AccountId: 011433970860
ContactId: 0915f61d-fe7b-4826-95f2-a67786d24a31
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 479399 ms
Total Talk Time (AGENT): 215000 ms
Total Talk Time (CUSTOMER): 160264 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/0915f61d-fe7b-4826-95f2-a67786d24a31_20250204T20:53_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] Yeah, I'm calling to see if um I have the intensive care policy and um I'm calling to see my husband was in the hospital in November for 11 days.
[CUSTOMER][NEUTRAL] With bacterial infection. And would that be covered?
[AGENT][NEUTRAL] Um, I would need to take a look at your policy, but I definitely can take a look for you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, yeah, I've got the policy number in front of me if you want that.
[AGENT][NEUTRAL] Um, yes, but may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK. My name is [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] Thank you for that. And, and may I have the policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 509-063
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] That you see the people that take out a gun and shoot.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] All right, and I'm showing you on the policy as well. and Mrs. [PII], can you verify your date of birth and the mailing address on file?
[CUSTOMER][NEUTRAL] P
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And hold on one moment while I take a look at your benefits. And he said he was in the hospital for 11 days, right?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] And what, um, my
[CUSTOMER][NEUTRAL] Phone is maybe going dead, so you might have to call me back in a little bit.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] But it's still, I still got a little bit of power.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, hold on one moment. I'm just waiting for all the benefits to pop here so I can see what's covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK, so for the daily hospital benefit for days 1 to 75, the policy will pay up to $300 per day. Um, so you, you could definitely benefit for the um 11 days in the hospital.
[CUSTOMER][NEUTRAL] OK, so I just need to send in the paperwork that has the codes on it, is that right?
[AGENT][NEUTRAL] Yes, ma'am, the, the itemized bill and then the um the claim form, the hospital indemnity claim form.
[AGENT][NEUTRAL] Well, actually, hold on one second. Did I say the wrong?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, this is your cancer policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, let me see if this, now that's different. Hold on, let me see if it has to be.
[AGENT][NEUTRAL] Let me see if it'll let me search it.
[AGENT][NEUTRAL] If it has to be um due to cancer, the stay, because it's a cancer policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, then I have an intensive care policy.
[AGENT][NEUTRAL] Yeah, I was gonna say now I can look on your intensive care policy and see if there's a hospital benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on, I'm pulling that up now.
[CUSTOMER][NEUTRAL] And I know we've gotten paid before the $300.
[CUSTOMER][NEUTRAL] I like
[AGENT][NEUTRAL] Yeah, it looks like he was paid for the um hospital stay at Providence Hospital.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Was that in relation to cancer or it was just a stay like this one for the infection?
[CUSTOMER][NEUTRAL] Well, this, this day I'm talking about is uh at USA University Hospital in Mobile.
[CUSTOMER][NEUTRAL] In November.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] So yeah, it looked like it, it looks like it would be under the cancer policy. um.
[AGENT][NEUTRAL] I'm waiting for your intensive care benefits. It goes by page and it's 14 pages, so hold on one moment. I'm.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And every time I click on the page, it loads up, so I'm trying to see which page it's on so I can go straight to it.
[CUSTOMER][NEUTRAL] All right, OK.
[CUSTOMER][NEUTRAL] There
[AGENT][NEUTRAL] See.
[CUSTOMER][NEGATIVE] refusing to get.
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Of availability.
[AGENT][NEUTRAL] No, this is a claim.
[CUSTOMER][NEUTRAL] One of them withdraw the [PII].
[CUSTOMER][NEUTRAL] well
[CUSTOMER][POSITIVE] Tremendous potential for.
[CUSTOMER][NEUTRAL] works on the.
[CUSTOMER][NEUTRAL] want.
[CUSTOMER][NEUTRAL] the.
[AGENT][NEUTRAL] Now, your um intensive care, I, I would still submit it because either way, whether it's processed under cancer or intensive care, if you file it under one and the others needed, it will be put to the other, but there is a daily hospital benefit on your intensive care um policy as well as $600.
[CUSTOMER][NEUTRAL] OK, and then there was another one that paid $300 is that just for any hospital stay?
[AGENT][NEUTRAL] Now, the one that paid $300 that was for the cancer policy.
[CUSTOMER][NEUTRAL] OK, alright, so what do I need to send?
[AGENT][NEUTRAL] Um, still the same documents. I would just send the itemized bill and the um claim form and depending on what they see in the charges and the, you know, the billing, they'll be able to determine if the intensive care is needed or the cancer policy, but you have the daily hospital benefit for both.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and so, um, will that itemized bill have like the codes that they need on it?
[AGENT][NEUTRAL] Yes, um, I will ask for the universal bill for whichever data service, um, you know, you're you're filing for. It'll have the diagnosis codes, the procedure codes, um, if there was any surgery, surgery codes, and then all the charges and what you all pay, so we know who to pay, you know, if you're owed something or if they're old.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, and I need, I have a claim form, so I just need to fill that out too.
[AGENT][NEUTRAL] Mhm. And you can fax it to us, you can mail it to us or you can send it electronically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what's that mailing address?
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], and the zip code is [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK then, well, thanks a lot.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] All right, you too, thanks.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] All right bye bye.