AccountId: 011433970860
ContactId: 02897c31-4ca6-4458-a47f-68ebcfa59acc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1053839 ms
Total Talk Time (AGENT): 450358 ms
Total Talk Time (CUSTOMER): 665659 ms
Interruptions: 13
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/02897c31-4ca6-4458-a47f-68ebcfa59acc_20250617T18:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII] and my husband has insurance through Williams Communications um for this APL gap, um, and I need to find out what this is because I was just in the hospital and I need to know what all kind of insurance we have.
[AGENT][NEUTRAL] OK, sure, Ms. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh huh [PII].
[AGENT][NEUTRAL] Thank you and may I have the policy number?
[CUSTOMER][NEUTRAL] Um, let's see here. OK, yes, that is 025593-04.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It says policy and certificate number.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so for security, may I have your date of birth and the mailing address on file?
[CUSTOMER][NEUTRAL] My date of birth is [PII] and the mailing address is [PII].
[AGENT][POSITIVE] Mm perfect, thank you. All right, let me go ahead and pull your benefits. One moment.
[AGENT][NEUTRAL] And you said you just went to, was it a clinic or urgent care?
[CUSTOMER][NEUTRAL] Uh, I went to urgent care and then they took me to the hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK. All right. OK, yeah, so.
[CUSTOMER][NEUTRAL] So both
[CUSTOMER][NEUTRAL] Yeah, I was in the hospital for 7 days.
[AGENT][POSITIVE] Oh wow. OK. Well, I'm glad you're better and you're out.
[CUSTOMER][NEGATIVE] Yeah, it's, it's not fun at all to be, it's not fun at all to be in the hospital, not at all, especially when you're in so much pain, you know, especially when you're in so much pain.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] It's not, mm.
[AGENT][NEGATIVE] Mhm. Yes, I know. Be there, no, it's, it's too much. It's like you cannot rest if it's not the pain, it's everybody else coming in, not letting you rest.
[CUSTOMER][POSITIVE] Exactly coming in and.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. So let's see. So this is a secondary supplemental plan to the major medical. Um, with this one, what we do is we help with the deductibles, co-payment, and co-insurance from the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And um let's see, so you have benefits on this one, let me break down.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, for
[CUSTOMER][NEUTRAL] Now when you say uh copay and insure whatever that that other thing you said insure something whatever is that um you like coin insurance yeah is that like when I go to the doctor because they charge that to me sometimes and I just paid on his card. So is that completed like is this this card take care of that?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Coin insurance. Mhm.
[AGENT][NEUTRAL] Not for the office visit. No. The office visits are not covered. So you, you should have a co-payment that you need to pay for an office visit. That co-payment is not covered by this one. we will cover if they do a treatment, like if they have to do a um sonogram X-ray, if they have to give you an injection, those kind of treatments or procedures are the ones that are covered.
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] Oh, OK, so when I was in the, so when I was in, right, so when I was in the hospital, does it cover those things? They did a lot of those things on me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Yes, um, let me go ahead and give you the benefit for the inpatient and outpatient and give you the difference of both of them. And this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. OK, so for the inpatient, you have a maximum benefit of 5000. That is your maximum benefit for inpatient. Inpatient is if you're in the hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Inpatient. That means I'm in the hospital.
[AGENT][NEUTRAL] Yes, if you're in the hospital 18 hours or more, that becomes an inpatient stay, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] Um, and that's the benefit. OK, for outpatient service, outpatient service is less than 18 hours, you're in and out of the hospital, either in an ER or if they have to like urgent care, um, treatment in the office. Those are covered at $500 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I was in the hospital for 7 days.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Not 7 days. I wanted to be there either, but I was in there for 7 days doing tests and operating and uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, I understand. Yes, so what you need to do at this point, um, if it's easier for you, you can go ahead and give this information to the hospital so they can go ahead and submit the claim directly to us, and you don't have to go through all the troubles of getting all the information. Yes. But just in case you want to submit your own claim, you can, but it's just a lot easier if they handle that for you.
[CUSTOMER][NEUTRAL] here
[CUSTOMER][NEUTRAL] I will do that.
[CUSTOMER][NEUTRAL] OK, we'll do that.
[CUSTOMER][NEUTRAL] OK, no, I'm gonna let them do it. I'm gonna let them do it. I don't care. I am gonna get the records though, so I am, um, because I need them for something else. I have to get the records, so but I'm just going to um keep on them and let them do it. Why should I gotta go through it all when they can do it?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh, right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, yes, they can go ahead and submit it. Yeah, so that's all they need to do is just go ahead and get the information of the card and submit the claim over to us once they receive all the information from the major medical.
[CUSTOMER][NEUTRAL] OK. All right. OK. And the hospital will do that. That's the hospital, right?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, usually they do, um, hospitals, they, they don't have no problems of sending secondary insurance. So, yeah, they usually go ahead and send us the claim and send all the paperwork we need with them.
[CUSTOMER][NEUTRAL] OK, alright, and that's for the and and then they would do they know where to send it or do I give them an address on the back of this file?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, you will give them all the information on the card. It's OK. You don't have to look at it. You can, whenever you get home, you can look at it. But yes, um, you need to give all the information on the card. Maybe they will ask you to send them a copy, just go ahead and send them a copy of it. um, but the information in the back is the mailing address, which is should be the one in [PII], and there's a fax number if they need to fax it. So just all the information on the card for them to process that claim, OK?
[CUSTOMER][NEUTRAL] Um, I'm sorry, I'm trying to drive to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, I can do that, yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, I can tell them I will call them today or tomorrow. I might not get home in time today, but I'll call them about that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I, I one thing I wanna go.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, do you have any other questions?
[CUSTOMER][NEUTRAL] I'm listening, honey. I'm driving, so, um, no.
[AGENT][NEUTRAL] No, it's OK, I understand.
[CUSTOMER][NEUTRAL] No, if that's all that's covered on there now, does, um, let me ask you, yeah, let me ask you a couple of questions, honey. The surgery, like when you have surgery, does any of that it covered on this?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Um, yes, it depends if you had.
[CUSTOMER][POSITIVE] I, I, I'm assured that they would.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] It's OK. No, no, no, go ahead.
[AGENT][NEUTRAL] OK, so, OK, OK. So it's basically everything that happened during that day is gonna be um processed under that $5000. So anything that happened during that day. So if if everything happened during that.
[CUSTOMER][NEUTRAL] Go ahead honey you can tell me what you forgot to tell me.
[AGENT][NEUTRAL] Those 7 days that you were in the hospital, that is what they're gonna charge. But we do cover surgery if you were in hospital, but you, we also cover surgery if you have like an in and out surgery, like a small surgery, then you can go in and get out the same day. Now,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][MIXED] I could have only wished that that was an in and out, but, but that's good to know though, that's a good thing to know, you know, so.
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Yes. Mhm. Yes. Now, the benefit amount for the outpatient, again, is $500 a day. So anything that is outpatient that is in and out is $500 a day.
[CUSTOMER][NEUTRAL] OK, OK, I get it. Alright, so we'll, I'll turn this all, I'll turn this over to them and tell them what they need to do and if they don't cooperate with me, then I will tell them, you know, you, you need to do this. This is what my insurance told me to do, told me to tell you, so.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, and if they have, mhm, go ahead.
[CUSTOMER][NEUTRAL] Now let me ask you one other question.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] There is another part of this insurance that we have and I don't know what it is. It, it's uh it's uh like a number 8 and it says guardian. Do you have anything to do with that?
[AGENT][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] Oh no, no, never mind, you won't. That's dental. That's dental. That's dental. Sorry about that. That's dental. OK, alright, so, so I will, I can have them just send you guys the information, just send it directly to you guys, OK, I can do that and let's see, let's make sure, OK, uh, to check claims status and I ain't doing that.
[AGENT][NEUTRAL] Yeah. Mhm. OK. Yeah, no, no, it's OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] Uh, I'm trying to drive and to do all this. All claims should be submitted to, OK, and it has American Public Life [PII] and it's got phone number there and a fax number. OK, so that's where they should send the claims to.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, alright, I will get on top of this and I will tell them and yeah, you know, I'm gonna have to fight with them I'm sure.
[AGENT][NEUTRAL] You
[CUSTOMER][NEGATIVE] I, I, I, insurance companies drive me crazy. They really do. They drive me out of my mind. Like, are you kidding me?
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So, but that's OK, but that's OK and they'll, so they'll pay directly to the hospital the money, the $500 a day and all that they'll just directly pay it to the people that are sending the bill.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Correct, we will pay to whoever sent the claim. If the provider or the hospital sends the claim, that's who we're gonna pay to. If the insured decides to send their own claim, then that's who we're gonna pay to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, I can't send you the claims though.
[CUSTOMER][NEGATIVE] Is that right? I can't send you the claims. I really don't want to. I really want them to do their job. I.
[AGENT][NEUTRAL] You can.
[AGENT][NEUTRAL] Yeah, that's optional. Mhm. Yeah, that's optional. Either you send it or they send it, but yeah, that's.
[CUSTOMER][NEUTRAL] That's just more work for me.
[CUSTOMER][NEUTRAL] OK, well, if I decide that I'm gonna have them, yeah, if I decide I'm gonna have them give me anything which I have to get stuff for some uh something else, but if I decide that they need to give me anything I might do that or I might just tell them nope this is where you send the claims to.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][POSITIVE] So you'll get paid
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, alright, honey, thank you so much and I, I hope you have a great day. That's good because I've never used this card my husband's had this insurance since.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] 11 124 and, and I didn't even know what the card was for, to tell you the truth.
[AGENT][POSITIVE] Oh boy. Oh boy. Yeah, if you have anything that you have done prior.
[CUSTOMER][NEUTRAL] I figured, well, I better be taking me.
[AGENT][POSITIVE] Yeah, I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, I'm like, I don't, I see, I just go to the doctor normally. I, the last time I was in the hospital was
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What did I have done in the hospital last? I can't even remember. Oh, when I broke my hip, but I didn't have this at that time because we only got this on [PII]. That's why I don't know anything about it because I don't know what it is. I'm like I'm gonna have to call and get some information.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, yes. Do you need me to.
[CUSTOMER][NEGATIVE] But I told my husband with all the insurances that we have mine and his, we shouldn't be paying anything for these bills.
[AGENT][NEUTRAL] Probably, yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That, that, that is the, the reason we get them, but yeah.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Sometimes it works, sometimes it doesn't.
[CUSTOMER][NEUTRAL] Yeah and it's a reason to have that. Yeah, it's a reason to have that, yeah, you pay for it every month, but it adds up $500 a day for the hospital. I was in there 7 days.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] That's like $3500.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] You know, so
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] It, it, it's, it's worth it to me. It's worth it to me because I'm, I live on Social Security. My husband works, but you know, I can't get a job. I can't work because I don't, I, they can't, um, I have to have a job where I can sit when I need to stand when I need to because I got teoarthritis in my back, so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It's like a job for me. I'm [PII], you know, people don't want to hire people like that that have disabilities and then they have to go with the disabilities, you know what I mean? And so people don't wanna hire people like that nowadays, and then they hire these young kids that don't wanna work, they just wanna stay on their phones.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] They do. I think it's it's terrible.
[AGENT][POSITIVE] That is good. Yeah, yeah, I understand. I understand exactly what you're saying because yeah, there's a lot of them.
[CUSTOMER][NEUTRAL] Yeah, yeah, there is a lot of them.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] And I don't understand, you know, my thing is, what are they going to do? What are they going to do if, you know, [PII] gets all these things that he wants done? What are these young people gonna do?
[AGENT][NEUTRAL] Live with mom and dad.
[CUSTOMER][NEGATIVE] You know, you, do you not, do you not understand? Yeah. Do you not understand that you have got to work to make a living?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] You know, your parents, look at your parents. Your parents did that their whole life.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, but that's why we are where we are. Mhm. Yes.
[CUSTOMER][NEUTRAL] You know, but
[CUSTOMER][POSITIVE] Yep, uh huh, um, but I'm glad I taught my son some he's got a good work ethic and everything in that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] You know, I taught him nothing comes for free. Nothing in life is free.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You know, when he was younger.
[AGENT][NEUTRAL] No. Somebody has to pay.
[CUSTOMER][NEUTRAL] Uh, that's right. He'd say, Mom, can I have some money to go to the movies? And I said, oh, what are you gonna do for me?
[CUSTOMER][NEUTRAL] And they had a they had a a school trip that they were gonna go on that would cost $200 and he came to me and he said, Mom, we're having a school trip, um, and it, I know it costs $200 could you help me to get the money? I said, Well, do you have any money?
[AGENT][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] No, he said no. I said, OK, well [PII], I don't really think we have anything to talk about because remember we talked about this before we talked about this and what did I tell you? The only way that you're gonna get anything out of life is if you pay for it, so you have to go out there and find at least you have to work for at least half of that money. So when you get $100 you come to me.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I will give you the, me and your dad will give you the other 100. You know, his dad's like, just give it to him. I'm like, no, you cannot treat children like that. You got to, you got to give them some kind of morals about life. You got to make them, you know, you gotta make them be responsible.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][POSITIVE] Yes, that's right.
[CUSTOMER][NEGATIVE] So he went out that weekend. He was so tired, honey, and so dirty when he came home. He went out that weekend, got his $100 and I gave him the other $100. I said, now, see, don't you feel better that you did some of that instead of getting it all from us? Don't you feel better?
[CUSTOMER][POSITIVE] And he said, yeah, so, you know, it was hard for him, but he was able to do it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] He didn't. Yeah, that's great. Mhm.
[CUSTOMER][NEUTRAL] You know?
[AGENT][NEUTRAL] Yeah I know, yeah, that's.
[CUSTOMER][NEUTRAL] Now nowadays, these kids, they're [PII], [PII] old. Hey mom, can I have some money to go to the movies with my girlfriend?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And they're living, moving in back home with their parents at [PII] and [PII] old. They're moving into their parents' house to live.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] I can't, I just can't stand it.
[AGENT][NEUTRAL] Oh, me neither, trust me.
[CUSTOMER][POSITIVE] So you know, but I'm gonna let you go. I know you have more customers than me, honey, but thank you so much. I learned a lot about this and I will get on top of it. I'm already on top of it, but you know it takes a while to get stuff.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. Yes.
[AGENT][NEUTRAL] All right, Mr. [PII].
[AGENT][NEUTRAL] Yes, yes, I understand. Yeah, take your time, but yeah, you can always uh call us back if you have any questions, OK?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK honey thank you very much and I hope you have a great day. Oh wait a minute, let me ask you a question one more before I get off the phone now oh you said that they would send them to to check claim status or view blah blah blah and register at but they would send them to oh the [PII].
[AGENT][POSITIVE] All right. You're welcome.
[AGENT][NEUTRAL] New US yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure, yeah.
[AGENT][NEUTRAL] In [PII]. Yes, that is the address.
[CUSTOMER][POSITIVE] OK, alright, I got it. That's where they'll send it. Alright, I will have that done. I'm sure it's gonna take me a while to even get this straight, but I will get it done.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] All right. All right. Well, you have a good afternoon, Ms. [PII]. Nice to talk to you. Thank you. Bye-bye.
[CUSTOMER][POSITIVE] You have a good day sweetie.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] You too bye bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so that works good and we get the $500 from them and.
[CUSTOMER][NEUTRAL] We'll have them pay the bill and I'll have [PII].