AccountId: 011433970860
ContactId: 20704646-9f2b-4003-a55a-cbce44cfbd4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 883200 ms
Total Talk Time (AGENT): 356184 ms
Total Talk Time (CUSTOMER): 502765 ms
Interruptions: 8
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/20704646-9f2b-4003-a55a-cbce44cfbd4e_20250124T15:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII], uh, and I am calling on behalf of my husband, [PII].
[CUSTOMER][NEUTRAL] Uh the last name is [PII]
[CUSTOMER][NEUTRAL] Uh, I am just looking about the deductible on his policy because he's gonna have a procedure, upcoming procedure, uh, this coming Monday, uh, and we just wanna make sure everything about it.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you this morning, Ms. [PII]. Do you have the policy number available?
[CUSTOMER][NEUTRAL] OK, uh, the policy number that I have right now is 25 250.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 325-3. I think it was changed.
[AGENT][NEUTRAL] All right. And what is Mr. [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And is Mr. [PII] right there to give me permission to speak with you, Ms. [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's sure. Yes, I'm here. That's you have permission.
[AGENT][NEUTRAL] Yeah, all right, thank you, Mr. [PII]. And is this proceed, can you verify your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] Yeah, it's um right now it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Phone number [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And now, were you, did you used to be in [PII]?
[CUSTOMER][NEUTRAL] In [PII] I'm temporarily up there too. I've got two addresses. I work temporarily in [PII] and back here in [PII], so I have.
[AGENT][NEUTRAL] I'm in [PII].
[AGENT][NEUTRAL] Well, now that's a long distance.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah, yeah, we have another company up in [PII], so I had to go back and forth. That's why you probably got, that's probably you got [PII]. That's the one over there in, in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's right. So is that a correct address or do we need to update that?
[CUSTOMER][NEUTRAL] That's correct. That's fine. You can use either one. I have to have 222 places.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, thank you. And then do you mind verifying your now your phone number that we have on file is a [PII], is that correct as well? Or do we need to update that?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, yeah, I think that's my, uh, my work phone, yeah.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][POSITIVE] Let me check and verify, but I'm pretty sure that's right.
[AGENT][NEUTRAL] And we can update it if we need to update it to your personal.
[CUSTOMER][POSITIVE] Yeah, [PII]. Yeah, that's my work phone. That's good.
[AGENT][POSITIVE] OK. All right, thank you for all that verification.
[AGENT][NEUTRAL] And will this procedure be in an outpatient facility or inpatient hospital?
[CUSTOMER][NEUTRAL] Uh, what would be inpatient at the hospital, but it should be just a one day, uh, they should be a one day operation.
[AGENT][NEUTRAL] OK. So if you're in the hospital more than 18 hours, that is considered inpatient.
[CUSTOMER][NEUTRAL] OK, so do you.
[CUSTOMER][NEUTRAL] Yeah it should be outpatient then. But uh we just we don't know we don't know yeah just when we go Monday last time they um yeah he he he spent the night over there so we just we don't know depends on what time to get done before they can release me and how he come out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Right. OK. So what I'll do is I'll give you both benefits that way you'll know what's covered, um, and be prepared for each situation. So for inpatient hospitalization, we can pay up to $3000 towards your deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I assume we can do the 3000.
[AGENT][NEUTRAL] On your APL plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If it is less than 18 hours, that is considered outpatient and we can pay up to $1500 towards your deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1500. OK, that's the difference. OK, OK then.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] Uh, so then on Monday we have to pay the 1500. No, but get will pay the $1500 when they get the bill. We gotta cover the rest of my due.
[AGENT][NEUTRAL] Yeah, did, when you were registering or have you pre-registered yet?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Did you provide your APL information?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, one thing, uh, uh, the policy number that I have, I got two things that I, I would like to talk to you about it. Uh, number one, the policy number that we used to have was 2361857, but the lady in the hospital tell us that they updated on [PII]. The policy number was updated to 2503253.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yes. OK, mm, and then they, I think last year when I called I I asked him for uh for the insurance company, the card, the the the member ID card, and never was sent it to us and now when the hospital was calling us they ask us, you know, for the insurance card. I said I don't have it. They just give me a policy number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, they never provide a uh member ID card.
[AGENT][POSITIVE] I can help you with that.
[CUSTOMER][NEUTRAL] Oh how can we.
[CUSTOMER][NEUTRAL] Uh-huh. Well, how
[AGENT][NEUTRAL] I can take care of that for you, not a problem. So there's several ways. Now I can request that they mail a copy to the address we have on file. That's at [PII] address, and they'll mail a copy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's
[AGENT][NEUTRAL] To that address
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can also email you a copy or we have a provider portal I mean a portal I see you have an active account online.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you can print a card from there as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I just don't have a printer available, but I mean uh.
[CUSTOMER][NEUTRAL] You can email it probably I guess right yeah you can email it and then we will uh go to that also I hate to ask this but.
[CUSTOMER][NEUTRAL] Um, I don't seem to remember having all my information to log back into that portal.
[AGENT][NEUTRAL] I got you. So your username now I can't see your password. You'll have to reset the password that's protected, but your username is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, right, OK.
[AGENT][NEUTRAL] And you can actually click on your policy number and it will download your policy documents and you can view what's covered on your plan.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, thank you, because I was, I usually keep that and I didn't have it.
[AGENT][NEUTRAL] And the benefits
[CUSTOMER][POSITIVE] So that was good. So, OK, so.
[CUSTOMER][NEUTRAL] Yeah, we got which way you wanna get the card. Uh, can, can she email, uh, we'll have her just I can go on policy capture that one she.
[AGENT][NEUTRAL] Why don't I email it and then also request that they mail it to you? Would that be good?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][POSITIVE] OK, that'd be that'd be good, yeah, mhm, mhm.
[AGENT][NEUTRAL] Now the email we have on file is the um your email at [PII]. Is that a good email?
[CUSTOMER][POSITIVE] Yes, correct, correct.
[AGENT][NEUTRAL] And that's [PII] OK. I'm fixing to email you a copy of your card, and then let me, if you don't mind holding just one moment, let me order that to be mailed. Are you going to be going back to [PII] soon?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, probably, uh, next week.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Soon as I get released to go.
[AGENT][NEUTRAL] Yeah, so be sure to check. It could take about 2 weeks to.
[CUSTOMER][NEUTRAL] It's so yeah.
[AGENT][NEUTRAL] Arrive by and of course that's going to depend on the um.
[AGENT][NEUTRAL] Postal service.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] And do you mind to repeat the email that you have because I didn't quite got it. The email that that you're gonna send the card just to make it sure that sometimes.
[AGENT][NEUTRAL] So that is the um [PII]
[CUSTOMER][NEUTRAL] Is that what it is, yeah, yeah. [PII], you say [PII] or [PII] what? PC or [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I just sent that email. It's from the care team.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, we will be able to see if it she send that now. OK, so when you send it, you let us know so that, oh, you already sent it.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, opening that up.
[CUSTOMER][NEUTRAL] Oh, he's looking for. Give us a second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] There it goes, yep, got it.
[AGENT][NEUTRAL] And make sure that you can open on that attachment if you don't mind.
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] Mm 6 weeks.
[AGENT][NEUTRAL] Just
[AGENT][NEGATIVE] Sometimes those attachments give trouble.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah, the TI file.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, let me see if I.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][POSITIVE] OK, you were able to open that good deal.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Good deal. OK. OK, so at least we got that.
[AGENT][NEUTRAL] And they should be mailing that card. It probably won't go out in the mail until Monday.
[CUSTOMER][NEUTRAL] This is.
[AGENT][NEUTRAL] But it
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Be looking for the APL ID card.
[AGENT][NEUTRAL] In an envelope
[CUSTOMER][NEUTRAL] OK, OK, thank God that I just got an envelope where I have write down the policy number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I, you know, like, before we, before we left, and I go, oh, let me just take this just in case, but I said the hospital should have had it already. Well, there was not the case, so thank God that I follow my instinct.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Absolutely
[CUSTOMER][NEUTRAL] I went back and got this, yes.
[AGENT][POSITIVE] Absolutely. A woman's instincts are always good, right?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] That's right, you're right.
[AGENT][POSITIVE] Well, I'm glad y'all are in [PII] where it's warmer right now.
[CUSTOMER][NEUTRAL] That's why.
[CUSTOMER][NEUTRAL] That's why that our husbands have to pay attention when we say something.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You hear that, Mr. [PII]?
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] We make sure that he get it.
[AGENT][NEUTRAL] We got to take care of, gotta take care of our husbands, don't we?
[CUSTOMER][POSITIVE] That, that is correct, and um, uh, that's a blessing that we could do that, you know. Mhm. Yes, yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Absolutely, absolutely. It is. And I certainly hope your procedure goes well, but if y'all need anything, be sure to give us a call. Now, Ms. [PII], you're not on the policy, so anytime you call, we will have to have that verbal permission that we can speak with you.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Well yeah, I understand. Yeah, I understand the reason that I was just like say, hey, let's just call because you know what, last time we didn't have to pay nothing and this time, yeah, but this time you, you, you outpatient. Oh that's different. Remember last time I was admitted over 18 hours.
[CUSTOMER][NEUTRAL] So if, if, if it be if he has to stay overnight then he don't have to pay the the oh they pay 3000 day OK.
[CUSTOMER][NEUTRAL] OK, I would just wanna have this clear because it was just like, hey, same, same insurance, you know, same policy. Why this time we gotta pay that, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, and it does depend on the benefit amount that we can pay and the amount of hours that he is actually at the facility. So if it's over 18 hours, that benefit changes to the inpatient benefit of $3000 that we can pay.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And of course it's going to depend on your primary insurance and how they process the claim and what they apply to your deductible. That's what we pay, whatever your primary insurance applies to your deductible, and then we can pay up to our maximum benefit amount toward that.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. OK, alrighty. Well, Ms. [PII], thank you so much. You really gave us very well explained all this, and now we're just gonna have to, uh, just wait until Monday and see what if anything we have any questions, we call you.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] We just
[AGENT][NEUTRAL] Absolutely, please do. We're open Monday through Friday from [PII] I'm sorry, [PII] Central Standard Time.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And we'll be happy to assist you any way you can. Again, enjoy that warm weather while y'all are in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And guess what, it's cold here.
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] I know, I know it's all that, like that's cold for [PII], but now y'all, it's not too cold for y'all, are you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEGATIVE] No, it's not, it's not. No, it's not.
[AGENT][NEUTRAL] And y'all are used to [PII] as well.
[CUSTOMER][NEUTRAL] Yeah. Now when I hear it's cold here and I go, you wait till you get there. Now there it's cold, it's freeze.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][POSITIVE] That's right. And I certainly hope everything goes well for you, Mr. [PII].
[CUSTOMER][POSITIVE] Thank you very much thank you so much.
[AGENT][POSITIVE] It's been my pleasure. Y'all have a lovely weekend.
[CUSTOMER][POSITIVE] You too you too. Thank you too bye bye.
[AGENT][POSITIVE] All right thank you bye bye.