AccountId: 011433970860
ContactId: 13bb3d79-de03-417d-973e-1c97a0292762
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 646270 ms
Total Talk Time (AGENT): 331781 ms
Total Talk Time (CUSTOMER): 197597 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/13bb3d79-de03-417d-973e-1c97a0292762_20250418T20:06_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Oh, yeah, sir. I'm trying to verify. I don't know what kind of coverages I have or what's going on. Um, I was in the hospital, um, on Saturday that just passed. I had, uh, an emergency appendectomy. I, I don't know if I have it, I don't know if it's I have health insurance with you guys or what's going on, but I just wanna get some clarification on what I do have with you guys.
[AGENT][NEUTRAL] OK, I can help you with your benefits, sir. Can you please give me your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] All right, [PII] Last name [PII]
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you [PII], and then what is your policy number?
[CUSTOMER][NEUTRAL] Um, I am not sure of my policy number. I'll be just a second, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can look it up with your social if you'd like to give that to me.
[CUSTOMER][NEUTRAL] Oh, OK. I find my policy number here it is. It's um 025.
[CUSTOMER][NEUTRAL] 972.
[CUSTOMER][NEUTRAL] 47.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I in this policy number that you.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK hello, can you hear me?
[CUSTOMER][NEGATIVE] Yeah, um, yeah, you're breaking up. I can hear you now.
[AGENT][NEUTRAL] Yes I can hear you.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] Oh, I'm so sorry. So the policy number that you
[CUSTOMER][NEUTRAL] You broke up after this policy number.
[AGENT][NEUTRAL] Yes, this policy number that you gave me is a dental policy.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah. Did you give that to the um hospital?
[CUSTOMER][NEUTRAL] No, um, I'm trying to figure out, I don't even know what I have with you guys, so that's what I'm trying to figure out, um.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] OK. You, you.
[AGENT][NEUTRAL] Yes, sir. You do have a hospital indemnity plan with us that would work um if you have to go into the hospital?
[CUSTOMER][NEUTRAL] OK, so, uh, can you explain that to me?
[AGENT][NEUTRAL] And um.
[AGENT][NEUTRAL] Yes, sir. Uh, first, let me verify your policy real quick. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you sir and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII]. My email address is [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying that policy, OK.
[AGENT][NEUTRAL] This is just to verify your benefits. It's not a guarantee of payment. If you have to go into the hospital and stay for more than 18 hours.
[AGENT][NEUTRAL] You have a hospital admission benefit one day per calendar year that pays $500.
[AGENT][NEUTRAL] And that happens every year. And you also have.
[CUSTOMER][NEUTRAL] OK, that
[CUSTOMER][NEUTRAL] OK, that
[CUSTOMER][NEUTRAL] That happened to me, yeah. What about surgery?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You also have a daily hospital confinement benefit, 30 days per calendar year that pays $50 a day if
[AGENT][NEUTRAL] So that first day it pays 500 and then.
[AGENT][NEUTRAL] Every day after that for 30 days pays $50.
[AGENT][NEUTRAL] Um, let me see if you have any surgery benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Did you have to go to the emergency room?
[CUSTOMER][NEUTRAL] Yeah, I was in the emergency room.
[AGENT][NEUTRAL] OK. So you have an outpatient accident and sickness treatment benefit, 2 per year for the emergency room.
[AGENT][NEUTRAL] That pays $50. Uh, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You have an accident?
[AGENT][NEUTRAL] Sickness and surgical benefit.
[AGENT][NEUTRAL] Uh, at a facility, one per calendar year.
[AGENT][NEUTRAL] That pays.
[AGENT][NEUTRAL] $500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's for like in a hospital facility. Now, if you ever have to have surgery in a physician's office, it, you get 2 of those a year and that pays $250.
[CUSTOMER][NEUTRAL] OK, now how do I make a claim to get these benefits?
[AGENT][NEUTRAL] OK, you've got two ways. Either you can give this insurance to the facility that you went to and tell them that you have this insurance and they can file a claim for you to help with your uh medical bills, or if you wanna file it yourself, you can sign up for our online service center and let me give you that address.
[CUSTOMER][NEUTRAL] OK, so you said the hospital, now does the hospital get paid anything or not?
[AGENT][NEUTRAL] Yes, if the hospital files the claim, they will get the payment. If you file the claim, then you will get the payment.
[CUSTOMER][NEUTRAL] Yeah, well, I want them to file and get the payment, um.
[CUSTOMER][NEUTRAL] OK, so what would I, uh, so what would I have to give the hospital for them to file and get paid?
[AGENT][NEUTRAL] Just your insurance card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if they need to call and verify benefits with us, they can do that.
[AGENT][NEGATIVE] They just can't
[CUSTOMER][NEUTRAL] Uh, but the insurance card I have is the is the dental one. Can I give them that one?
[AGENT][NEUTRAL] No, that one has a different uh policy number. Let me give you all the information.
[AGENT][NEUTRAL] Your policy number?
[CUSTOMER][NEUTRAL] OK, yeah, let me get, alright, so hold on, just hold on one second, ma'am. Let me get, this is American Public Life.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright, and what's the policy number?
[AGENT][NEUTRAL] 259-7245.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Policy, one second. Alright, policy number is 2, I'm sorry, could you repeat the policy number for me please?
[AGENT][NEUTRAL] Yes, 259.
[AGENT][NEUTRAL] 7245.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] your policy effective date, they will need that.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Your group number, they're gonna need that also.
[AGENT][NEUTRAL] Is 70. Yes, sir.
[CUSTOMER][NEUTRAL] One second, what can you give me a minute? I'm sorry.
[AGENT][NEUTRAL] I'm sorry, I'm going too fast. Tell me to slow down.
[CUSTOMER][NEUTRAL] Uh, no, no worries group number.
[CUSTOMER][NEUTRAL] Alright, what's the group number?
[AGENT][NEUTRAL] 70094.
[CUSTOMER][NEUTRAL] 7009 4
[AGENT][NEUTRAL] And that's North Staffing Group.
[CUSTOMER][NEUTRAL] OK, so the group number is 70094.
[AGENT][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And that's North Staffing group and then you're also going to need um for them to send the claim in you're gonna need the payer ID number.
[CUSTOMER][NEUTRAL] OK, so I will give this to then.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK, pay your ID, pay your.
[CUSTOMER][NEUTRAL] ID OK.
[AGENT][NEUTRAL] That is 60.
[AGENT][NEUTRAL] 801.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][POSITIVE] OK, payer ID 60801. Perfect, thank you so much, ma'am.
[AGENT][NEUTRAL] Yes, you're welcome. And then also if they decide they want to fax in the claim, we have a way they can fax it in to let me give you the fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll have to get the address also.
[AGENT][NEUTRAL] But the fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is 1877.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 365 0 wait one second. 365, OK.
[AGENT][NEUTRAL] 9
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the claims mailing address and everybody asked for this because they have to put it in their system is APL claims.
[CUSTOMER][NEUTRAL] OK, one second, please.
[CUSTOMER][NEUTRAL] Hold on, claims, mailing.
[CUSTOMER][NEUTRAL] Address
[CUSTOMER][POSITIVE] Alright, I'm ready.
[AGENT][NEUTRAL] It's APL [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then the zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Beautiful. All right, perfect. All right.
[AGENT][NEUTRAL] Yes, and it.
[CUSTOMER][NEUTRAL] I think we're
[AGENT][NEUTRAL] If they need to call and verify your benefits or anything like that, you give them the same number you called and us girls will go over the benefits just like we did with you for them, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much, ma'am. I appreciate it.
[AGENT][POSITIVE] You're very welcome. Is there anything else that I can help you with before we go, [PII]?
[CUSTOMER][POSITIVE] Oh, that's it that you've been of great help. I appreciate everything.
[AGENT][POSITIVE] Well, I enjoyed helping you. I hope you have a wonderful [PII] weekend, and we thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Same to you, dear.
[AGENT][POSITIVE] Thank you, sir. Bye-bye.