AccountId: 011433970860
ContactId: 4b5c0ecb-d4ff-46b2-b193-f1bf374582fa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297059 ms
Total Talk Time (AGENT): 125310 ms
Total Talk Time (CUSTOMER): 118978 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/4b5c0ecb-d4ff-46b2-b193-f1bf374582fa_20250513T13:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII], and I have, um, APL gap plan.
[CUSTOMER][NEGATIVE] And I'm in a group and um I'd, I'd like to, um, I've never used it and I've had it for a number of years and I'd like to know exactly how this works because um my husband's been diagnosed with cancer, so I'm starting to get a lot of uh medical bills.
[AGENT][NEUTRAL] OK, I'm sorry to hear that. Do you have a policy number?
[CUSTOMER][NEUTRAL] Yeah, I have a group number. It's number 24533.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] And [PII], may I have a good callback number for you?
[CUSTOMER][NEUTRAL] Um, yeah, my cell number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you one moment, I'll get this pulled up. Can you verify your date of birth, your mailing address, and your email please?
[CUSTOMER][NEUTRAL] Yes, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And my email address is [PII].
[AGENT][NEUTRAL] And your mailing address?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim.
[AGENT][NEUTRAL] And I have this pulled up.
[AGENT][NEUTRAL] So, to submit a claim, you can either have the provider file for you.
[AGENT][NEUTRAL] Or you can submit the claim.
[AGENT][NEUTRAL] So if you submit the claim, you would need 3 items when you file.
[AGENT][NEUTRAL] You will need an itemized bill from the provider.
[AGENT][NEUTRAL] You will need your primary insurance explanation of benefits.
[AGENT][NEUTRAL] And you would need the Medlink claim form.
[AGENT][NEUTRAL] Which you can obtain online at [PII] and go under forms.
[CUSTOMER][NEUTRAL] So it's A M like mom.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] AM, uh, can you repeat it?
[AGENT][NEUTRAL] Public
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Explanation there, OK, so it would be 3 items that I would need if I did it myself, otherwise the provider, um, does, and what, what does it cover? What does this, uh, gap cover?
[AGENT][NEUTRAL] OK. So under this plan, it will pick up your copays, your co-insurance and or deductibles up to your benefit amount. So anytime you're inpatient, it will allow up to
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] $4000 per calendar year.
[AGENT][NEUTRAL] And if you're outpatient, it allows 500 per calendar day. It does not have the office visit benefits. So there's no office visit or office treatment benefits, but you do have.
[AGENT][NEUTRAL] Um, urgent care, any outpatient testing, diagnostic testing, lab procedures, anything like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK, and my last question is, um, let's say I, I didn't do this and we just had surgery like in [PII]. How long do I have to, to file a claim for that year or we already passed it?
[AGENT][NEUTRAL] There is, there is no time limit to submit a claim. As long as your policy is active, you can submit that claim.
[CUSTOMER][NEUTRAL] Oh really? OK, because he had a knee replacement, so I know I did my um deductible was $4000. OK, so I'll just have to go back and get those um explanation of benefits from the United Healthcare, right? and then try to submit it, I guess.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, thank you so much for your information so I just uh need to start showing the card, uh, when he does his visits and then any kind of uh out of pocket stuff, OK, and see what is covered, I suppose.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Thank you so much for your help today.
[AGENT][POSITIVE] [PII], you're so welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, that'll do it. Thank you so much.
[AGENT][POSITIVE] You're so welcome, and [PII]. Thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] You