AccountId: 011433970860
ContactId: efc271c5-c0cc-4e97-a741-9929732ad4e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 507179 ms
Total Talk Time (AGENT): 224057 ms
Total Talk Time (CUSTOMER): 233773 ms
Interruptions: 8
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/efc271c5-c0cc-4e97-a741-9929732ad4e3_20250325T21:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Uh, hi, [PII]. I just got a check in the mail from uh APL uh for $75. Uh, I know a claim has been submitted and I was expecting, first of all, this to go directly to the, the healthcare provider and it was supposed to be, I think, 4 times as much, but I only see one. I don't know exactly what happened. I tried to get to log into my account. It seems like, uh,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] As they couldn't recognize me. So I don't, uh, if maybe you can just check my profile and let me know what was paid.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely I can take a look at that claim, yes, absolutely we'll take a look at that claim and just verify uh what that check was regarding um what was your name?
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And last name is [PII]
[AGENT][NEUTRAL] OK thank you and then just before we go any further, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, I have the policy number, yeah, it's 02584564.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and then uh just gonna verify some information really quick just can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and can I get your mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you uh looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] Awesome thank you so much for verifying that information OK and this claim um this was for you, is that correct or was this for, uh, [PII]?
[CUSTOMER][NEUTRAL] No, it's for me.
[AGENT][NEUTRAL] It was for you, OK, give me just a moment, let me take a look there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so right off I will tell you the reason you received the check and not the provider is because you are the one who filed the claim so that's how we work how we operate if you file the claim we're going to send that information to you.
[CUSTOMER][NEUTRAL] Actually, I'm sorry, he filed the claim. I think he's the one who filed the claim, the provider.
[AGENT][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] OK, that's not the information we're showing we are showing that it was uh through you.
[CUSTOMER][NEUTRAL] Or maybe there was a mistake. Did you pay the, the provider anything? Uh, can you check if how much?
[AGENT][NEUTRAL] Maybe.
[AGENT][NEUTRAL] No, so this is the only.
[AGENT][NEUTRAL] Yes, so this is the only claim we've got on file for you it's just this one,
[AGENT][NEUTRAL] Let's see, and we did pay that benefit of $75 so that is that check, um, and per this policy that is the maximum amount payable for this service.
[CUSTOMER][NEGATIVE] No, I was expecting $75 per visit, not $75 for everything.
[AGENT][NEUTRAL] Yes, that's the maximum, uh, uh, for date of excuse me, per date of service.
[CUSTOMER][NEUTRAL] Yeah, for service. So is he expecting, yeah, I'm looking.
[AGENT][NEUTRAL] For the date for the date of service.
[CUSTOMER][NEUTRAL] OK. So there will be a uh checks coming. So this is only for [PII], correct?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, that is the only claim that I'm showing for you is for that date of service that's correct.
[CUSTOMER][NEUTRAL] OK, yeah, because there are 4 sessions and it's, did you, did you receive a claim for the other sessions or sessions.
[AGENT][NEUTRAL] I have not, uh, again this is the only claim that I've got on file for you, uh, depending on when they were sent it's possible that they're uh still being processed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, I got you, thank you. I just have to get in touch with the, the, with the, the provider and just basically send this to him. OK, alright, so, uh, now the other question is I was trying to log into my account online because in here according to this notice they say you can log in but I didn't know what was my login ID or password. Do you have a login ID for me? Is that my email address?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Give me just a moment let me.
[AGENT][NEUTRAL] I can definitely see if you have created an account and I can get that username if you have uh give me just a moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I'm showing that you have not yet set up an online account, um, so you would set up as a new user.
[CUSTOMER][NEUTRAL] Set it up as me. Now they're asking because I hesitated to set it up because they're asking for the social, the full social security number. Is that a normal thing that you guys do?
[AGENT][POSITIVE] Right, that's correct.
[AGENT][NEUTRAL] Yes absolutely so that portion where it asks for that or a member ID you would have to uh put in your social um the member ID is different from the policy number, so it would not work otherwise um and then you would just enter in all of the information that we just verified so you would use that same uh Gmail account that we've got.
[CUSTOMER][NEUTRAL] OK, all right. I just wanna, I wanna.
[CUSTOMER][NEUTRAL] I try, but.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, I tried but it didn't go through for some reason. It says something went wrong now do you have by any chance the let let me go back let me see if I can go back.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, see if I can do this while I still have you new user.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm an individual.
[CUSTOMER][NEUTRAL] Next, so.
[CUSTOMER][NEUTRAL] Uh, let's see, I'm gonna, I'm gonna do I'll have you on the phone.
[CUSTOMER][NEUTRAL] Now instead of a first, do you have member member ID?
[AGENT][NEUTRAL] No, um, so there's specific policies that have a member ID. This kind of policy does not, so that's why you would use your social.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Because I tried this the last time and it's just now when I enter the social I don't put any uh like uh it's just 11 number no dashes nothing OK.
[AGENT][NEUTRAL] No dashes, right.
[AGENT][POSITIVE] That's correct, just the numbers.
[CUSTOMER][NEUTRAL] Alright, so I'm trying it while I have you on the phone, so bear with me for a second.
[AGENT][POSITIVE] Sure, absolutely.
[AGENT][NEUTRAL] Yeah, of course.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] So I'm entering everything the same way and it. OK, let's see next. So, OK, OK, I think this time it seems to be working all right, so I can create a new user. OK, alright, thank you so much. I appreciate it.
[AGENT][POSITIVE] OK awesome.
[AGENT][NEUTRAL] Yes, um, and so if you ever forget uh the user name uh or anything like that that's very easy for us to recover so you could just give us a call back um I will tell you well I've got you just so that you're aware um our website really doesn't have a lot of.
[AGENT][NEUTRAL] For for mobile devices, so like phones or tablets so if you were to upload a claim information it would have to be done on a desktop or a laptop computer but most everything else I believe you can do through a mobile device if you were just to check on a status or something like that.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] No, for the username, can I enter my email address as the username?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I don't, I mean you could try, um, I, I don't know that I've not seen anyone who has before, so I'm not sure, um, but I think you should be able to.
[CUSTOMER][POSITIVE] It's OK, no problem.
[CUSTOMER][POSITIVE] OK, it's all right. It's just because it's easier for me to remember. Alright, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, oh yeah, I understand. Yeah, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] No, that's it. Thank you. You have a good day. Take care.
[AGENT][POSITIVE] Alright, yeah, thanks for calling APL you too thank you bye bye.
[CUSTOMER][NEUTRAL] Bye.