AccountId: 011433970860
ContactId: dfa3a46d-92bc-4e94-bbe5-419d23fd1c63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1253800 ms
Total Talk Time (AGENT): 304701 ms
Total Talk Time (CUSTOMER): 257482 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/dfa3a46d-92bc-4e94-bbe5-419d23fd1c63_20250604T21:37_UTC.wav
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[CUSTOMER][NEUTRAL] This
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Uh, yes, this is [PII]. Um, I have submitted two claims and I got an email saying, um, I guess the claims are done, but every time I try to go in and set my account up to get things it's, I feel like I'm just going in circles. It's not, you know, it's not doing anything. I can't get on.
[AGENT][NEUTRAL] OK, I can help you with that. And Miss [PII], may I have a callback number just in case we get disconnected and the policy number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Let me see if I have the policy number on me.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, it is 01293871.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII]. Not sure which email you have. It might be [PII] or it's [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] We have the first one. Thank you.
[CUSTOMER][NEUTRAL] Is it [PII]?
[CUSTOMER][NEUTRAL] Oh that's
[CUSTOMER][NEUTRAL] The one with number 4.
[CUSTOMER][NEUTRAL] The [PII] Linda 40 is what you have?
[AGENT][POSITIVE] Yes, yes, that's the one we have. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Alright, that's my most.
[AGENT][NEUTRAL] All right. So, um, we have, um,
[AGENT][NEUTRAL] We have changed our system and right now we are requesting everybody to go ahead and create the account again. Have you gone to those steps yet or no?
[CUSTOMER][NEGATIVE] I, I did, I just created the account now and then it when it says to log in it's just sitting there, it's not doing a thing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, the, whenever you get the code, the, the tab is gonna open in a different tab. It's not gonna be on the same one. It's just gonna be a separate tab. So if you see the login and the login is spinning, go ahead and um browse over the Chrome circle, you know, the Chrome logo, and you're gonna see a different tab that open. You're gonna click that tab and that tab is gonna have um
[AGENT][NEUTRAL] It's gonna ask you for the, you know, the, the code.
[CUSTOMER][NEGATIVE] Well, I'm trying to do this on my phone and I don't see what you're talking about.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] All right. And the phone is a little bit harder. OK. When you scroll up to see what taps are open, can you go ahead and check and see what tabs are open on your phone? Um,
[AGENT][NEUTRAL] You should see a different tab opening.
[AGENT][NEUTRAL] So you should have one that is gonna be the one that says log in and it's just circling and there's gonna be another one that has your email and it's asking for a code.
[CUSTOMER][NEUTRAL] This is asking for my phone number?
[AGENT][NEUTRAL] Um, it should be asking for a code.
[CUSTOMER][NEUTRAL] It says hello [PII]. You can receive claim status updates via text message from American Public Life. Enter your 10 number to receive updates.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, yeah, that is 1.
[CUSTOMER][NEUTRAL] Now I, I had
[CUSTOMER][NEUTRAL] Already done this and I received the update but then it says you have to log in to see the claim.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. So when you go in and log in, uh, that's when you're getting that circle just going round and round.
[CUSTOMER][NEUTRAL] OK, now something brought up and it says [PII] active with a CO number. Would you like to review the coverage details of your policy? Do you need access to your ID card?
[CUSTOMER][NEUTRAL] And then start your claim. Those are the three options I have on my dashboard.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] If I bring up on the upper right it says my policy resource center help my profile and contact.
[AGENT][NEUTRAL] OK. So if you click on my policy, um, do you see the list of claims? It should be my policy, my details and then claims. And then it's gonna have like open claims.
[CUSTOMER][NEUTRAL] OK, claim 3608199 processed.
[CUSTOMER][NEUTRAL] Amount paid
[CUSTOMER][NEUTRAL] Alright, and now I had two claims, right? So.
[CUSTOMER][NEUTRAL] Where the other claim.
[AGENT][NEUTRAL] Mm I see.
[AGENT][NEUTRAL] OK, so it looks like the claim um that we processed recently is the one under your name that is on the 36081999. That is the most recent claim we processed. Uh, are you calling about that one or you're calling about a different one?
[AGENT][NEUTRAL] Because it looks like they bundle everything together into that one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't know. I put in two claims. I, I thought I got 2 claim numbers.
[AGENT][NEUTRAL] Mhm. OK. Yeah, I do see that you put in um a few documents and there were two different claims that they bundled them together into that one into the [PII].
[CUSTOMER][NEUTRAL] OK, and where am I supposed to see that? Like I feel this has always been, oh just trust me, you got paid correctly. I really.
[AGENT][NEUTRAL] Mhm. OK. If
[CUSTOMER][NEUTRAL] Yeah, I feel like policy is um just.
[CUSTOMER][NEGATIVE] I don't know, it's ridiculous that I don't feel like I can understand what's paid for and how and and that I see that.
[AGENT][NEUTRAL] OK, you should be able to see the claim number that is blue. I'll go ahead and double click that blue number so it can give you the um details of the explanation and benefits where you can click on download documents. But yeah, the claim should take you to the details of the payments.
[CUSTOMER][NEUTRAL] Uh, claim number is in bold black. It can't be clicked.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. What about download documents?
[CUSTOMER][NEUTRAL] Um, open claims, no claims available. Process claims, claim number insured relation, policy number, date received.
[CUSTOMER][NEUTRAL] Earliest service date date completed the process limited benefit amount paid.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not seeing where I'm supposed to press.
[CUSTOMER][NEUTRAL] There's under my name there's a CEO number and just says active to the right of my name that looks like a button I can press I don't think that's the claim.
[AGENT][NEUTRAL] Uh no, no, that's not the claim. OK, so you should be seeing the claim number. It, it is bold black, it's bold letters, OK? And then it says insured group, and you know, I will have the name of the insured, the insured. And then it's gonna have like a little bit of details and it says in in progress or it's gonna say process already. If you see that it says process, um, there should be, it should be a button that you can either download the documents or you can view the explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] It does not. It says status process. The next thing is coverage type limited benefit medical plan.
[CUSTOMER][NEUTRAL] Um, these are not things I can press on. They're grade out.
[CUSTOMER][NEUTRAL] There's no detail to this claim on this.
[CUSTOMER][NEUTRAL] Page that I can.
[AGENT][NEUTRAL] OK, and, and you're under process claims current?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] I'm trying to see if it will show do anything different. Let me see.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you mind holding for me?
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me.
[AGENT][NEUTRAL] OK. Um, I had to call IT just to make sure there's not been a problem. Um, they're getting back to me, it's taking a little bit longer. I do apologize. Um.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I did, um, went ahead and went to one of the accounts just to see how it looks, but yeah, I, I don't see a button. It should be there, but I don't see it. So, um, is it OK if um.
[AGENT][NEUTRAL] I'll give you a call back once I get that information?
[CUSTOMER][NEUTRAL] Sure, I mean, if you could call me back, um, you know, once you can explain to me why I'm not seeing how to get the detail, but can you also email me the details?
[AGENT][POSITIVE] I can email you the explanation of benefits. Sure, yes, no problem. Let me go ahead and do that right now.
[CUSTOMER][NEUTRAL] Yeah, I mean, meanwhile, while
[CUSTOMER][NEUTRAL] Them to work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And that's fine.
[CUSTOMER][NEUTRAL] And then I have one question.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, with regards to anesthesia, do you know, does the policy pay for it if you get anesthesia for colonoscopy?
[AGENT][NEUTRAL] A colonoscopy is it a um
[AGENT][NEUTRAL] What type of colonoscopy? So a diagnostic colonoscopy preventative? No, no, we do not cover it for preventative colonoscopies.
[CUSTOMER][NEUTRAL] Preventative.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so anesthesia for no tentative things.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, all right, and I'm sorry, your name again was?
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And I am sending you, uh, you should be receiving the email with the explanation of benefits shortly, OK?
[AGENT][NEUTRAL] And once I get the information of the IT department, I'll give you a call back. Maybe today, maybe tomorrow. Um, I'm just waiting for them to respond, OK?
[CUSTOMER][POSITIVE] OK great and
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] That's not a problem. Uh, can you tell me too was a check sent or I can't remember if I have it set up to go into my bank account or?
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] It was a check.
[CUSTOMER][POSITIVE] It was a check. OK. All right, thank you so much. I appreciate it. I'll wait to hear from you then.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome. Sure, no problem. I'll be calling you back. Have a good day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Um