AccountId: 011433970860
ContactId: 642333a1-9ff5-4d49-8ac2-0f99108928fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 311559 ms
Total Talk Time (AGENT): 90103 ms
Total Talk Time (CUSTOMER): 138639 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/642333a1-9ff5-4d49-8ac2-0f99108928fc_20250616T20:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is.
[CUSTOMER][NEUTRAL] So we
[AGENT][NEUTRAL] OK. I'm not able to hear you. Your phone is going in and out.
[CUSTOMER][NEUTRAL] West Kan the Baptist Hospital?
[CUSTOMER][NEUTRAL] Can you hear me now?
[AGENT][NEUTRAL] Yes, I can hear you. What is your name again?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK. And are you calling from the provider or the insured?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] I want to say
[CUSTOMER][NEUTRAL] I have no idea. The provider or the insurance?
[AGENT][NEUTRAL] Are you the provider or are you the insured?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm the insured.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I please have your call back number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, and the policy number please.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 02508098 M as in Mary L as in Larry number 7.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], I do need to verify your date of birth and mailing address on file, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, the mailing address was just changed. I don't know if it'll show there.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Is that the new one?
[CUSTOMER][NEUTRAL] Yeah, I just called and then the lady just changed it. Now I can give you the old one.
[AGENT][NEUTRAL] OK, because it hasn't been updated in our system as of yet.
[CUSTOMER][NEUTRAL] OK, so the old one is [PII].
[AGENT][NEUTRAL] Thank you, and that email address is listed on file please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And thank you so much, [PII] for verifying your policy. How may I assist you?
[CUSTOMER][NEUTRAL] Um, I just called West Kendall Baptist Hospital in regards to this bill that they sent me.
[CUSTOMER][NEGATIVE] And this, my secondary insurance, which is the American Public Life, um, I don't have a specific amount, it's unlimited, so normally everything is supposed to be covered, and when I called them they said that there wasn't an explanation as to why I was covered, so I'm calling to see as to why I wasn't covered.
[AGENT][NEUTRAL] Do you have that data of service?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It was December.
[CUSTOMER][NEUTRAL] I mean, they sent me the bill now on [PII].
[CUSTOMER][NEUTRAL] But I remember her saying it was for [PII].
[CUSTOMER][NEUTRAL] And I received the mail, the bill from on May.
[AGENT][NEUTRAL] OK, so there, is that an emergency room visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I did pull that claim up and you can also check claim status via our secured portal which is [PII], and for that claim, it does show that we did make a payment in the amount of $750. Once we made that payment, that is the maximum amount per calendar day that could be paid.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, calendar day, so then the rest would you guys wouldn't be able to cover it?
[AGENT][NEUTRAL] No, because we may, we pay the maximum amount that we could pay out for that day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] Even though, but that doesn't make sense because everything is unlimited. Like I don't have an X amount of money like before my old gap was $5000. So, even though it was for December and I haven't been to the emergency room at all, it should have been fully covered.
[AGENT][NEUTRAL] Per the policy that is chosen, you have a per calendar day max benefit.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And that is the amount that was paid out.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Thank you so much for calling American Public Life, [PII]. Have a great day.