AccountId: 011433970860
ContactId: 28c1c1a0-a040-437e-9f63-f630a3249241
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291119 ms
Total Talk Time (AGENT): 130583 ms
Total Talk Time (CUSTOMER): 130242 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/28c1c1a0-a040-437e-9f63-f630a3249241_20250306T22:18_UTC.wav
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[CUSTOMER][NEUTRAL] So much does pop up.
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APO. This is [PII]. How may I assist you?
[CUSTOMER][POSITIVE] Hello ma'am how are you today?
[AGENT][POSITIVE] I'm good, thank you. How about you?
[CUSTOMER][NEUTRAL] I'm, I'm fine. I'm fine. Well, my name is [PII], and uh I had some questions about some gap insurance that I have through my payroll company, ma'am.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Um, and do you have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh yes, ma'am, I sure do. It is 025.
[CUSTOMER][NEUTRAL] 81933
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected, Mister [PII].
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] For security, may I have your date of birth, mailing address and email address?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And my home address is [PII]
[CUSTOMER][NEUTRAL] And my email address is [PII].
[AGENT][POSITIVE] Perfect. Thank you. And that's in [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. All right. And how may I assist you with this policy, Ms. [PII].
[CUSTOMER][NEUTRAL] OK. Well, what's going on is that, uh, [PII], I'm having a hip replacement, ma'am.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] And uh I was, when I was signing up for insurance, a friend was telling me, you know, that this, if you get this, it's gonna help you pay that deductible.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And so I guess what my question is is how much is this gonna pay towards the deductible, ma'am?
[AGENT][NEUTRAL] OK, so let me look at your benefits and is this gonna be a, um, are you gonna stay in the hospital for the knee replacement, like more than 18 hours or is it gonna be less?
[CUSTOMER][NEUTRAL] Well, they, they're telling me that I might be going home that evening.
[CUSTOMER][NEUTRAL] But yeah, they, they're saying it depends on how much blood I lose and how much, how it feels when I, after the surgery. So I might have to stay the evening there.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Got you. OK, so there are two benefits. Um, one is gonna be for more than 18 hours and the other one is gonna be for less than 18 hours. This is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, if you're gonna be in the hospital less than 18 hours, um, the policy has a benefit maximum of 1000 per covered person per calendar year.
[AGENT][NEUTRAL] Now, if you're gonna stay there 18 hours or more, it pays up to 5000 per year.
[CUSTOMER][NEUTRAL] Yes, ma'am. And so now when this pays, I mean, how does this work? Do y'all pay this to me or do y'all pay this to the hospital? We have to pay the hospital that more.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We pay to, we pay to the person that sends the claim in. If you want to send the claim for reimbursement, we send the check out to you. If we receive the claim directly from the provider of service, we'll go ahead and pay the provider of service.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] What, what do you, what else do you need to know, babe? Yeah, that's exactly what I need to know just so that we can call the hospital. We were just trying to have less out of pocket, if at all possible cause that morning, they're wanting us to pay our remainder of our um deductible that morning of the surgery. And I was making sure that I wasn't shelling out more money than
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] What I need to because it's gonna be hard to get refunds from from a hospital yeah.
[AGENT][NEUTRAL] Got you. Yeah, if you can just present this card and let them know that this is your secondary and have them to verify this information, we can go ahead and um confirm this information with them so they can have it on records for that um payment for the deductible. Um, but yeah, you can go ahead and go that route if it's easier and sometimes they will go ahead and take that as a method of payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All right, that's what we need to know. Thank you so much.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. and Mrs. [PII]?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, I think that's, that's it.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. You have a good afternoon.
[CUSTOMER][NEUTRAL] You too, ma'am.
[AGENT][POSITIVE] Thank you. Bye-bye. Bye.
[CUSTOMER][NEUTRAL] Alright bye bye.