AccountId: 011433970860
ContactId: 5d9763f0-e755-4415-aa06-6894ec6aa596
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541869 ms
Total Talk Time (AGENT): 211338 ms
Total Talk Time (CUSTOMER): 265206 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/2025/02/24/5d9763f0-e755-4415-aa06-6894ec6aa596_20250224T15:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm just calling to check on um the, the status of my claim because I just received the 3rd past due notice from the hospital and they're adding charges on there.
[AGENT][NEUTRAL] OK, I can help you, [PII]. What's your policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is 022.
[CUSTOMER][NEUTRAL] 70967
[AGENT][NEUTRAL] OK, and what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, let me pull up your file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was just also wanted to know, I don't know what the status is going to be, but since they sent me past due notices, should I start paying something towards it because they keep adding on.
[AGENT][NEUTRAL] OK, let me pull up your information.
[AGENT][NEUTRAL] Uh, what's your date of birth, [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And if you can verify your complete mailing address and your email address on file.
[CUSTOMER][NEUTRAL] Yes, it's [PII] and my email address is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that information.
[AGENT][NEUTRAL] And now you have you already submitted the information?
[CUSTOMER][NEUTRAL] Yeah, I submitted it. Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I got a letter back saying that we've received a claim on your policy and a review of the claim has started.
[AGENT][NEUTRAL] OK, got it. So is this for an inpatient stay in [PII]?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like we processed this claim on [PII].
[AGENT][NEUTRAL] And did you receive a check for $1900?
[CUSTOMER][NEGATIVE] No, I haven't received anything yet, and they asked me for a diagnosis codes, and I had to send that back and that's when I received this letter saying that we've received the claim.
[AGENT][NEUTRAL] Which we did receive and processed it on the [PII].
[CUSTOMER][NEUTRAL] And this letter
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we mailed it to the address that you verified, so let me check to see.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] I mailed it to give me 1 2nd.
[AGENT][NEUTRAL] Let me pull that up again.
[AGENT][NEUTRAL] Uh, it was mailed to [PII]. I'm showing that it is still outstanding, so since it's been 30 days from the date that it was issued.
[AGENT][NEUTRAL] Um, I can verify, uh, with a different area if the check has cleared.
[AGENT][NEUTRAL] Uh, the bank, if it has not, uh, since we've confirmed the address that we have is correct, um, they'll void the check that was issued and then we can get a new check issued and mailed, uh, to the address that you verified.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, cause I haven't
[CUSTOMER][NEGATIVE] Yeah, cause I haven't received anything.
[AGENT][POSITIVE] Yeah, I show it on my end I show it outstanding so we can move to the next step which is verifying uh if it has um cleared.
[AGENT][NEUTRAL] And then what will happen is um we can uh give you a call back either way if it's cleared we can call you back to let you know when it cleared and then we could get you a copy of the front and the back and if it has not, then they will go ahead and void the check that we issued on the [PII] and then get a new one reissued.
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] Should I go on and start paying making payments because there's this, I got my 3rd.
[CUSTOMER][NEUTRAL] Um, late fee past due bill yesterday.
[AGENT][NEUTRAL] Um, that's up to you, uh, that's up to you, um, the, the funds are, are coming to you.
[CUSTOMER][NEUTRAL] Well, over the weekend.
[AGENT][NEUTRAL] So, I mean that's.
[CUSTOMER][NEUTRAL] OK, what am I waiting for?
[CUSTOMER][NEUTRAL] I'm waiting for the check, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And you say how much
[AGENT][NEUTRAL] The check is uh $1900 even.
[CUSTOMER][NEUTRAL] So, with that check, that's what I'm sending, that's all I have to send to [PII]?
[AGENT][NEUTRAL] Well, what, what is your balance? What are they saying your balance is?
[CUSTOMER][NEUTRAL] $24,000.
[CUSTOMER][NEGATIVE] And I don't understand why BWA was the insurance company that I had because I retired [PII]. So I just had to get some quick, quick insurance, you know, to last me until I turned [PII], but DWA.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Um, their planston was supposed to be covering the bills and I kept receiving things over the mail that they're not they're not paying anything. Then when I called the company they said and Novacare was supposed to be paying it, but BWA is the insurance company that I had, Builders Workers of America, and they haven't paid nothing.
[CUSTOMER][NEUTRAL] And I'm just really confused about that.
[AGENT][NEUTRAL] You're confused as to why BWA has not paid anything?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I mean they were my insurance people from [PII] up to I turned [PII] in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean [PII].
[AGENT][NEUTRAL] OK, so now the policy that American Public Life administers under that group is a limited hospital indemnity plan. Did you have another plan other than the one with AP with us, with APL?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] I only got with APL because one of the ladies from [PII] called me and said you're not gonna pay that big bill. The initial bill was for $58,000. So she said, you're not gonna pay all that money. Get with APL and I think she was making some phone calls, but then her [PII] told her no, she can't do that, you know, to let me do it. So that's when I got in touch with ATL. She told gave me the information and that's when I got in touch with them and I sent them what they asked for.
[AGENT][NEUTRAL] Right. And so the benefit payment uh per your policy is $1900 for the inpatient stay.
[CUSTOMER][NEGATIVE] Well, cause they sent me a bill for $24,000. They just added more, more money on since this 3rd 1 $24,633. I thought the APL was going to.
[CUSTOMER][NEUTRAL] A look at this information that I sent them, and they were going to negotiate with [PII] and then they'll give me a lower price. They have to pay them.
[AGENT][NEUTRAL] Yeah, we do not negotiate your benefits are paid based on the policy that you have with ATL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I, yeah, I can't, I'm, I'm retired, so I, I don't have all that money like that, but I just have to pay them something until I get it paid off.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] OK, yeah, but regarding that $1900 check, I haven't received anything yet.
[AGENT][NEUTRAL] OK, we'll verify if it has cleared, and as I was saying earlier, if it hasn't, we can, we can, we can void it and then get a new check reissued and mail to the address that, that, you know, we verified.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] Alright, well, let me just start paying them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Any other
[CUSTOMER][NEUTRAL] Or do you have any other, do you have any other suggestions who I can call to try to get some assistance?
[AGENT][NEUTRAL] No, um, I can just kind of speak to the policy that you have with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I'll start making payments.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you very, very much.
[AGENT][NEUTRAL] Oh, you're welcome. Uh, [PII], any other questions?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEGATIVE] No, no, no, just go start paying.
[AGENT][POSITIVE] OK. All righty.
[CUSTOMER][POSITIVE] OK, thank you very much. Have a good day.
[AGENT][POSITIVE] Thank you for calling APL. Have a good day as well.
[CUSTOMER][NEUTRAL] Alright, oh, if they, if you need to contact me, you have my phone number.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, I have [PII].
[CUSTOMER][NEUTRAL] Yup
[AGENT][POSITIVE] OK. All righty, we have it. Uh, you're welcome. Have a good day, [PII].
[CUSTOMER][POSITIVE] Alright thanks a lot right.
[CUSTOMER][NEUTRAL] All right, OK, bye bye.
[AGENT][NEUTRAL] Bye bye.