AccountId: 011433970860
ContactId: ecb13a70-f391-45aa-b86d-70071803ad53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 918659 ms
Total Talk Time (AGENT): 209416 ms
Total Talk Time (CUSTOMER): 376124 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/ecb13a70-f391-45aa-b86d-70071803ad53_20250613T16:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Oh, hi. Um, I'm trying to log on to your website and I'm using what I thought was my email address and password, but it says that they can't seem to find my account.
[AGENT][NEUTRAL] Um, yes, ma'am. We've upgraded our system and um everyone would have to go in and create a new account. So what you'll do is when you go to the home screen, you'll click on where it says create new account and let the system know that you're insured and answer the questions um to set up your new policy.
[CUSTOMER][NEUTRAL] OK, well, it's not a new policy. It's been in effect for a while, so.
[AGENT][NEUTRAL] Yes ma'am, you would have to reset it up in our new system.
[CUSTOMER][NEUTRAL] So where it says create your OSC account, is that what I click on?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So if I go to sign in.
[CUSTOMER][NEUTRAL] And it says create your OSC account. I click on that.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I click on insured. Is that what I click on?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Cause it's under a group, it's under group insurance with my university.
[AGENT][NEUTRAL] Yeah, but um you'll still set up a new um account for your individual policy. Um, could I get your name and a good callback number and I can assist you further.
[CUSTOMER][NEUTRAL] OK, my name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And a good callback number?
[CUSTOMER][NEUTRAL] My phone number
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get your policy number, please?
[CUSTOMER][NEUTRAL] Uh, group number you mean?
[AGENT][NEUTRAL] Um, I would need the policy number. It's the outpatient certificate number on your card?
[CUSTOMER][NEUTRAL] Well, it says insured Ilona Davies coverage family group number 23143.
[CUSTOMER][NEUTRAL] Effective date [PII].
[AGENT][NEUTRAL] OK. And this is for Medlink Secondary Gap Insurance?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So you don't see anywhere on the card where it says inpatient or outpatient certificate number?
[CUSTOMER][NEUTRAL] It's got, yeah, it's got in hospital benefits certificate number and outpatient benefits.
[AGENT][NEUTRAL] OK. What's that number?
[CUSTOMER][NEUTRAL] Which one? Oh, it's the same thing?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] OK, the in hospitals one is 0255.
[CUSTOMER][NEUTRAL] 08
[CUSTOMER][NEUTRAL] 82
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] OK. And please verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] And the mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, yes, I found you in our system and please verify your email address.
[CUSTOMER][NEUTRAL] Um, I think it's using my school one which is IDs at nova.edu.
[AGENT][NEUTRAL] Yes, ma'am. That's the one we have on file. Is that the one you'd like to use? Um, if not, I can update it for you.
[CUSTOMER][POSITIVE] Yeah, that's the one that I like to use.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing that your policy is active and yes, what you would need to do is create a new policy, um, click on create new policy, let the system know that you're insured and um answer the questions from there.
[CUSTOMER][NEUTRAL] So I click on the insured one.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Next, OK, last name.
[CUSTOMER][NEUTRAL] Do these member, Social Security or member ID. So do I put in my social security number or what?
[AGENT][NEUTRAL] Put in your social.
[CUSTOMER][NEUTRAL] What number do I put in for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, date of birth.
[CUSTOMER][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Next.
[CUSTOMER][NEUTRAL] Complete account sign up.
[CUSTOMER][NEUTRAL] Continue.
[CUSTOMER][NEUTRAL] Email address.
[CUSTOMER][NEUTRAL] OK, and then it wants a new password.
[CUSTOMER][NEUTRAL] Can I
[CUSTOMER][NEUTRAL] Uh, no, I don't wanna do that. Choose, OK.
[CUSTOMER][NEUTRAL] Display, what do you mean display name?
[AGENT][NEUTRAL] That's what it's asking you to display name.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, what does that mean?
[AGENT][NEUTRAL] I'm not sure. I never heard of that one, this play name.
[AGENT][NEUTRAL] So you filled in all the info.
[CUSTOMER][NEUTRAL] OK, I'll just put in
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Continue, uh.
[CUSTOMER][NEUTRAL] It says, do I need to send the verification code?
[CUSTOMER][NEUTRAL] OK can I just go to continue?
[AGENT][NEUTRAL] Um, yes, it, yes, it'll send a verification code to your email. Yes, click on yes or continue.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, and then I'll check my email.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, there you go um.
[CUSTOMER][NEUTRAL] I'll copy and paste that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, verify code right.
[CUSTOMER][NEUTRAL] So claim not verified email address.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] Oh email address verified now you can continue. I don't know what the hell.
[AGENT][NEUTRAL] Email address.
[CUSTOMER][NEUTRAL] Alright, I just click the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, I agree to terms of use. I agree to privacy policy, continue.
[CUSTOMER][POSITIVE] OK, your account has been successfully created.
[AGENT][NEUTRAL] Yes, so you should be able to log in.
[CUSTOMER][NEUTRAL] Go to dashboard.
[CUSTOMER][NEUTRAL] OK, log in.
[CUSTOMER][NEUTRAL] And each time let me send a verification code.
[AGENT][NEUTRAL] Send another code to your email or?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My code.
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] OK. Welcome to the online service center.
[AGENT][NEUTRAL] Yes, ma'am. It sounds like you're in. So what were you trying to do once you got logged in?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, I just wanted to see what has been paid and what hasn't.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So you're able to pull up your claim history and verify that information?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] They just want me to do another verification of my phone now.
[CUSTOMER][NEUTRAL] Detail verification code.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so.
[CUSTOMER][NEUTRAL] Access the ID card.
[CUSTOMER][NEUTRAL] In my dashboard.
[CUSTOMER][NEUTRAL] So where can I see?
[CUSTOMER][NEUTRAL] What has been paid and what hasn't.
[AGENT][NEUTRAL] Um, do you see the options?
[CUSTOMER][NEUTRAL] Resource center.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Claims support.
[AGENT][NEUTRAL] Right, look under that. It should be under there.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Details.
[CUSTOMER][NEUTRAL] But this says that the policy is effective until [PII], but I
[CUSTOMER][NEUTRAL] I renewed it for this year.
[AGENT][NEUTRAL] Yes, I'm showing that it's still active.
[AGENT][NEUTRAL] It has that as a pay to date, but it's showing in our system that it's still active, so it hasn't expired.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. So if I look under [PII].
[CUSTOMER][NEUTRAL] No, I can't see. Where can I see about the claims I've filed?
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Oh, there it is. I see it. It's under policy, my detailed claims.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, no claims available. Hold on, there is this.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 73.
[CUSTOMER][NEUTRAL] OK, so there was a
[CUSTOMER][NEUTRAL] There was a claim for Saint Joseph's Hospital?
[AGENT][NEUTRAL] For which dependent?
[CUSTOMER][NEUTRAL] Are you seeing that?
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] OK, and what's the date of service?
[CUSTOMER][NEUTRAL] I, I don't remember right now.
[AGENT][NEUTRAL] OK. Was it an ER visit?
[CUSTOMER][NEUTRAL] Uh, no, it was, it was for about $3000.
[AGENT][NEUTRAL] OK, so was it a visit to the emergency room or for outpatient services? I would need some mhm.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Yeah, yeah, it was for.
[CUSTOMER][NEUTRAL] Some sort of uh heart monitoring or something.
[AGENT][NEUTRAL] OK, yes, ma'am. I'm showing it.
[CUSTOMER][NEUTRAL] It was an outage.
[AGENT][NEUTRAL] Yeah, I'm showing that for date of service [PII] and the claim um have been processed and it's denying, you will receive an explanation of benefits in the mail. With the reason for the denial, we would need the um diagnosis code and you can get the diagnosis code from the provider. We'll just need some type of documentation from the provider with the diagnosis code and you can resubmit that so that we can get it um paid and processed for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] This website is not as easy to sort out as your previous ones.
[AGENT][NEUTRAL] Oh, I apologize, ma'am.
[CUSTOMER][NEGATIVE] It doesn't, yeah, it doesn't show.
[CUSTOMER][NEUTRAL] What it's for. It just says co-insurance, medical expense. It doesn't show the name of the company, you know, the name of the hospital or anything. So it's very hard for me to sort out which is what is what.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] So you might wanna tell the people who run this website that you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I'm gonna look at it from the point of view of.
[CUSTOMER][NEUTRAL] Which hospital or which doctor, right? This doesn't show any doctor names or names. And so how are we supposed to know one, especially when, when somebody has a lot of issues going on, you know, a lot of claims.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I have no idea which is which.
[AGENT][NEUTRAL] Yeah, we usually go by the date of service, so that's how it's set up to go by the date of service. That's why that was the first question I asked.
[AGENT][NEUTRAL] But you thought it was easier to look it up by the provider. I'll suggest that.
[CUSTOMER][NEUTRAL] Yeah, but
[CUSTOMER][NEUTRAL] Yeah, yeah, because data service, you know.
[CUSTOMER][NEUTRAL] It's very hard to keep track of dates, right, in your life, like when did this happen? When did that happen? I don't know, it was some time recently.
[CUSTOMER][NEUTRAL] Uh, so for you, the service is, is good, but for us, for the user, it's more, you know, which doctor did we go to, which hospital did you go to?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm. Yes, ma'am. I understand.
[CUSTOMER][NEGATIVE] It's a very hard.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Well, is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No, that's all. Thanks very much. You've been helpful.
[AGENT][POSITIVE] OK. I thank you for calling APL. You have a great weekend. Mm bye.
[CUSTOMER][NEUTRAL] OK, bye-bye.
[AGENT][POSITIVE] Thank you.