AccountId: 011433970860
ContactId: 72bdac39-bf2a-4801-9470-9aecdc42fd81
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284769 ms
Total Talk Time (AGENT): 93502 ms
Total Talk Time (CUSTOMER): 180925 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/72bdac39-bf2a-4801-9470-9aecdc42fd81_20250327T17:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning or afternoon depending on where you are. Um, I'm just trying to get information. I'm a policyholder with you guys and I have a, uh, group hospital coverage. My wife managed to fall and break her wrist Friday night.
[AGENT][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] And she was taken by ambulance. Oh yeah, it was as bad as it sounds. Um, and she was transported by ambulance to a hospital. We were actually out of town, eating dinner with friends. Um, they fixed up in the emergency room, said she would have to have surgery sooner than later. Um, so this past Monday, 4 days ago, we
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] An an appointment with an orthopedic surgeon, uh, specializing in hands and met with him. He said, yeah, we need to do this sooner than later. So Tuesday morning they put a plate and screws in and she's forever going to be, uh, setting metal detectors off. But I don't have an EOB, a bill, anything yet. So my I was telling one of the gentlemen I work with who happens to be our benefits fellow, and he said, do you need to file this.
[CUSTOMER][NEGATIVE] But is it pre I know we have a certain amount of time to do it and uh I'm just at a loss. I don't know what to do. Should I go in and file a claim and say this happened and then upload the the documents as I receive them or what, what do I need to do? I'll shut up at this point.
[AGENT][NEUTRAL] OK. What, what was your name?
[CUSTOMER][NEUTRAL] [PII] and I have our policy number if you need it.
[AGENT][NEUTRAL] OK, [PII], yeah, if you can give that to me.
[CUSTOMER][NEUTRAL] It's 249-4497.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, just need to verify a few pieces of information. Um, what's your birthday?
[CUSTOMER][NEUTRAL] Certainly [PII].
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And lastly, what is your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, perfect. Oh, and one more thing, what was your callback number just in case I lose you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so for the timely limit, there is no timely limit to file your claims, so you're OK there, um, if you wanna wait, no, no worries there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so, and, and what we would need is like an itemized bill showing exactly what happened, you know, like that it was for the break, etc. in the um hospital, so once those become available, um, then you can get that filed. So like I said, don't have to worry about a timely limit or anything that that does not applicable so.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good deal.
[CUSTOMER][NEUTRAL] OK, that was my biggest concern. So as soon as Gills bar and Cigna starts sending the bills my way, I will upload them and uh.
[CUSTOMER][NEUTRAL] I guess follow the prompts on the the website.
[AGENT][NEUTRAL] Yeah, just look at that claim form, be sure that you look at that list of what's required because it does require, you know, specifically, you know, we need to be able to see that it was performed in the hospital, what the accident was, etc. so.
[CUSTOMER][POSITIVE] Excellent, sure alrighty well I will take care of that as we get them in and and I appreciate the information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], is there anything else I can help with today?
[CUSTOMER][MIXED] No, you can come sit with my wife cause she's getting real frustrating, but other than that, um.
[AGENT][NEGATIVE] I know it's frustrating. I broke my ankle. I had a catastrophic ankle break, so I totally like it's life, it's life changing when you break a, you know, something you use all the time, so I get it. It's, it's really frustrating.
[CUSTOMER][NEUTRAL] It's, it's, yeah.
[CUSTOMER][NEUTRAL] Oh my God.
[CUSTOMER][NEUTRAL] Yeah, she's not a good patient. I'm not a good nurse, but after 35 years I guess it works. No, it's all good. I really, I, I, I'm, huh? I'm sorry.
[AGENT][NEUTRAL] Well, I'm, I'm sitting with.
[AGENT][POSITIVE] I'm sending, sending well wishes your way.
[CUSTOMER][POSITIVE] Well, I appreciate it. I, I do, and I'll quit driving you. I know they have a ton of other folks that probably need help, but, but I do. I appreciate your info.
[AGENT][POSITIVE] All right, thank you, [PII]. Have a great day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you as well, hon, thank you.
[AGENT][NEUTRAL] Bye.