AccountId: 011433970860
ContactId: 46452243-099d-4cdb-8bd3-412607d838d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 745109 ms
Total Talk Time (AGENT): 322821 ms
Total Talk Time (CUSTOMER): 346441 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/46452243-099d-4cdb-8bd3-412607d838d1_20250314T22:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. Um, I have, um, your company, um, with our work, um, I needed to find out, I guess my hospital was billing you that, um, billing you guys for imaging, and I knew that you guys don't cover that, but I was trying to figure, I was trying to figure out, um, what does it cover when I'm in the hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, alright, I can help you with your benefits. Can you please give me your name and your policy number?
[CUSTOMER][NEUTRAL] OK, my name is [PII], and let me find my card.
[CUSTOMER][NEUTRAL] Um, yeah, right here. It is policy number.
[CUSTOMER][NEUTRAL] You said?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, 978555.
[AGENT][NEUTRAL] OK, let me look your policy up.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then also, can you verify your address, phone number, and email address?
[CUSTOMER][NEUTRAL] Um, it's uh [PII], and, um, it's [PII].
[AGENT][NEUTRAL] It looks like I have your work email address.
[CUSTOMER][NEUTRAL] A what?
[AGENT][NEUTRAL] Your work email address?
[CUSTOMER][NEUTRAL] Oh, the working out, um, it's, uh, [PII].
[AGENT][NEUTRAL] Yes ma'am, and then one last verification, can you give me your phone number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it might have, it probably changed, but the old one, it was, [PII].
[AGENT][NEUTRAL] OK. And then what do you want the new one to be?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, thank you. I'll get that updated and then if we do get disconnected, can I call you back on that number?
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] Yes ma'am, that's what I'm talking to you on. I think I'm needing a new card also because this one is effective date [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know if they changed or.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, it's not changed for you. Um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alright let me pull up your policy so that I can look at it and read to you your benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can also get a copy of this and your card if you sign up for our online service center. It's a direct portal to your policy and you can also file claims through there if you need to. Would you like that site?
[CUSTOMER][NEUTRAL] Pop
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Um, um, yes.
[AGENT][POSITIVE] OK. It's secured, [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. OK, OK.
[AGENT][NEUTRAL] OK. Let me see what your policy reads.
[CUSTOMER][NEUTRAL] I got
[AGENT][NEUTRAL] It just pulled up.
[CUSTOMER][NEUTRAL] 7 cross city and also and er to your kids so many.
[CUSTOMER][NEUTRAL] cloud.
[AGENT][NEUTRAL] OK, you have just the basic hospital indemnity plan, which covers hospital stay. So, um,
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yeah, and I've been in the hospital, let's see, um, let's see, the week of January the [PII] and the whole month of February.
[AGENT][POSITIVE] Oh my goodness. Bless your heart.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, yes, for surgery, so yes, ma'am, and that's why I was checking on it because I know it pays something back to you when you are in the hospital. That's what I, that's why I remember them telling me, but I wasn't sure.
[AGENT][NEUTRAL] OK. Oh yeah, that's a long time.
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] Yes. Yes, ma'am. OK, so on your benefits, you have, um,
[AGENT][NEUTRAL] A hospital daily confinement benefit.
[AGENT][NEUTRAL] Of $30 for the days that you are in the hospital.
[AGENT][NEUTRAL] And then, and this is just to verify your benefits, it's not a guarantee of payment and then once a year you, you, it pays $1500 towards the hospital stay.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's for 18 hours or more.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's basically
[CUSTOMER][NEUTRAL] Now how do I
[CUSTOMER][NEUTRAL] Now, how is that, um, how is that being, um, how is that, um, how, how do you claim that or, or, or does that go straight to, because I gave them my card at the hospital.
[AGENT][NEUTRAL] Basically, mhm.
[AGENT][NEUTRAL] Mhm, well, let me see if they've sent in any claims for you because usually when you get the hospital your card they'll submit the claim for you so let me see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like um.
[AGENT][NEUTRAL] It looks like they've been submitting claims for you on [PII] and [PII] they've sent in documentation um that's in progress right now.
[CUSTOMER][NEUTRAL] OK, but I should.
[AGENT][NEUTRAL] So they're reviewing it?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I should have um [PII] [PII].
[CUSTOMER][NEUTRAL] To let me find a
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Give me one sec here.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, let me see calendar.
[CUSTOMER][NEUTRAL] Let's see. I was, let's see, from [PII], I was in the hospital.
[CUSTOMER][NEUTRAL] And I was discharged the [PII].
[AGENT][NEUTRAL] OK, let me give you our website where you can get your claim forms. Well, you can, you can file the claim through the online service center that I gave you the site for, um for your hospital indemnity plan there and if you choose not to do it online and you wanna fax it or mail it in, let me give you another website to go to where you can get the claim form.
[CUSTOMER][NEUTRAL] OK, um, let's see. Give me one sec.
[AGENT][NEUTRAL] It's
[AGENT][POSITIVE] Just let me know when you're ready, yes ma'am.
[CUSTOMER][NEUTRAL] Is it the one that's on the back of the card?
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] There's a
[CUSTOMER][NEUTRAL] Yeah, [PII], yes.
[AGENT][NEUTRAL] Yes, so if you go to that website on page 2 when you go to claims and forms.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On page 2, the first one, the hospital indemnity claim form is what you're going to need.
[AGENT][NEUTRAL] And up at the top of the claim form it tells you exactly what you need to send in with your claim form to your claim can be examined.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's um what was that? I'm gonna look for the, the hospital.
[AGENT][NEUTRAL] Indemnity.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Find a pen that works in this house.
[AGENT][NEUTRAL] Claim form
[CUSTOMER][NEUTRAL] Uh, OK. Hospital.
[CUSTOMER][NEUTRAL] Identity?
[AGENT][NEUTRAL] Yes, indemnity plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's on page 2 and it's the first claim form on page 2.
[CUSTOMER][NEUTRAL] Page 2.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And that's on page 2, you said. And that's what I'll need.
[AGENT][NEUTRAL] Right. When you first.
[AGENT][NEUTRAL] Yes, when you first get into the website up at the top right hand corner you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And when that loads, then on page 2 will be your hospital indemnity claim form.
[CUSTOMER][NEUTRAL] Claims and forms.
[AGENT][NEUTRAL] In the top right hand corner.
[AGENT][NEUTRAL] Of the website.
[CUSTOMER][NEUTRAL] OK, claims and forms and then I'm gonna click on what now?
[AGENT][NEUTRAL] You'll click on claims and forms.
[AGENT][NEUTRAL] And then when it loads for you, you're gonna choose page 2.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And it'll be the first one on page 2.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and then uh and then fax it.
[AGENT][NEUTRAL] You can fax it at [PII].
[CUSTOMER][NEUTRAL] I yeah, I have it on the back of the, on the back of the card too, yes well.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] And do you also have the [PII] in [PII] for the mailing address?
[CUSTOMER][NEUTRAL] Um, I have [PII].
[AGENT][NEUTRAL] To mail them in?
[AGENT][NEGATIVE] No, that one's no longer good.
[AGENT][POSITIVE] Let me give you the good one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is it the one that, um, you guys been sending me the letters to?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The [PII]
[CUSTOMER][NEUTRAL] The [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] Yes, yes, that's the good one.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] I gotcha. OK. So I know what to do cause I was wondering cause I knew I, I knew, I knew they were saying something that's why I have a plan for um because I did go in the hospital that they did pay something towards your um when you were in the hospital so many days.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, and that's what I was trying to figure out. I was like, wait a minute here, I keep on getting these for these claims that um it's um they paying for the imaging. Well, I know you guys don't pay for imaging. It's that goes towards my other my Blue Cross and Blue Shield.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, that's why it's like, I knew that.
[CUSTOMER][NEUTRAL] Cause I know they have these claim forms.
[AGENT][NEUTRAL] Yeah, they
[CUSTOMER][NEUTRAL] But I don't know what uh the.
[AGENT][NEUTRAL] They use, uh-huh.
[CUSTOMER][NEUTRAL] I don't know what the March is for because I wasn't, um, I got, I mean, I got out the end of February.
[AGENT][NEUTRAL] Right, and they're probably just now sending in the claim. It happens a lot they don't send them right away yeah um we have sometimes I'm still getting claims from June that are just now being submitted by the facilities and which is OK because we don't have a timely filing limit on on claims you can file them at any time as long as your policy was active on the date of service at any time.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can file them so they take advantage of that you know they do and which is fine because I'm sure they've got a lot to do.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're so welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Um, no, ma'am, I think that's all.
[AGENT][NEUTRAL] OK well if you find there's something else that you need you pick up the phone and call us OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. You have a great night and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah you too thank you.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEGATIVE] [PII].