AccountId: 011433970860
ContactId: 4526d610-d101-48eb-94c9-933d905cee3c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423440 ms
Total Talk Time (AGENT): 144180 ms
Total Talk Time (CUSTOMER): 282634 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/4526d610-d101-48eb-94c9-933d905cee3c_20250609T17:37_UTC.wav
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[AGENT][NEUTRAL] For contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, this is, yeah, this is [PII] I calling from here in uh in uh [PII] or here in [PII]. And I got a quick question for you. I was wondering on how can I possibly, uh, the, uh, my wife has got some dental, uh, has, or has to get some, uh, medication or not medication, I'm sorry, get a surgery done.
[CUSTOMER][NEUTRAL] And she's gotta get uh surgery on her elbow done. And she tried calling a, a hospital that she normally goes to, and they said that they do not accept the APL insurance cause it's like not in their network or something. And so they're wondering on what we could do about like how we can go about getting her into that doctor or that hospital to get the surgery done.
[AGENT][NEUTRAL] Well, let's, certainly, let's look at our policy. Absolutely. um, and what is that policy number, please?
[CUSTOMER][POSITIVE] Oh, good question.
[CUSTOMER][NEUTRAL] Policy number is, I believe.
[CUSTOMER][NEUTRAL] It might be 02574692. That is for the dental part though. And I want to see if I can find the medical.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh yep. OK. Uh, oh, no, I gave you the wrong policy number. Uh, for the hospital one would be 02616778.
[AGENT][NEUTRAL] Thank you. If I can just verify your name and date of birth, and a phone number, please, sir?
[CUSTOMER][NEUTRAL] Yep, it'd be [PII] and it'd be [PII].
[AGENT][NEUTRAL] And I'm, I'm sorry, just to make sure that I have the right, uh, policy, I'd also is asking for my, for your phone number that we have on file.
[CUSTOMER][NEUTRAL] Oh, what was that?
[AGENT][NEUTRAL] Yes, sir. If I could just have your phone number, please, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Thank you, [PII]. So it looks like you've had a policy with us since [PII]. Now, um, this is a hospital indemnity policy and what we do is, uh, they can, you can go to any, um,
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Any service, uh, you can go to any provider, uh, now what we do is we can provide them with information on, um, it's a hospital indemnity policy and we can provide information on how to submit a claim to us which is really the only thing that they're looking at, uh, we do have surgical benefits if you need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Yeah, cause
[CUSTOMER][NEUTRAL] OK. Yeah, cause she said when she called in to the doctor that, and uh to get her to the hospital uh for Iowa's, uh, I believe it was Iowa specialty uh clinic here in [PII], to get the services done, uh, or to get the, um, the, uh, surgery done.
[CUSTOMER][NEUTRAL] They said that they ended up running the insurance number and they said that that doesn't come up in their network or is not in their network or something or that the insurance like the hospital is not in the network or something.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So she's like, I don't understand what they're talking about. I was like, well, it should, it should be in the network. I'm like, it's kind of like a national like it covers everything everywhere because it's, uh, you know, it's for like truck drivers. Now truck drivers were, we're covered in like everything. It's kinda, you know, and, and so that's kinda odd. It's OK, so I'll, I'll call them, yeah, so I'll call APL and
[AGENT][NEUTRAL] And every day, yeah.
[CUSTOMER][NEUTRAL] See what's going on and, and uh let him know, you know, hey, you know this is what's going on and see if they know anything but I said I tried reaching out to uh [PII] my uh account, the accountant person I normally talk to, and uh, I emailed him but he has not emailed me back yet but I was gonna call him, uh, and see what happens. I thought, well, I'll just call you guys direct and see, you know, what you guys would, you know, suggest to so that's why I thought I'd call and find out what I need to do or what she needs to do or how does she need to.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, well, if they have any questions, what would that.
[CUSTOMER][NEUTRAL] You know, if she talks to the hospital again, what does she need to tell them to go that route or if I should just tell them, OK, if they have any questions, to call you direct and go that route.
[AGENT][NEUTRAL] Well, you know what we could also do is if you have the billing information for the for the hospital or for the surgery center, we can send, we can even provide them uh a uh.
[AGENT][NEUTRAL] Uh, information about your, about your policy and where to submit the claim, and that might be where they, where they're, uh, have a question. So by all means, um, if they do have any, yeah, if they do have any additional questions, let us know, uh, we will be glad to submit that that documentation to them, let them know where to submit their claim, and usually that's all they're looking for, uh, they just wanna know where to submit the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so, uh, and you, you, they can go to any, any provider, and so, um, if they have any questions we'd be glad to do that. We just need to have their, uh, fax number for the billing department so that we can send that on to them.
[CUSTOMER][NEUTRAL] Right, OK, OK.
[CUSTOMER][NEUTRAL] OK. All right. I will get that from the wife and uh and I'll go from there. And if not, I'll just have them, uh, you know, give them your number or I'll have, I'll give the wife your number cause I'm, I'm not with her right now, but uh I'll just give her, uh.
[AGENT][POSITIVE] Sure, absolutely.
[CUSTOMER][NEUTRAL] The number to you guys and just say, you know, if she has any questions when she gets there that, you know, they can call you guys direct or, she can call you guys direct or, you know, however it's, you know, however it's done. But yeah, she's, she's gotta get some elbow surgery and she's like, well, I, the insurance here, the medication, you know, has gone through, but she's.
[AGENT][NEUTRAL] Please
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Like now I'm trying to get the hospital done, and she's like, the hospital's saying that it's not in the network or something like that. And I'm like, that's odd. I'm like, I've never heard APL not being network. I'm like, it's kind of like a national, or, you know, all 48 state kind of thing. So I'm like, you can go practically anywhere with this insurance, so.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] So, but I'm guessing it's because this hospital that she's going to it's kind of a small hospital or small clinic, so they may not understand APL and how it works and things like that. So, you know, which, you know, I won't be back to the house and I won't be around the wife until tomorrow afternoon. So um we'll uh we'll just go that route then so that'll work out perfect.
[AGENT][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, OK, well just let us know if there's anything we can do and we'll be looking forward to and we'll be glad to tell them exactly what they need to know so we can get this resolved, your wife will get searched.
[CUSTOMER][POSITIVE] Alrighty sounds good. So then, uh, so basically to wrap it up is basically just call them up and then get like a fax number and have them, uh, you know, and then just fax, you know, fax them all, you know, my information or whatever or just have them call you direct and you guys can work it out together on what you need and what you don't need.
[AGENT][NEUTRAL] Please, sir.
[AGENT][NEUTRAL] Either one of those two things will.
[AGENT][POSITIVE] Yes, absolutely. Either one of those two things would be acceptable, and then we can get this, you know, we can start talking about how to get this resolved and, and, and get, you know, so that you can get this thing this thing done. Either one of those two options will be great.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right, we'll go that route then.
[AGENT][NEUTRAL] Now is there anything else at all that I can help you with?
[AGENT][NEUTRAL] Anything else at all that
[CUSTOMER][NEUTRAL] No, that'll, that'll be it, just that.
[AGENT][POSITIVE] OK, well, thank you for contacting EPL. You have a very good day, [PII]. Thank you for calling us. We'll try and help you if we can. Thank you, sir.
[CUSTOMER][NEUTRAL] Nope, just that.
[CUSTOMER][NEUTRAL] You do.