NEUTRAL] OK, let me see, uh.
[AGENT][NEGATIVE] Incomplete claim information.
[AGENT][NEUTRAL] Medical imaging benefit, yeah.
[CUSTOMER][NEUTRAL] But I had to get detailed list and then of, of the two ambulance calls, they were, um, I don't know. I was thinking I had to put those on separate lines, but now that I, I can't go back in there and look, I, I'm not sure. Uh, there were 2 ambulance calls, one in November and then one in January. And then also, there were 2 hospital stays and, and I think they wanted me to send those to prove the ambulance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, he is.
[AGENT][NEUTRAL] Yes, um, and that's
[CUSTOMER][NEUTRAL] Oh, I don't know if you can see ambulance.
[AGENT][NEUTRAL] Yes, uh, ambulance ground, that's exactly what I'm seeing where it's the asking for that, um, itemized hospital or facility bill. OK, so I have seen um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In real time when you know we were kind of trying to learn all of this that sometimes it can just simply take quite a while for claim information to load or uh populate I guess um let me also confirm are you using a uh desktop or a laptop computer or are you using a mobile device?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm using my laptop.
[AGENT][NEUTRAL] You are using OK perfect uh the reason I ask is that, uh, to my knowledge as of right now I still don't think there's a lot of support for mobile devices so give me just a moment I'm still trying to.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, that's OK. I was just like, oh, where did my account go? And, and I thought, OK, I didn't, because he had two ambulance, then he had in January, so they want me to send the hospital stuff to prove the ambulance, which I didn't really understand because he stayed in the hospital both times, and I had all the stuff that those two didn't make sense. And then I had intensive care days.
[AGENT][NEUTRAL] On the weekend.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And maybe that's on a whole, maybe that's slumped in with those claims, the intensive care in January, and maybe all those were just all lumped together, but I was thinking I I had to file 3 separate claims, but, you know, maybe they lumped them all together or something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, and what I'm thinking to, um, Pam is with this information having been submitted just before this website had its kind of overhaul change um.
[AGENT][NEUTRAL] Wondering if it's just kind of having a hard time associating it or putting it with there as it is still being processed so with it that was the [PII] I would imagine it should be complete any time uh as it takes about 7 to 10 business days for claim information to complete processing we're kind of getting to that mark so you of course can keep an eye on the website.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, well, maybe I'll just call back. Yes, well, that's why I said when it's not on the website I thought well what where did it go? because it doesn't show it so maybe it'll pop in OK.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][POSITIVE] Right, right. Well, I can still see it in our system, so no worries there. I do apologize for all of the confusion. Um, it's, it's not been fun, but hopefully, you know, here at once it's been up for a while. Well, you know, with anything new like this, there's bound to be some kinks, um, but hopefully it should all be worked out here pretty soon.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I bet it hasn't been.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK. Well, I'll just, I'll call back and I just kind of wanted, because I, what happened was it took them like, took me 2.5 months to get to the hospital. I filed the thing back in April, and it took very many, finally, I was just like so upset and I was getting ready to go out of town, and I said,
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I called them and I said, so they, they said, we're gonna fax it over today. And I think I called to make sure y'all got the facts for all the stuff. OK. So I'm sure that's what you got on [PII] or something, was the fax from the hospital. OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, it does, it can take some time for it to be, you know, fully processed and assigned and all that fun stuff.
[CUSTOMER][NEUTRAL] OK. Well, I'm gonna, I have another one to file, but I am I'm, I'm, I'm afraid to file it right now until I see what happens with this one. So it's one for, OK, OK, well, I'll just, I'll keep looking at the website and then and then maybe in a I'm going back out of town so maybe next Tuesday or something I can call back and.
[AGENT][NEUTRAL] Sure, yeah.
[AGENT][NEUTRAL] Yeah, whatever you feel comfortable then.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And just see if anything else is or or keep looking on this.
[AGENT][NEUTRAL] I would
[AGENT][POSITIVE] Sure, absolutely, and then, yeah, um, you can always give us a call as well if it's giving you trouble or anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. OK. Well, if I don't see it pop up on here, then I'll probably call back. OK, thank you so much for your help.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, definitely.
[AGENT][POSITIVE] All right, you are very welcome. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you. Uh-huh. Bye-bye.
[AGENT][POSITIVE] Thank you bye bye.