AccountId: 011433970860
ContactId: 753d58bb-8eb9-4571-8274-6f5e2deb90c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 730900 ms
Total Talk Time (AGENT): 242074 ms
Total Talk Time (CUSTOMER): 340058 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/753d58bb-8eb9-4571-8274-6f5e2deb90c1_20250505T17:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] Hi, I called in earlier. I'm sorry I let you guys on hold too long. Let me start again. I'll give you the uh number here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I think you guys wanted my.
[CUSTOMER][NEUTRAL] Uh, let me find it.
[CUSTOMER][NEUTRAL] ID number of sorts. Let's see.
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] I do remember I do remember.
[CUSTOMER][NEUTRAL] OK, APL, um, and hospital benefit card.
[CUSTOMER][NEUTRAL] 02582282 M like mother L like Larry 7.
[AGENT][NEUTRAL] OK. Can I get your name and your date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. Do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then just need to verify your address and your email address.
[CUSTOMER][NEUTRAL] [PII] and my email is [PII].
[AGENT][NEUTRAL] I actually don't have an email on file. Do you want to add that?
[CUSTOMER][NEUTRAL] Sure, so it's pink like the color.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] [PII]
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], so [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me get that entered in real quick.
[AGENT][NEUTRAL] OK, and how can I help you, Ms. [PII]?
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Um, no, hold on one sec.
[CUSTOMER][NEUTRAL] Um, I was trying to pull up the forms for the different policies that I have.
[CUSTOMER][NEUTRAL] And on my work one anyway they're a little vague and some don't have any.
[CUSTOMER][NEUTRAL] So trying to get a clear understanding of which ones I have, which ones to use today I think some of them are stackable.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First I want to see, can I get copies of the ones I have emailed over.
[CUSTOMER][NEUTRAL] In general, so I've got something uh a little more detailed than what they have on my work website.
[AGENT][NEUTRAL] Uh, it looks like the only policy I show is the Medlink policy. So it's like that's your gap policy. It it picks up after your primary insurance processes claimed.
[CUSTOMER][NEUTRAL] OK, so you mean that's the one that does.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Inpatient, outpatient at like 6650 or some such thing. Does that ring a bell?
[AGENT][NEUTRAL] Uh, yes, um, let me see what the amount is. Are you interested in creating an account online?
[CUSTOMER][NEUTRAL] I think it's
[AGENT][NEUTRAL] On our portal
[CUSTOMER][NEUTRAL] Um, sure.
[CUSTOMER][NEUTRAL] Yeah, that'd be fine too. I think I might be on there already. I'm just having a hard time logging in on them in the hospital, so what I'm trying to do is get all three. So I've got that one. I think I've got another.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] One or two under you doesn't my hospital and themity fall under you as well.
[AGENT][NEUTRAL] Um, I don't show a hospital indemnity, so I don't know if that's maybe through a different company. All I've got is the Medlink.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] What they said it with a bunch of different ones, um.
[CUSTOMER][NEUTRAL] It was unlikely, but
[AGENT][NEUTRAL] Yeah, we, it looks like.
[CUSTOMER][NEUTRAL] So you're not sure.
[AGENT][NEGATIVE] Yeah, I, I'm not sure who it would be through. We used to do way back in [PII]. Looks like we did a critical illness for you and a group accident.
[AGENT][NEUTRAL] Um, but the only one I have now is the Medin. That's the only one I show active.
[AGENT][NEUTRAL] But they probably switched carriers. That's entirely possible, so.
[CUSTOMER][NEUTRAL] You did a credit
[CUSTOMER][NEUTRAL] You get critical illness and then accident back in [PII]. Did I have anything else through you? Did I do short and long term disability for you back then?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, I don't show that.
[CUSTOMER][NEUTRAL] Where is that Mutual of Omaha?
[CUSTOMER][NEGATIVE] OK, now under the new ones because they put some company called Walnet or something in charge of this. We just redid our in January. I got the Medlink. I got and I got accident and I got hospital.
[CUSTOMER][NEUTRAL] You're saying the other two aren't with you though.
[AGENT][NEUTRAL] Correct, the only one we have is Medlink, so they, they must have it through a different carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Jesus Christ, so messy. OK.
[CUSTOMER][NEUTRAL] Um, alright, so even this one will be relevant. Um, I have a big understanding of how it works, and I don't think the card got to hospital billing while I was being ambulanced in, but, um, I'm gonna bring it to them and see what can be done, um.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] In a slightly larger nutshell, it covers or reimburses ambulance trips and then.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Was it my copay or my deductible towards.
[AGENT][NEUTRAL] Yeah, so for
[CUSTOMER][NEUTRAL] Hospital visits?
[AGENT][NEUTRAL] For outpatient benefits, which would include the ambulance. Um, this is not a guarantee of payment. It's a basic outline of your policy. So, the, the Medlink policy that you have, it covers 2250 per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's for, again, that's for ambulance. So, once your primary processes the claim, whatever is left over, that's the maximum we would pay up to 2250.
[AGENT][NEUTRAL] And then you have a different
[CUSTOMER][NEUTRAL] OK, wait, let me write that down. That's, that's desk to um.
[CUSTOMER][NEUTRAL] Ambulance that covers?
[AGENT][NEUTRAL] Yeah, it would be ambulance, outpatient benefits, um, there's just an emergency room, surgery and an outpatient facility.
[CUSTOMER][NEUTRAL] OK, you're talking in general. OK, so in the case of this one just today or this week, it would cover seemingly.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Ambulance.
[CUSTOMER][NEUTRAL] What else was it? I'm sorry?
[AGENT][NEUTRAL] Um, so you have like that 2250 would cover hospital ER surgery in a hospital, um, diagnostic testing.
[AGENT][NEUTRAL] Physical therapy and ambulance.
[CUSTOMER][NEUTRAL] OK, and that's from an outpatient point of view.
[AGENT][NEUTRAL] Correct, 2250, yep, and then you have a separate inpatient benefit.
[CUSTOMER][NEUTRAL] OK, and what was that one?
[AGENT][NEUTRAL] Um, that one is, let me get that pulled up.
[AGENT][NEUTRAL] That one is 6750.
[CUSTOMER][NEUTRAL] OK, and that one would cover.
[CUSTOMER][NEUTRAL] The same.
[AGENT][NEUTRAL] Yes, so it's gonna be for inpatient hospital benefits. So for the facility charges.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] It says ambulance, but I'm not sure. Let's see, let me.
[AGENT][NEUTRAL] Were you inpatient when you were transported or were you outpatient?
[CUSTOMER][NEUTRAL] Well, I was a patient of where I lived and then I took an ambulance to the hospital and then I don't know where they.
[CUSTOMER][NEUTRAL] Decided after that.
[AGENT][NEUTRAL] OK, but I mean, did you spend the night at the hospital when you were transported?
[CUSTOMER][NEUTRAL] Yes, I got transported and then I spent the night in the hospital.
[AGENT][NEUTRAL] OK, if it was more than 18 hours, um, that would be defined as inpatient.
[AGENT][NEUTRAL] So, if uh if you were discharged as outpatient under 18 hours, then you would have access to the 2250. If it was more than 18 hours, then you would have access to 6750.
[CUSTOMER][NEUTRAL] Got it. OK, so.
[CUSTOMER][NEUTRAL] So the inpatient is where I feel probably all this would fall.
[CUSTOMER][NEUTRAL] It covered the ambulance, any types of uh what MRI's and tests and whatnot there.
[AGENT][POSITIVE] Yes, correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But basically just covers.
[CUSTOMER][NEUTRAL] What I think would fall into like a copay for me.
[CUSTOMER][NEUTRAL] It just covers that. It covers the remainder.
[AGENT][NEUTRAL] Yeah, so what
[AGENT][POSITIVE] Yeah, so it covers like your primary insurance, whatever they apply to your deductible, co-pay or co-insurance, this picks up to the maximums of what I've mentioned.
[CUSTOMER][NEUTRAL] OK, so we cover either any copays left over or.
[CUSTOMER][NEUTRAL] Coinsurance or any remainder like if it was an 80/20, it would cover the 20.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so it covers you, so 20, OK.
[CUSTOMER][NEUTRAL] OK, ambulance and then.
[CUSTOMER][NEUTRAL] OK, and then what would I do? Just give this card to billing here at the hospital?
[AGENT][POSITIVE] Yes, you can give it to them.
[CUSTOMER][NEUTRAL] OK, and then they bill it to you or do I prepay it and then you send it to me?
[AGENT][NEUTRAL] Uh, they, it's up to them how they charge you. I don't know how they charge. So, but the way it processes through us is they have to process it through your primary insurance first, because we have to see that explanation of benefits from your primary insurance showing how it processed. That way we know how we can pay on it.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] But it's, it's up to them what dollar amount they charge you. I don't know about that part, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, so it goes to them and then it goes to you and I have a plastic card with you guys already so.
[CUSTOMER][NEGATIVE] I feel somewhere online that's probably a better explanation of all of the details. I should think that you guys sent me a book a while back, mailed at home, but you are not in charge of.
[AGENT][NEUTRAL] Yeah, but um
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I was gonna send you, I'll email you the instructions to set up your account online on our portal because there you can reference a 44 page PDF document you can reference um that shows, you know, what's covered, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect that'd be great and then I'll find out why or who or what's going on that work has a different group for.
[CUSTOMER][NEUTRAL] Everything else.
[AGENT][NEUTRAL] Yes, I would uh talk to your HR, yep.
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][POSITIVE] Yeah, OK, alrighty, great, thanks for your help.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thanks bye bye.