AccountId: 011433970860
ContactId: 2231010b-d8c3-42ac-a7b4-1e1621c8011f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 892500 ms
Total Talk Time (AGENT): 442518 ms
Total Talk Time (CUSTOMER): 548030 ms
Interruptions: 19
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/2231010b-d8c3-42ac-a7b4-1e1621c8011f_20250122T19:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling. I'm sorry, good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I'm hoping that you can. I had called yesterday and I spoke to a very nice lady who was pretty helpful. I had, um, I have insurance through, I did for the 2024 year Florida Blue and then the secondary was APL. I went in a um emergency vehicle in on [PII], and I received a bill from them for the full amount of 1,428 49.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Now they did send it to the Florida Blue Insurance and I had Florida Blue send me a claim summary report and and this is what was asked of me from APL just to make sure that they paid some of it, but obviously I, I don't do this for a living and to me this is like foreign.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So I have a summary report that shows it shows the co-pay is $100 the amount billed was $984 and then the amount paid was 45368. Is that what you guys would need to see if the secondary insurance covers it?
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Mhm. We would need the, now with Floor, you said your insurance was with Florida Blue?
[CUSTOMER][NEUTRAL] Yes, when I went in an ambulance on [PII], it was Florida Blue. It has since has changed since [PII], but when this incident happened, it was Florida blue.
[AGENT][POSITIVE] Perfect.
[AGENT][POSITIVE] OK, so that really makes it easy for you because Florida Blue does provide what's called a health statement, that's H E A L T H statement for your claims information and we can actually process a claim from that health statement for that data service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so how do I go about getting the health statement?
[AGENT][NEUTRAL] So on the health statement you would contact Florida Blue or go to their website. Now I'm not real familiar with their website, but I know under the claims section it seems like there is an option.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Under the I think it's under the claims details maybe.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Where it says health statement.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so then what would I do put in the claim ID number?
[AGENT][POSITIVE] I think so, uh, and, and again I wish I was familiar with that website because it is so beneficial.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, but I just, you would need to contact Florida Blue to see how to get that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Health statement.
[CUSTOMER][NEUTRAL] And then once I get that, I call you guys back or do I process or can you tell me like at this point is it covered, is any of it covered? Have I reached the 2500 for the year?
[AGENT][POSITIVE] Well, it would be my pleasure to check that for you. Do you have your policy number?
[CUSTOMER][NEUTRAL] I do, I do. I have the, you're talking about the group number or the inhospital benefit?
[AGENT][NEUTRAL] Policy er, yeah, that one.
[CUSTOMER][NEUTRAL] OK, it's 1479643.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][POSITIVE] Perfect. Thank you. And can you verify your name and date of birth?
[CUSTOMER][NEUTRAL] Sure, my name is [PII]. My date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you. And what is your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] My phone number is [PII]. I'm actually calling you from my office. My address is [PII], and my email is [PII].
[AGENT][POSITIVE] OK, perfect, thank you.
[AGENT][NEUTRAL] And let me ask you, what was the date of service?
[CUSTOMER][NEUTRAL] The date of service was [PII].
[AGENT][POSITIVE] OK. Right before [PII], bless your heart.
[CUSTOMER][POSITIVE] I know, please, you don't even know. It's the first time I can check it off my bucket list, first time being in an ambulance.
[AGENT][POSITIVE] Oh my gosh.
[AGENT][NEGATIVE] Oh no
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] Yes, thank [PII] everything was OK. I wound up, uh, just, I have low hemoglobin. My, I have anemia, and so my hemoglobin level was at like an 8. So I literally was having like major heart palpitations. And so essentially my heart rate was at like 130 and I literally, I'm not kidding you, it cost me $1,428 to go in that ambulance. So next time I literally have to be dying.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Oh my gosh, that's scary.
[AGENT][NEUTRAL] Oh bless your heart. I, I know. I feel the same way. That's like so many times, you know, people, I'll have something, I'll call my sister she's like, well, you need to go to the emergency room. I said, I am not gonna go to the emergency room for a Tylenol, you know, and pay for two years on that.
[CUSTOMER][NEUTRAL] I know
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] Yes, it's true. It's so true.
[CUSTOMER][POSITIVE] Yes, exactly. It's so true. It is like walk-in clinic. They even suggest now like if you break your arm to go into a walk-in clinic first, which is unheard of, like 10 years ago you would have went right to the hospital if you broke an arm or something. It's just crazy how things have changed.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm. It is. It's sure, it's a lot of times when you go to the urgent cares, they send you to the emergency room and then you've got two bills.
[CUSTOMER][POSITIVE] I know, it's true. That's exactly right. Let's just give everybody money. Very expensive to get sick.
[AGENT][NEGATIVE] Exactly. And then we're sick. Exactly. And then we're sick from worry about paying.
[CUSTOMER][POSITIVE] Yes, and you're sick on top of it. Yes, yes. The gift that keeps on giving, yeah.
[AGENT][NEGATIVE] Exactly. I'm like, I cannot afford to get sick. I mean, I just suck, I'll just suck it up and keep on going.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] That's funny. Oh, I have a fellow.
[AGENT][NEUTRAL] Person in my world now.
[CUSTOMER][NEUTRAL] Yes, yes. I'm telling you, it's crazy. It is, it's crazy. So, uh, so you'll be able to tell me what um what what kind of coverage I had left for I guess 2024.
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] It is completely like a.
[AGENT][NEUTRAL] Yeah, that's what I'm looking at.
[AGENT][POSITIVE] And I see your policy is still active, so that's good.
[CUSTOMER][NEUTRAL] Yes, it is. It's active with you too, yeah. It's just not. I have, we, our insurance, unfortunately somebody here was really sick, so the insurance Florida Blue that they offered us was like astronomical, so we had to switch insurance companies, so that was another thing that after I'm 46, as you know, I'm not kidding you, I've had the same doctor since I'm 18 and I now have to change doctors because she's not in the same network after all these years. So I'm just having a good old time over here. It just gets better and better.
[AGENT][NEUTRAL] I hear you. I'm, I'm with you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And, and, and then when it hits I'm, I'm 63, so once it hits 50, everything changes, but just keep on doing the best you can.
[CUSTOMER][POSITIVE] Good times.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Right, yes. It's what I have to look forward, what I have to look forward to a few more years.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Oh my, that was my little piece of encouragement.
[CUSTOMER][NEUTRAL] Yes, thank you, thank you. I still can't believe that like it's not even the aging process. It's, I don't think of myself as somebody who's going to be [PII] soon and that's the part I'm struggling with. Like, do you say to yourself, I'm not [PII] in my brain, I'm like [PII], yeah, it's crazy. Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] All the time.
[AGENT][NEUTRAL] All the time. And I keep trying to do things my [PII] would person would do. And then I'm like, oh, wait a minute.
[CUSTOMER][NEUTRAL] Oh mind wants to do, yeah.
[CUSTOMER][POSITIVE] I know, it's so true. That's right, or you pay for it like the next day, yeah.
[AGENT][NEUTRAL] Let's still try.
[AGENT][NEUTRAL] Exactly. But I'm gonna keep on trying.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] They won't take me down easy.
[CUSTOMER][NEUTRAL] That's right. You're gonna go with in with a fight.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Gotta enjoy life the best we can for sure. Well, I'm checking your benefits now, you know, um, you have a $2500 calendar year benefit on your plan.
[CUSTOMER][POSITIVE] That's right, yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And for [PII], we paid out $575.08.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So that you have the rest of that balance remaining, which is good. That'll help.
[CUSTOMER][NEUTRAL] Yes, OK. Yes, hopefully it does. So I'm gonna go on, now I can't call this your insurance and ask for you specifically, right? I have to just get whoever I get.
[AGENT][POSITIVE] Oh, you, no, you can always ask for me if I'm available. I would be happy to assist you.
[CUSTOMER][NEUTRAL] OK, so if I get I just do the normal call, the normal number and then if I get when I get somebody on the line I can ask if I can be transferred to you.
[AGENT][POSITIVE] Absolutely. And my name is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect. OK, alright, so let me go online, go ahead.
[AGENT][NEUTRAL] Now once you get, and let me check one other thing for you, do you have our portal account?
[AGENT][NEUTRAL] Have you created
[CUSTOMER][POSITIVE] I don't know if I ever set it up, but I've been to that website before I should create it, right? It'll make it easier.
[AGENT][NEUTRAL] I'm gonna check.
[AGENT][NEUTRAL] Well, let me check and see if you have an active account.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You do.
[CUSTOMER][NEUTRAL] Oh OK good so I just have to reset my password because God knows I don't remember what it was. OK, I can do that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Your username is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect, the user name yep.
[AGENT][NEUTRAL] And you reset your password and once you get the health statement from Florida Blue, you can just upload it on your policy online.
[CUSTOMER][NEUTRAL] OK, that's great and then you guys will see it and you guys will pay how do I know? Will you send me a notification or something that it was paid to them? How does that work?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, there's several options. We do have a text messaging option. You will get a text message notification once the claim has been processed. Now if you go to the portal to view the claim decision, it could take up to 24 hours to be able to view it because that's the process overnight. You'll get the.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Text message immediately when it's processed, but it does have to press process and imaging and all that overnight so it could take up to 24 hours to be able to check it online but you can um click on the claim number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And view claim decision.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. Well thank you very very much.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I did check we do not have a claim on file for [PII].
[AGENT][NEUTRAL] So I would just want to make sure that they didn't.
[CUSTOMER][NEGATIVE] OK. Yeah, they don't even show. That's another thing. So, all kidding aside, I gave the insurance information to the paramedic. I gave it to the hospital, and they never uploaded the secondary insurance, which is just terrible.
[AGENT][NEUTRAL] I agree. They, I mean, it, it's like, do they want to get paid?
[CUSTOMER][NEUTRAL] They never
[CUSTOMER][NEUTRAL] Yes, I just, I just, I, I really think they're like trying to because you got to, you know, if somebody's elderly, they're not going to have the resources to go through all of this back and forth, you know, and it's like they, I feel terrible for them. I really do. That's why I always have my dad's back. I'm always there helping him out.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] That's good. And you'll appreciate that even later in life that you did that.
[CUSTOMER][NEUTRAL] So anyway, yeah.
[CUSTOMER][POSITIVE] That's right. Yes, exactly. So, thank you so much for your time. Let me do my homework and uh hopefully it'll all work out and you have yourself a blessed day.
[AGENT][POSITIVE] You too, Ms. [PII]. Such a pleasure to assist you today and thank you for calling APL and I don't, let's see, if it's cold down there in [PII], stay warm.
[CUSTOMER][POSITIVE] Likewise, thank you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Cold, it was snowing, it hasn't snowed in [PII], OK, it hasn't snowed.
[AGENT][NEUTRAL] I mean, it might be cold for y'all.
[AGENT][NEUTRAL] Did it snow where you are?
[CUSTOMER][NEUTRAL] It didn't snow where I am because I'm in [PII], but my niece goes to [PII] State and it snowed by them. It snowed in [PII]. We haven't seen snow and I've been living in [PII] since like [PII] and I never ever saw snow ever. So here, I obviously living in [PII], I have experienced snow. It's been years. So I just, it was nice that she got to see that, but it is cold here. For example, I just came back from lunch and we're freezing because it's like 60. That's very cold for us.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I know.
[AGENT][POSITIVE] I'm sorry, I love it. That's why I want to move to [PII] so bad.
[CUSTOMER][NEUTRAL] It is, it's
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, what's the temperature by you?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] So this morning it was 14. I'm in [PII].
[CUSTOMER][POSITIVE] Oh my gosh.
[AGENT][NEGATIVE] And I think it's finally about to get up above freezing. We've been below freezing for about 42 hours.
[AGENT][NEUTRAL] Street.
[CUSTOMER][NEUTRAL] So now do you go outside, like what do people just live their normal life when it's that cold? I have no idea. I can't even imagine.
[AGENT][NEUTRAL] So in, in [PII], well, we did not get snow or ice in my area.
[AGENT][NEUTRAL] But, uh, let me tell you, if there's any snow or ice on the ground, I'm talking one flake.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Around where I am, we shut down.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And nobody knows how to drive in it, you know.
[CUSTOMER][POSITIVE] You do, yes.
[CUSTOMER][NEUTRAL] Right, I'm getting emails from trucking brokers because I work for a juice manufacturer and I'm getting emails, sorry, but due to the weather, we're probably not gonna be able to get our trucks out of [PII] and I'm like, was it that bad? But people down here don't know what to do, so, you know.
[AGENT][NEUTRAL] So both dates are.
[AGENT][POSITIVE] We don't, and, and probably you being from [PII], you're probably like, oh my gosh.
[CUSTOMER][MIXED] It is. I really did think it was funny. I mean, I saw pictures that people posted online and it was not that serious, but you know, it is what it is. It more than anything for me, I would imagine if it's windy, that's when it gets really bad, like painful. If it's at least just cold.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we did have
[AGENT][NEGATIVE] And I don't know about [PII], but with the humidity down here when it gets so cold and then the wind blows, it hurts. It hurts.
[CUSTOMER][NEUTRAL] Yes, yes, it does, it does. Well, you poor things, so you're just staying indoors. Stay indoors, yeah.
[AGENT][NEUTRAL] I don't know the humidity.
[AGENT][NEGATIVE] Oh, heck yeah. Well, I'd have to go out for, I just can't stay indoors 24/7. I have to get fresh air. Um, I just
[CUSTOMER][NEUTRAL] I know, me too.
[AGENT][NEGATIVE] It drives me bananas. I have to go outside.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But like people walk their pets in this weather, like do they take the dog, does the dog go for a walk in this weather?
[AGENT][NEUTRAL] OK, so I do some 5Ks, you know, some, some races, depends on who it's for, you know, I, I like to do it for the reason and, and for my health as well. But we have a, a running forum of Mississippi Coffee runners. There were people out running their mouths in the snow, and I'm like,
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm just not that diehard. I'm sorry. I don't like pain.
[CUSTOMER][NEUTRAL] How can you breathe, right? Like, can you breathe when it's that cold?
[AGENT][NEGATIVE] So, I'm thinking that must really do damage to your lungs, getting all that cold air in your lungs. I don't know. I'm not gonna do it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I can't even imagine.
[CUSTOMER][POSITIVE] Yeah, I know, you'll wait. Let it, let it at least get to like 50 degrees, right? Exactly. Good for you. Good for you. Well, thank you so much for your time and hopefully this all works out and you stay warm in [PII].
[AGENT][NEUTRAL] I'll get on the treadmill. Exactly.
[AGENT][NEUTRAL] So
[AGENT][POSITIVE] Yes. You too, in Florida. Enjoy, enjoy that cold 60 degrees.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Yes, I will.
[AGENT][NEUTRAL] I'd be wearing my flip flops in 60 degrees.
[CUSTOMER][NEUTRAL] Thank you so much. Yes, I have, I do have flip flops on. I'm not gonna lie. I do, but I have like a sweatshirt on. Yeah, I do have a sweatshirt on. It has to be like below 50 to take out, God forbid I wear cold, you know, what you call it, closed-toe shoes. I don't think so.
[AGENT][NEUTRAL] That
[AGENT][POSITIVE] I love it.
[AGENT][NEGATIVE] I don't like those shoes either.
[CUSTOMER][POSITIVE] I know, I know. Have a wonderful day. Take care.
[AGENT][POSITIVE] You too thank you Don. Take care bye bye.
[CUSTOMER][POSITIVE] Thanks. No problem. Bye-bye.