AccountId: 011433970860
ContactId: 55b4e264-d84a-4bb0-b873-5cb3bbfa9f18
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378890 ms
Total Talk Time (AGENT): 208444 ms
Total Talk Time (CUSTOMER): 135835 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/55b4e264-d84a-4bb0-b873-5cb3bbfa9f18_20250304T16:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes Miss, my name is uh [PII].
[CUSTOMER][NEUTRAL] And my account number is 2,566,030.
[AGENT][POSITIVE] Thank you for that, and Mr. [PII], how may I assist you today?
[CUSTOMER][NEUTRAL] Just to ask you a question, uh, with the plan I have with y'all, I think they kind of want me to stay like in a, uh, once I get my, my, uh.
[CUSTOMER][NEUTRAL] Radiation treatment for a castle, but they call them the um the hotels, whatever you stay in uh.
[AGENT][NEUTRAL] Like for lodging?
[CUSTOMER][NEUTRAL] I think that a lot, yeah, so I have to pay for that one and y'all just reimbursed me for it.
[AGENT][NEUTRAL] You, you said you want, it's breaking up, you said you're, you're wanting to pay for it and you want to know if we'll reimburse you?
[CUSTOMER][NEUTRAL] Yeah, if I'm saying if I have to pay for it, would I get reimbursed for from you.
[AGENT][NEUTRAL] Oh, I can take a look at the policy, um, and I just need you to verify your date of birth, your mailing and email address, and I can look at the benefits for you.
[CUSTOMER][NEUTRAL] 9965 mailing address [PII] [PII].
[CUSTOMER][NEUTRAL] And you said what else now?
[AGENT][NEUTRAL] Your mailing, I'm sorry, your email address.
[CUSTOMER][NEUTRAL] Oh, but Facebook [PII] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. Um, hold on just one moment. I'm looking through your benefits to see if there is a lodging benefit. Um, do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, go ahead.
[AGENT][NEUTRAL] OK, hold on one moment. Actually, it just came up for me. Um, so the lodging is, so you have benefits for you and a family member. So like if your wife, um, for you, the lodging would be uh pay per day, a maximum of 100 days um per calendar year, we will pay $100 per day for lodging, and then the same would apply if you have a family member with you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] So my wife was spending a couple of like a day or two days with me, it'd be $100 too right.
[AGENT][NEUTRAL] Right, it would, um, we would just need the billing and then however many days she stayed, we would, um, it could, you know, be paid out to her, of course, after this exam.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do they charge you for staying in the lodgings?
[CUSTOMER][NEUTRAL] Cause I've never done this before.
[AGENT][NEUTRAL] Does who charge you? the the facility?
[CUSTOMER][NEUTRAL] Yeah, you know, like the, yeah.
[AGENT][NEUTRAL] Oh, well, see, now, I don't know how that works. You'll have to contact whoever the facility is and see how they charge, but once we receive the claim, um, these are your the benefits that will pay towards that or could pay towards that.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Did y'all get the other stuff, the uh the bills and stuff I sent y'all last Thursday?
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] It was an itemized billing.
[AGENT][NEUTRAL] Yes, we received it on um [PII], so,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, last Thursday.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So what was that for? I a nice building.
[CUSTOMER][NEUTRAL] What did y'all need that for?
[AGENT][NEUTRAL] So, anytime you file a claim, the itemized billing shows the charges, it shows what primary insurance pay, it shows the coding, so that we could prove necessity, medical necessity, so that we can pay out on the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Now, I think this is my radiation treatment is like $4000 but this I can pay like 44 uh like so much percentage of like $400 down and just make monthly payments on the rest of it.
[AGENT][NEUTRAL] So, um, for your
[AGENT][NEUTRAL] Radiation therapy, chemotherapy, or immunotherapy, you have a maximum of $20,000 per calendar year, I'm sorry, per 12-month period, so per year per person. So, the um when you
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Do begin the services, just I would just give them our um give them your policy number and our phone number and have them call us to verify benefits so that they can go ahead and bill your primary and then bill us so that you don't have to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, primary be like other insurance, like medical insurance, something like that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then y'all get the other part of. OK, I got you.
[CUSTOMER][POSITIVE] Alright, thank you, ma'am.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Now, how long would it take if I here for like another 1 week or 2 weeks if I got approved for anything?
[AGENT][NEUTRAL] Um, it's usually a 7 to 15 business day turnaround. So let me see, hold on one second, the [PII].
[AGENT][NEUTRAL] So around the [PII], so around next Friday would be uh exactly 15 business days.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] So you send me a letter saying I got approved or not approved.
[AGENT][POSITIVE] Yes, sir, you'll receive an um explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's, that's one to let me know who proved or not prove. That's the one to let me know who proved or not prove right.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Yes, and since you sign um I see that you submit your claims on the online service center. If you, um, if you entered your cell phone, you know, like when you were signing up for it, if you put your cell phone number there, then you'll receive a text message as well letting you know that there is a claim that was processed.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, thanks. And I'm going to what now? To do that?
[AGENT][NEUTRAL] Or a claim that has finished processing.
[AGENT][NEUTRAL] The, the online portal where you went to upload your documents?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um it'll it'll be there for you.
[CUSTOMER][NEUTRAL] Alright then, I'll look at it.
[CUSTOMER][POSITIVE] All right, thank you, man.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with?
[CUSTOMER][POSITIVE] No that was it. Thank you. I appreciate you. Talk to you in 2 weeks.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Alrighty, well, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too, man.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm, yeah.