AccountId: 011433970860
ContactId: edb53fe8-6bef-4bb0-9f86-77d2386a1f65
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 797159 ms
Total Talk Time (AGENT): 214036 ms
Total Talk Time (CUSTOMER): 224063 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/edb53fe8-6bef-4bb0-9f86-77d2386a1f65_20250224T20:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? So, um, I wanted to get access to my account. Um, I need access to the payment that you guys made to the hospital. So I don't know if I try to give you my.
[AGENT][NEUTRAL] You're trying to take a claim?
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] Yes, I wanna have access to that claim.
[AGENT][NEUTRAL] OK. And you're the insured?
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] You're the insured or you're calling with the provider's office or? OK. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] I insured. I'm insured.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And [PII], may I have your policy number?
[CUSTOMER][POSITIVE] Yes, give me one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it is um
[CUSTOMER][NEUTRAL] In hospital benefit? Is that the one?
[AGENT][POSITIVE] Yes, we can use that.
[CUSTOMER][NEUTRAL] 02273057
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 7.
[AGENT][NEUTRAL] Thank you for that and I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII]. And then my birthday is [PII], I mean, [PII]. Um my email is [PII]. And what else? What?
[AGENT][NEUTRAL] Your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So when you say you need access to the account, are you speaking of the online portal?
[CUSTOMER][NEUTRAL] 5.
[CUSTOMER][NEUTRAL] Yes, and also when I have the, if you could send me what we pay to the hospital.
[CUSTOMER][NEUTRAL] To some Miami hospital if you could send me that information.
[AGENT][NEUTRAL] OK, let me take a look at the policy. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait, and you said it was for November of last year?
[CUSTOMER][NEUTRAL] Well, it should be well, the hospital was [PII]. I don't know when they, when they send the claim.
[AGENT][NEUTRAL] Oh, October. Oh, I'm thinking of your birthday. OK. Sorry about that. I'm thinking of November.
[CUSTOMER][NEUTRAL] Yeah, the, yeah, it was when my, no, yeah, my baby was born, so I'm trying to figure out those bills.
[AGENT][NEUTRAL] Would this be, OK, so I see a few. I see one for [PII]. This looks like anesthesia.
[CUSTOMER][NEUTRAL] Yes. Yes.
[CUSTOMER][NEUTRAL] Yes, but it should be the hospital, not the anesthesia.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on, there's more, let me see.
[CUSTOMER][NEUTRAL] From [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Hold on one moment. There's about 4 of them. I'm gonna see which one.
[AGENT][NEUTRAL] Oh, here it is, um, South Miami Hospital.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so this one.
[AGENT][NEUTRAL] [PII]. OK, and you said you want to be able to access it on the online service center?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I, I just don't know how to get access if, if, um, I just need a copy of those bills.
[AGENT][NEUTRAL] OK, um, so we do have the online service center, um, that's like our online portal. I can let you know how to access that, or did you just want me to send you a copy of the explanation of benefits? We paid it in full, the $1983.
[CUSTOMER][NEUTRAL] Yeah, if you could send me both things, if you could let me know how to access it and also you could send me that and whatever documents that you guys already paid.
[AGENT][NEUTRAL] OK, hold on one moment. So let me go to the, are you near a computer now?
[CUSTOMER][NEUTRAL] Um, yes, give me one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I am.
[AGENT][NEUTRAL] OK, so you're gonna go to um [PII].
[CUSTOMER][NEUTRAL] OK, so you
[CUSTOMER][NEUTRAL] So you said [PII]
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then what [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, right there.
[AGENT][NEUTRAL] All right, and then once it comes up, you're going to look to the top right and you'll see sign up. It may say sign in.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so click there and then once that page comes up, you're gonna click on new user.
[CUSTOMER][NEUTRAL] Yeah, I'm there.
[AGENT][NEUTRAL] Alright, so from new user, you'll choose I'm an individual.
[AGENT][NEUTRAL] And then you could just follow those prompts. Um, when it asks for your social security number or your member ID, um, make sure you put your full social there.
[CUSTOMER][NEUTRAL] OK. But am I registered already?
[AGENT][NEUTRAL] That's what we're doing now.
[CUSTOMER][NEUTRAL] I will
[CUSTOMER][NEUTRAL] But I don't have a username.
[AGENT][NEUTRAL] Oh, I searched to see if you had a um account already and you didn't.
[CUSTOMER][NEUTRAL] Uh, I didn't. OK, OK. Got you.
[CUSTOMER][NEUTRAL] OK. If I don't wanna put my social, can I put my member ID?
[AGENT][NEUTRAL] We don't have a member ID, um, in that field is only for the social.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, on one second.
[CUSTOMER][NEUTRAL] Let me go through my phone just because I'm not in my.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm trying to come up with um the username.
[AGENT][POSITIVE] Mhm. Take your time.
[AGENT][POSITIVE] And I just sent you over the explanation of benefits as well, so you should be receiving that in your email shortly.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I think I.
[CUSTOMER][NEUTRAL] I think I um in so then you said.
[CUSTOMER][NEUTRAL] OK, when proceed, proceed. OK, I see the
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, so I'm able to see here.
[AGENT][NEUTRAL] You got logged in?
[CUSTOMER][NEUTRAL] Basically what that logged in, yeah, I logged in right now.
[AGENT][NEUTRAL] OK, so you're gonna go to my claims?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I see contact, claim forms help, and then I see at the bottom claims receiving the last 24 hours.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] So it should be on your dashboard, um, like once you get in there and you see your name and everything and your coverage, there should be a contact us or a claim form at the top.
[CUSTOMER][POSITIVE] Oh yes, I see a contact us OK.
[CUSTOMER][NEUTRAL] Claim claim form.
[AGENT][NEUTRAL] Mhm. When you click on claim forms, um, do you see my claims? It should, it should be on your dashboard though.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I see the dashboard. Hold on.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Oh, I.
[CUSTOMER][NEUTRAL] Yeah, I see all the claims so far.
[AGENT][NEUTRAL] OK, so if you see all the claims, you're looking for claim number 3546513?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So you see the one that says uh claims in the last 24 hours.
[AGENT][NEUTRAL] It says, say that again?
[CUSTOMER][POSITIVE] Thank the city the past 24 months, I mean.
[AGENT][NEUTRAL] Right, and then do you see like the list of the claim numbers?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Oh yeah, yeah, I see the list. OK, so it's the one that I put up.
[AGENT][NEUTRAL] So you're looking for
[AGENT][NEUTRAL] You're looking for the one that ends in 6513?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] And then it should have a link to the documents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that'll be the same thing uh um that you have in your email.
[CUSTOMER][POSITIVE] Perfect. Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, no, I think that's it. Thank you.
[AGENT][POSITIVE] Alrighty, well, you're welcome and thanks for calling APL. I hope you have a great day, [PII].
[CUSTOMER][POSITIVE] You too. Thank you. Bye. Thanks.
[AGENT][POSITIVE] Thank you. You're welcome.