AccountId: 011433970860
ContactId: 7262ddfa-f5d4-47aa-9715-fa0fe8158714
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557280 ms
Total Talk Time (AGENT): 285407 ms
Total Talk Time (CUSTOMER): 166132 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/7262ddfa-f5d4-47aa-9715-fa0fe8158714_20250414T19:58_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I need to send in some um hospital bills and stuff.
[CUSTOMER][NEUTRAL] I didn't know exactly how to what I need to do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, well, I can help you with filing a claim. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] Number [PII]
[AGENT][NEUTRAL] Thank you for that. and Ms. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Oh, I got two of them. I got a, um, hospital identity, it's 673685.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] And then I have a can I, do you need the cancer also?
[AGENT][NEUTRAL] Um, are you, uh, well, no, one will get me to both. Hold on one second, and that was 673-685?
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, I have you here, Ms. [PII], can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] and I don't know if it's my home email if it's [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Or [PII], OK, OK, not a full one then, OK.
[AGENT][NEUTRAL] Alrighty, thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. And so to, so are you filing for the
[AGENT][NEUTRAL] Medical policy or
[AGENT][NEUTRAL] Well you said hospital bills, so.
[CUSTOMER][NEUTRAL] I had an accident. I had an accident and I have a bunch of hospital bills and mammograms and women's health and things like that. I did send in.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, so,
[AGENT][NEUTRAL] There are 3 things that you'll need. You'll need the hospital indemnity claim form.
[AGENT][NEUTRAL] You also have an accident and a critical illness policy, so you, you may be able to file for more than one.
[AGENT][NEUTRAL] of your products that you have here.
[CUSTOMER][NEUTRAL] OK, I don't know what. OK, I don't know what forms I'm gonna need then.
[AGENT][NEUTRAL] So, um, just to be on the safe side, you'll need the hospital indemnity claim form and the itemized bill from, you know, the bills from the hospital, but make
[CUSTOMER][POSITIVE] OK, I've got all skills and I've got flash drive. I'm ready to send them in.
[AGENT][NEUTRAL] But make sure that they're the hospital's version of the bill, not your patient version. Your patient version only.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, but that
[CUSTOMER][NEUTRAL] They've got the diagnosis codes on them.
[AGENT][NEUTRAL] OK, so, um, you can file.
[CUSTOMER][NEUTRAL] Is that
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] That's right, as long as they have the uh uh diagnosis codes on them.
[AGENT][NEUTRAL] Yes, if you have the diagnosis codes and the procedure codes and the charges, you should be OK. Um, you can fax it, you can mail it, or you can send it to us electronically on our portal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me send it because it's a bunch of pages I've got like I said on, on a thumb drive. Can I, um, send it in like that?
[AGENT][NEUTRAL] At, like on the thumb drive?
[CUSTOMER][POSITIVE] Yes, I can put it in the email and send y'all, yeah, off my thumb drive.
[AGENT][NEUTRAL] Well, we can't accept claims through email because of HIPAA, um, but you can upload them um electronically.
[CUSTOMER][NEUTRAL] OK, how do I do that?
[AGENT][NEUTRAL] So, on our portal, um, our website is [PII].
[CUSTOMER][NEUTRAL] Hang on [PII]. I need y'all to sit down. I'm busy, [PII]. I'm sorry, my kids just they came back my classroom. [PII] what?
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, AM.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you're gonna click, once it comes in, you're gonna click on sign in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm checking now to see if you have an online service. OK, so you have a portal. So you would just click log in.
[AGENT][NEUTRAL] Your username is [PII].
[AGENT][NEUTRAL] And if you don't remember the password, you can just use the forgot password link and then once you get into your portal, you'll just click on upload, uh, sometimes it says upload documents, it might say upload files, but you'll click on that and just follow the prompts and it'll take you to where you can attach your documents.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, will someone be able to get back with me just to let me know that these came through to be on the safe side?
[AGENT][NEUTRAL] So no one will let you, I mean, you're gonna receive a text and you'll receive a text letting you know that the um claim has been received and is in processing.
[CUSTOMER][NEUTRAL] I've
[CUSTOMER][NEUTRAL] OK, that's why I wanna make sure they they came through.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, you said [PII], OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, yep, don't remember the password. That's not great.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So I need, so I don't need.
[CUSTOMER][NEUTRAL] The hospital I what I what's that word right there and the other one.
[AGENT][NEUTRAL] The hospital indemnity farm?
[CUSTOMER][NEUTRAL] Yeah, and what was the other one you said?
[AGENT][NEUTRAL] You have an accident and a critical illness. I'm sorry, um, you have a cancer and a critical illness policy.
[CUSTOMER][NEUTRAL] So what do I need to fill out then?
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] I would start with hospital indemnity because they are hospital bills, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if there's multiple um
[AGENT][NEUTRAL] I mean
[AGENT][NEUTRAL] Were you, where you use the hospital indemnity form, you would just switch it out for the cancer form or the critical illness form, but I would first start with everything hospital indemnity.
[CUSTOMER][NEUTRAL] OK, because it was an accident and I had to have a uh uh ambulance and everything else.
[AGENT][NEUTRAL] So let me see, hold on one second. What's all in your critical illness.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] When you say accident, like, like what type of accident was it?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] I had to, I had a horse accident and the bone came out of my, my ankle bone, literally, my foot went to the right, the ankle bone comes to the left. Yeah, it wasn't bad. I had 10 surgeries. Yeah, I had 10 surgeries on it.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let me see, I'm just looking up the critical illness benefits to see like if something would apply.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, so for your
[AGENT][NEUTRAL] The critical illness policy will pay up to $325.
[AGENT][NEUTRAL] 1 to 45 days for an accident.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEGATIVE] And it doesn't specify like what it's literally one page and um for accident it's 1 to 45 days, $325. So I would, uh, the same documents, I would just send in the hospital indemnity form and the critical illness form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that's what I will do then.
[AGENT][NEUTRAL] And then once
[CUSTOMER][NEUTRAL] And just upload my.
[CUSTOMER][NEUTRAL] Like I'm sorry, go ahead.
[AGENT][NEUTRAL] No, no, you're fine. Go ahead.
[CUSTOMER][NEUTRAL] Um, and I just upload them.
[AGENT][NEUTRAL] Yes, ma'am, and I do want to let you know, so if like if you're uploading and something happens and you need to start over, it's going to look like you anytime you submit something to the online service center, it'll look like your um
[AGENT][NEUTRAL] Submitting a new claim, but we'll know when we get it that this is all together. Um, so don't, don't be alarmed if you see that cause, and you will get a new confirmation number.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And I was saying critical illness, I mean, but it's it's an intensive care policy, so you'll use that form just to be specific.
[CUSTOMER][NEUTRAL] OK, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I will get started on this thank you very much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No ma'am, that's it thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] Yes ma'am you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.