AccountId: 011433970860
ContactId: f44e4ca4-a631-4bba-b00d-fcd11f61c07f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 985630 ms
Total Talk Time (AGENT): 526656 ms
Total Talk Time (CUSTOMER): 411869 ms
Interruptions: 17
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/f44e4ca4-a631-4bba-b00d-fcd11f61c07f_20250605T17:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Can you hear me OK?
[AGENT][NEUTRAL] Yeah, I can hear you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] I have, um, I've been with APL for a while as a secondary to Blue Cross Blue Shield, and I, because I, I'm trying to get into APL with my sign in for the first time in a long time, and I guess I completely forgot my, my ID and my password.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, it's not you, um, OK, so our website did just undergo quite a big change, um, so it's nothing that you've done or forgotten you would have to create a new account, um, and the biggest difference would be that you would use, uh, an email address, uh, to log in instead of uh user name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. How do I do this?
[AGENT][NEUTRAL] OK, so it's the exact same website, the same web address and everything, um, you would just simply go to uh create new account or new user.
[AGENT][NEUTRAL] And then it's all the same information, of course, it just has to be recreated.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I reach for an insured account.
[CUSTOMER][NEUTRAL] Let me make sure I still, can you, can you verify before I go and do all this that I'm, I still have an account with you?
[AGENT][POSITIVE] Oh, we can get that pulled up and make sure that what you're entering is correct. Absolutely, yeah, definitely, um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] OK, and then, uh, before we go any further, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Absolutely it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. Uh, do you happen to know your policy number?
[CUSTOMER][NEUTRAL] I have group number 15,710.
[AGENT][NEUTRAL] 15,710. OK, give me just a moment, let me see if I can find you there.
[AGENT][NEUTRAL] Bear with me just a moment.
[AGENT][POSITIVE] OK, I do believe I found you.
[CUSTOMER][NEUTRAL] So verification code while you're doing that, I'm also trying to get in so.
[AGENT][NEUTRAL] Oh sure.
[AGENT][NEUTRAL] No worries yeah no I do believe I found you um just gonna verify some information really quick uh can I get your
[AGENT][NEUTRAL] Your date of birth please?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] Thank you and then can I get your.
[AGENT][NEUTRAL] Or mailing address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect uh last thing I need is the email address that we've got on file for you uh looks like it's a Gmail account.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] Perfect alrighty thank you so much for verifying all of that. OK, so that is going to be um all of the information.
[AGENT][NEUTRAL] That you enter uh to create the account it would be that same email all of that uh it does have to match what we have in our system.
[AGENT][NEUTRAL] Um, and of course this policy still is currently active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK great so it's I got as far as OK verify your email, put in the code to verify it's my email and now it's saying new password. So do I need one of your passwords or do I just make up a password of my own?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, no, no, you could just make up your own whatever you'd like your password to be.
[CUSTOMER][NEUTRAL] OK. So I'm just while I have you on the line, I'm actually doing this display name, what does that mean, display name?
[AGENT][NEUTRAL] Oh yeah, sure.
[AGENT][NEUTRAL] Um, that's just your name.
[CUSTOMER][NEUTRAL] Do I need that?
[CUSTOMER][NEUTRAL] And my name's [PII], OK.
[CUSTOMER][NEUTRAL] OK. Please wait while we process your information.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Save. I agree to terms, I agree. Looks like it's letting me in. Your account has been successfully created. Yay. So now I should be able to get in. OK. Oh, nope, it's telling me to send a ver.
[AGENT][POSITIVE] Awesome.
[AGENT][POSITIVE] Yes, absolutely. It is going to.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Ask me again to send a verification.
[CUSTOMER][NEUTRAL] It is, it's asking me for a verification code again.
[AGENT][NEUTRAL] OK, so it.
[AGENT][NEUTRAL] Yes, so yes, uh it is going to do that uh every time you go to log in it will require a verification code.
[CUSTOMER][NEGATIVE] Oh my God. Oh, that's kind of a pain in the ass.
[AGENT][NEGATIVE] Yeah, it's a little annoying.
[CUSTOMER][NEUTRAL] Oh wow, really? Oh my gosh, [PII]. What if I don't have my verify code?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Continue.
[CUSTOMER][NEUTRAL] Welcome to the center. OK. Finally, let me in.
[AGENT][POSITIVE] Awesome. Alright, I'm so sorry it
[CUSTOMER][NEUTRAL] Now, if this is totally new. How do I find my stuff?
[AGENT][NEUTRAL] Oh absolutely it's only um been but like this little update happened uh just a couple of days ago so trust me when I say you are not the only one who has been the least bit confused as to what's going on and what happened.
[CUSTOMER][POSITIVE] Oh my gosh.
[CUSTOMER][NEUTRAL] Oh my gosh. 669-498-669498.
[AGENT][NEUTRAL] Yeah, it's been something.
[AGENT][NEUTRAL] Should though honestly it does look a lot cleaner I think um and it should just make the operations much much easier it's just that initial you know what is going on kind of thing.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, um, how do I, uh, I'm gonna let you go, I promise. I'm sorry because you're probably getting inundated with calls. Um, how do I find.
[AGENT][POSITIVE] You're OK, no, no, no worries. You are perfectly fine.
[CUSTOMER][NEUTRAL] How do I thank you? How do I find the, the most recent, uh, um, like I have a, I have a bill from the hospital. Yeah. How do I, how do I, how do I navigate this now? She's different.
[AGENT][NEUTRAL] Uh, claim
[AGENT][NEUTRAL] So the um yeah it's again it's pretty different so there is a spot where you can view a recent claim information I believe it's under oh goodness let me actually get it pulled up here so I can kind of look at it with you.
[AGENT][NEUTRAL] I don't remember the exact verbiage. I think it's the um on the left there under my policy.
[AGENT][NEUTRAL] Do you see that?
[CUSTOMER][NEUTRAL] Yes, I see my policy, and now I'm in, I'm in claims, not my details, but I'm, I'm in claims.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so click that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, OK, so, and it might take.
[CUSTOMER][NEUTRAL] So I want all.
[AGENT][NEUTRAL] Yes, and now it might take a while depending on how many claims there are uh the it could take a while for them all to uh populate or if you're looking for um wanting to access the actual explanation of benefits, uh, if you see a little circle kind of rotating on the top right of the claim, it's downloading that or making that information available to download.
[CUSTOMER][NEUTRAL] OK, so I have a, I have a particular claim. I'm glad I kept you on the phone cause I don't see this claim here. You paid recently, the most recent claim you paid was like $1500 and I don't see that here. I saw it a couple of months ago when you paid it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're fine.
[AGENT][NEUTRAL] Mhm. I see.
[AGENT][NEUTRAL] 1500.
[AGENT][NEUTRAL] OK, let's see now was this claim for you or was this for um [PII]?
[CUSTOMER][NEUTRAL] It's for me. It is for me, not my husband, it's for me.
[AGENT][NEUTRAL] It was for you. OK, let's take a look.
[AGENT][NEUTRAL] Let's take a look.
[AGENT][NEUTRAL] The last claim I'm showing we paid was in December. There it is 1500 there it is OK that looks like that was in December, um, so again it might just be taking a while for that information to um populate or you know gathering that information. I have watched in real time uh this entire process so I can honestly tell you it might just be taking a while for it to load um I think with it being so.
[CUSTOMER][NEUTRAL] Yeah, I have a bit of
[CUSTOMER][NEUTRAL] Right. How do I find that?
[AGENT][NEUTRAL] Fresh off the plate, you know, it's might just be taking it a little bit. So if you would like, are you wanting a copy of the EOB?
[CUSTOMER][NEUTRAL] I, I, yeah, I need to pay this like I'm overdue and paying it and, and on that note, Delray Medical isn't acknowledging that they got this payment. Like I'm just making sure of what I'm paying, so I actually do need to talk to you.
[AGENT][NEUTRAL] 00, yes, we did pay them as well.
[AGENT][POSITIVE] Absolutely. OK, so let me, oh yes, we paid $1500 to them. They're the ones that filed the claim, so I can absolutely get this, uh, explanation of benefits sent to you.
[CUSTOMER][NEUTRAL] You did.
[AGENT][NEUTRAL] I also recommend just for the sake of you know you're not having to be stuck in the middle um having them reach out to us so that we can confirm you know if there's um an incorrect address that we sent it to if they never received it um it could be an honest mistake like that um but they should reach out to us regarding that um let's see.
[CUSTOMER][NEUTRAL] I will do that, but could you send that EOB to my email so that I can be in control and try and deal with this for you so that you don't have to if you don't necessarily, and I'm, I'm, this is for Service state.
[AGENT][NEUTRAL] Oh yes.
[AGENT][POSITIVE] Absolutely. Oh yes, just know that that option is there.
[CUSTOMER][NEUTRAL] Yes, the er this is for Service date. I'm making sure we're on the same page here. [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That is correct. Let's see, yes, um, Delray Medical Center, yes, uh, paid to provider $1500.
[CUSTOMER][NEUTRAL] Now, just out of curiosity, why did you pay the, the full deductible? Usually you do. Has your policy changed?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see and let's take a look at what this one is.
[CUSTOMER][NEUTRAL] Because the year before, I was in the hospital too, and they paid all 3000.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it does say that with this payment um it did meet the maximum so let me take a look there is one claim that was just before this one.
[CUSTOMER][NEUTRAL] This time they're only paying half.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That was also
[CUSTOMER][NEUTRAL] Oh, there was.
[AGENT][NEUTRAL] Oh yes, this one is also, there were 2, there were two claims. Um, oh goodness, OK. There were 2 for [PII], um, both for Delray Medical Center and on both of these, we paid $1500.
[CUSTOMER][NEUTRAL] Oh my gosh, are they two separate claims?
[AGENT][POSITIVE] So I will send that to you as well. Yes, I will send that to you as well, absolutely.
[CUSTOMER][NEUTRAL] Please, yes. Well, then that explains that, so they don't, they're not receiving it or something. I need, yeah, I, I, if you can email that to my email.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, there must be some kind of, yes, absolutely, um, do you want to send it just to this Gmail account that we have for you?
[CUSTOMER][NEUTRAL] Yeah, please, please, please the [PII] I just gave you [PII], send me all that and then.
[AGENT][POSITIVE] With [PII], yes, absolutely. OK, I will go ahead and send both of those to you.
[CUSTOMER][NEUTRAL] And I will take care of this with the Deray Medical Center. I just need, I need, I can't speak intelligently until I know what's been paid and what hasn't.
[AGENT][NEUTRAL] Oh wait, hold on.
[AGENT][POSITIVE] Give me, I'm so sorry for the confusion. Give me just a second. Let me see.
[CUSTOMER][POSITIVE] By all means. Thank you for helping me.
[AGENT][NEUTRAL] It's kind of a, yeah, definitely. I just don't want there to be any kind of.
[AGENT][NEUTRAL] Hiccups or anything like that? OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Cause Debra Medical Center, of course, they don't send an EOB. They just send the bill.
[CUSTOMER][NEGATIVE] And you're supposed to, I guess, know what this is, what the bill is for. They never sent any explanation of any kind.
[AGENT][POSITIVE] Oh yeah, of course, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm sorry about the confusion, [PII]. um, so there was just the one claim your outpatient benefit for the calendar year is a maximum of $1500. This was one claim. It looks like there were, uh, it might have been submitted a couple of times, so I apologize for that confusion. So it was the single claim, um, and the single payment of $1500 which did meet your outpatient maximum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so if you could at least send me that, that's no problem, no, no, no problem.
[AGENT][POSITIVE] OK, I'm so sorry about that confusion. Oh yes, definitely. I just didn't wanna.
[AGENT][NEUTRAL] OK, I will get that sent now you should be getting that shortly um do you have any other questions for me at the moment?
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Is there any other way for me to get this information like once I hang up from you if I don't get it, you're saying it's it will show up in the claims section of.
[AGENT][NEUTRAL] Yes, it will be on the online portal. Oh, I can go ahead and give you that claim number as well if you'd like to write that down just so you know exactly what you'd be looking at.
[CUSTOMER][POSITIVE] Oh my God, yes, that would help me. Yeah, let me see it clean, I'm ready.
[AGENT][NEUTRAL] Sure, let me know when you're ready.
[AGENT][NEUTRAL] OK, that is 35.
[AGENT][NEUTRAL] 42.
[AGENT][NEUTRAL] 874.
[CUSTOMER][NEUTRAL] Let me repeat that 3542874.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] 3542874
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] My dyslexia is kicking in. OK.
[AGENT][NEGATIVE] No, I have to read it out loud like a million times too just like that's not right, is it? It is right.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] Oh my God, I'm like an idiot where that's concerned. OK, and so if I, let me ask you, uh, let me go one step further. If I put in that claim number, maybe it would populate.
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] If yes, if you have that you can um you should be able to search um otherwise you know you can scroll there's doesn't appear to be that many claims that we have for you um but this one would be pretty close to the bottom it looks like that was actually one of the first claims we received.
[CUSTOMER][NEUTRAL] 35428.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] My policy.
[CUSTOMER][NEGATIVE] Uh, the system does not like me. It's, I'm, I guess I'm asking too much too quick with the system. Oh God.
[AGENT][NEUTRAL] No, it's, it needs to take its time. I think it's still kind of learning what it's doing like I said it just launched a couple of days ago.
[CUSTOMER][NEUTRAL] Oh God
[CUSTOMER][NEGATIVE] Text message, I mean, like it's constantly, it doesn't let you go. 651-273651-273. It, it's constantly asking for verification so you can't get to what you want to get to.
[CUSTOMER][NEUTRAL] All right, hold on. Profile insured Metlink. OK, this is all about my coverage. Whoops, no, I want claims.
[CUSTOMER][NEUTRAL] And now if I put in claims and I put in search.
[CUSTOMER][NEUTRAL] Should I, would I be able to put in the claims number and search that number?
[AGENT][NEUTRAL] I think so, but honestly again there's not that many um on file so you should just be able to scroll kind of towards the bottom.
[AGENT][POSITIVE] Tell you what, I'm also going to send you I'm sorry, you're gonna get a couple of emails from me, [PII]. I'm also going to send you uh there is a user guide um that they've created and you can kind of learn the new system a bit um so I'll go ahead and send that to you as well if you'd like.
[CUSTOMER][POSITIVE] Oh, that would be wonderful.
[CUSTOMER][NEUTRAL] And I think I just got your email.
[AGENT][NEUTRAL] And I felt like I had to.
[AGENT][NEUTRAL] Take a look at it myself every now and then because I'm still.
[AGENT][NEUTRAL] I'm still trying to learn to see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I just got your email thank you so much.
[AGENT][POSITIVE] Oh, you are very welcome um you'll be getting another one from me for the with this uh user guide, um.
[CUSTOMER][POSITIVE] That helps
[AGENT][NEUTRAL] Do you have any other questions for me at the moment?
[CUSTOMER][POSITIVE] No, you've been so helpful in dealing with my stuff. Thank you.
[AGENT][POSITIVE] All right. Oh, no, no, no, I completely understand and I'm happy to help. Well, I hope you have a great rest of your day, [PII].
[CUSTOMER][POSITIVE] I will thank you so much for all your help. I appreciate you have a wonderful day.
[AGENT][POSITIVE] You are very welcome. You too, thank you. Bye bye.
[CUSTOMER][POSITIVE] OK talk to you soon bye bye.
[AGENT][NEUTRAL] Bye.