AccountId: 011433970860
ContactId: 7b351485-bc83-46f2-a0f5-e63cf49c715b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 617359 ms
Total Talk Time (AGENT): 146335 ms
Total Talk Time (CUSTOMER): 440521 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/7b351485-bc83-46f2-a0f5-e63cf49c715b_20250624T17:25_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I am calling actually regarding my husband and a little bit of information about the heart attack, uh, writer, and I can give you my certificate number if that would help you pull us up.
[AGENT][NEUTRAL] Yes ma'am, what is that? Excuse me, what is that number, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK, sorry, I was reading through it while I was on hold. Let me pull it back. Hold on.
[CUSTOMER][NEUTRAL] I apologize. I should have had it right in front of me.
[CUSTOMER][NEUTRAL] Oh come on page. OK, certificate number 01654443.
[AGENT][POSITIVE] Thank you, ma'am, give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Absolutely it's [PII].
[AGENT][NEUTRAL] OK, thank you, ma'am, and verify your date of birth, mailing address and little uh email address please.
[CUSTOMER][NEUTRAL] Uh, my, I'm [PII], and mine is [PII], and the, the address is [PII], but um, the question I have is regarding my husband [PII], his date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] Um, the, the letter [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see, and you say you have a question in regards to the um writer?
[CUSTOMER][NEUTRAL] Yeah, what I wanted, I was gonna tell you guys what happened and see if there's anything that I can if I can file this or not with you guys. If I can't, then I can't, um, and I'm waiting on all the paperwork to come from the hospital. [PII] was admitted through the emergency room last Friday, let's see, today is the [PII]. It would have been um.
[CUSTOMER][NEUTRAL] He was admitted on [PII] and discharged on the [PII], um, from Baylor Hospital. He went in through the emergency room and the diagnosis was bilateral pulmonary embolisms that did damage, also did damage to his heart. So what they did was some stress tests after [PII], he was taken by ambulance from the emergency room here in [PII]. We live out in the rural area into [PII].
[CUSTOMER][NEUTRAL] To they were gonna put him in the Baylor Heart Hospital. Instead they put him in the hospital right next door and then transferred him for the procedure that he had to have by the vascular cardiologist. So what I am wondering is on this writer it says heart attack. His was pulmonary embolism has some damage to his heart. The doctor said some people would call it a mild heart attack, but on the diagnosis it's gonna say bilateral pulmonary embolism.
[CUSTOMER][NEUTRAL] I was gonna just send all the records and file this as a claim, but I didn't know if you know that's something that you guys would even look at does it classify as a critical illness? Does it classify as some of the stress tests and the they did um.
[CUSTOMER][NEUTRAL] They did a a few EKGs and they did some stress tests, you know, many of the heart tests on him during this, and I don't know if any of that is something that I can file with you guys.
[AGENT][NEUTRAL] Let's see, I mean you can submit that information like his medical notes, the EKG results, um.
[AGENT][NEUTRAL] So they can review.
[CUSTOMER][NEUTRAL] So it'd be worth it just to file it and see because I mean, I don't know, it just depends on the doctor, the doctor that did the procedure was the cardiologist. Thank the Lord, praise [PII], he didn't have a massive heart attack which he could have had, you know, so I, I feel.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][MIXED] I mean, I'm glad for for that but um I know when they sent us to the emergency room from the emergency room to the um hospital I'm looking at all the paperwork that they've given me the after visit summary and everything that's what I'm reading off of the doctor in the emergency room wanted him to go to the heart hospital because they were afraid, you know, one of these embolisms is gonna move he's gonna have a massive heart attack, um.
[CUSTOMER][NEUTRAL] And instead there wasn't a bed in the heart hospital so they put him in the Baylor Hospital right next door and then when they, the cardiologist came over there to see him and so what ended up happening is they said that um.
[CUSTOMER][NEUTRAL] They had to do the vacuum procedure where they go up and they took out all the pulmonary embolisms they got one side of his lung. The other side, the clots were too low in the alveoli of your lungs to do. And they said if they put too much more pressure on it, that would cause him to have a massive heart attack. So he's under the cardiologist and it's, it's probably a mild heart attack because we caught it time, praise the Lord. But I thought maybe some of these heart tests or some of these things.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, I don't know what to call it. I'm trying to be as honest as I can on the diagnosis they're probably gonna say bilateral emb embolism that is the reason that his heart was having trouble was because these blood clots were pushing on his heart and he couldn't breathe, um, and it caused heart damage.
[AGENT][NEGATIVE] That's a hard.
[CUSTOMER][NEUTRAL] Yeah, caused heart damage, but it's not, I'm not gonna say that it was a fall down in the parking lot heart attack, but it was a mild heart attack. That makes sense. I don't know how to say it, trying to be honest here, so I thought, well, at least you know I did this this writer cover for any of the tests that he would have like the EKG or any, any of that, you know, I, I just called the hospital and ask for copies of all the records.
[AGENT][NEUTRAL] No no.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I was gonna send them but.
[AGENT][NEUTRAL] I would say you can just submit the claim form and um submit the medical records that you have so it can be reviewed cause I'm not sure uh if it's labeled as a heart attack that will fall under the heart attack stroke rider, but they will need to review that, those medical notes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does the do any of the tests?
[AGENT][NEGATIVE] It's just the, the writer just like uh critical illness writer, it just plays a flat fee if been diagnosed uh with a heart attack or stroke.
[CUSTOMER][NEUTRAL] Ok and see what was sent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's critical illness only critical illness would be heart attack or stroke, and it's a flat fee, not, not based on a test. Like if you had an EKG they don't cover the test independently because I thought, well, maybe if they didn't cover the heart attack they would pick up $50 on a test, you know, something along those lines.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah, it just, it doesn't.
[CUSTOMER][NEUTRAL] That's not, it's, it's a
[AGENT][NEUTRAL] In individually, it's just a flat lump sum if the diagnosis for heart.
[CUSTOMER][NEUTRAL] OK, it's just a flat out right or either you did, either it's classified as a heart attack or it's not, it's what this is basically.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] It's the way, OK, well it still might be worth it to get a claim form and file it and just see um.
[AGENT][NEUTRAL] I would say it never hurts, so they can review it, um, review the notes. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It just depends on the doctor who you were talking to. I mean, they see a lot of stuff for us. Yes, that's where he's headed. Have we not gone to the emergency room, the heart, his blood pressure was low, his heart wasn't pumping, right? They had to take him in an ambulance, but we caught it in time and I'm, I'm always forever gonna be grateful for that. But there's damage to his heart whether they consider that a heart attack or not.
[CUSTOMER][NEUTRAL] I guess it just kind of depends.
[CUSTOMER][NEUTRAL] I'm gonna be just gonna sound meaner than I mean I guess it kind of depends on if it's your heart, you know, in our mind that that day, that was a heart attack as close as we ever wanna get.
[CUSTOMER][NEUTRAL] You know, but at the same time we know it was being caused by the, the, the blood clots we're just pushing so hard on his heart it could not pump.
[CUSTOMER][NEUTRAL] So that, that's kind of the whole thing. OK, but you've answered my question. What I need to do is just get a copy of those records and just file it and see what happens. And I think that that would be the most honest thing that I can do is just send them the paperwork and let them decide.
[AGENT][NEUTRAL] Yes, ma'am. And also, uh, he would need to fill out a claim form that is available on our website.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It should, well, you don't need to log in to get a claim form. If you go to [PII] under claims, excuse me, I'm trying to lose my voice under claims and forms.
[CUSTOMER][NEUTRAL] OK, I'll have to log in and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] Uh, let me see if it's.
[CUSTOMER][NEUTRAL] Ok clients so.
[AGENT][NEUTRAL] would be under critical illness.
[AGENT][NEUTRAL] And let me see which form.
[CUSTOMER][NEUTRAL] Our policies cancel with this is the writer, so.
[AGENT][NEUTRAL] Uh, it's called miscellaneous treatment and service claim form.
[CUSTOMER][NEUTRAL] Miscellaneous treatment and service claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And that one would work and then just put the medical records with it and that would get us to the right place.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I will do that. I'm keeping, you know, I've got pieces of it, but what I have asked for is everything so that I can because they give you a discharge summary, but it's not in detail.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, send any and everything you have so they can review and just look over those notes and cardio words, cardiologist reports and everything so you can just submit that to us.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I will, I will do that. Thank you very much for your help.
[AGENT][POSITIVE] Oh, you're welcome, Ms. [PII]. Thank you for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.