AccountId: 011433970860
ContactId: 79e4f2ee-d3a1-417b-9c30-6e3797b393d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 260480 ms
Total Talk Time (AGENT): 124697 ms
Total Talk Time (CUSTOMER): 79686 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/79e4f2ee-d3a1-417b-9c30-6e3797b393d6_20250424T16:23_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, [PII]. Um, I actually pay for, um, hospitalization, accidental critical illness. Um, I wasn't sure if my, um, hospital, uh,
[CUSTOMER][NEUTRAL] Um, insurance covers my surgery.
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 259-3870.
[CUSTOMER][NEUTRAL] And then I have my group number too.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what was your name and your date of birth?
[CUSTOMER][NEUTRAL] [PII], and my birthday is [PII].
[AGENT][NEUTRAL] And [PII], do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. Just need a few more pieces of information. What is your address?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then lastly your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let's see. So you're checking to see if it covered surgery, is that right?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, this is not a guarantee of payment, basic outline of your policy. Um, let me see.
[AGENT][NEUTRAL] OK. So it looks like um surgery in a hospital, a hospital outpatient facility or free-standing outpatient surgery center pays $500.
[AGENT][NEUTRAL] And that's a maximum one day per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So how do I go about doing that?
[AGENT][NEUTRAL] Um, so
[CUSTOMER][NEUTRAL] Or filing for that.
[AGENT][NEUTRAL] Um, so you'd wanna get, uh, we need a like an itemized bill that shows the codes for the surgery that you had, your diagnosis.
[AGENT][NEUTRAL] Um, you know, where the surgery was, like what hospital?
[AGENT][NEUTRAL] Um, so data service bill charges, so basically just something that shows all those pieces of information and then you can upload that to the portal for processing. Do you have an account through our online service center?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] No, I do not.
[AGENT][NEUTRAL] OK, um, are you interested in setting one up?
[CUSTOMER][NEUTRAL] Sure. What, what do I need? Do I need to download an app or?
[AGENT][NEUTRAL] Uh, no, it has to be done from a desktop or laptop. Um, I can email you the instructions, um, that you can go through the guide and then.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I actually don't have.
[CUSTOMER][NEUTRAL] You have a laptop? OK. I forgot we had a laptop. OK. Sorry, I just got a laptop and I forgot we just got it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you want me to email you those instructions?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, OK, I'll get those instructions emailed to you and then it'll also um once you get in there and create your account, um, the this policy we're talking about is your hospital indemnity, so there'll be a claim form that you can look at, um, to complete that shows what we need, um, but like I said, the most, most important thing is.
[AGENT][NEUTRAL] Get information from the hospital that shows, you know, what surgery you had, diagnosis, where it was rendered, um, and then the bill charges and the date. And then off of that information, you can potentially process the claim, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Perfect. Thank you very much. You've been very helpful.
[AGENT][NEUTRAL] OK. Anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] No, I think that's all.
[AGENT][POSITIVE] OK, well, thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well. Bye-bye.
[AGENT][NEUTRAL] OK