AccountId: 011433970860
ContactId: 82655607-5e62-412d-8384-14d2589859ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 590380 ms
Total Talk Time (AGENT): 236123 ms
Total Talk Time (CUSTOMER): 153356 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/82655607-5e62-412d-8384-14d2589859ea_20250424T14:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello? [PII]?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, you hear me?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, this is, OK, this is [PII].
[AGENT][NEUTRAL] I'm sorry, can you spell your name for me?
[CUSTOMER][POSITIVE] [PII]
[AGENT][NEUTRAL] OK, Mr. [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, I go to the hospital and then the.
[CUSTOMER][NEGATIVE] I have a bill here, but they're saying, they're saying you got, the hospital saying you got a bill, but you guys doesn't pay any of the bill and then the bill keep come to my house and I just called to verify what's going on.
[AGENT][NEUTRAL] OK, so you're wanting to check on a claim that the hospitals with APL but it was not paid, is that correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Yes, so I can check that for you and Mr. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number?
[CUSTOMER][NEUTRAL] My policy number is 02567481.
[AGENT][NEUTRAL] OK, Mr. [PII]. Thank you. Give me a couple of moments, please, to get your policy information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK Mr. [PII] any information that I provide for you today would be a verification of benefits and not a guarantee of payment. I will need to verify several.
[AGENT][NEUTRAL] Things with you first for security. So if you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] Thank you. Your home mailing address?
[CUSTOMER][NEUTRAL] Uh, the home address?
[CUSTOMER][NEUTRAL] It's on um.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, [PII], um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same.
[AGENT][NEUTRAL] As the one that you gave me. So that is your best contact number. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you and lastly your email address please.
[CUSTOMER][NEUTRAL] Email is [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII] for verifying your information. So what is the date of service that you're calling about?
[CUSTOMER][NEUTRAL] The service?
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] You
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I don't remember, but it's on the they send you guys bill?
[CUSTOMER][NEGATIVE] I got, I got two bills here. One's about no one's, uh, one's in, um.
[CUSTOMER][NEUTRAL] No, memorial ambulance.
[AGENT][NEUTRAL] I'm, I'm sorry. I did not understand what you said. Yes, sir, I didn't understand what you said.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, let me see.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's um.
[CUSTOMER][NEUTRAL] They'll put a day here but uh um.
[CUSTOMER][NEUTRAL] It's on the.
[CUSTOMER][NEUTRAL] The account number is, the account number.
[AGENT][NEUTRAL] No, sir. I need the date of service. No, sir. I need the date of service that you had, that I'm looking for, that you received medical treatment.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] I'm looking for.
[CUSTOMER][NEUTRAL] Mm, I don't remember here.
[CUSTOMER][NEUTRAL] I mean, I maybe I should call the.
[CUSTOMER][NEUTRAL] So you need a day. I need to call the hospital for the day?
[AGENT][NEUTRAL] Well, yes, sir. I need to know exactly what type of claim I'm looking for.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's a hospital clean. I go to sleep in the hospital.
[AGENT][NEUTRAL] But you don't know what day you went to the hospital?
[CUSTOMER][NEUTRAL] I know, but I just don't remember.
[CUSTOMER][NEUTRAL] Don't, don't the hospital send you guys um.
[CUSTOMER][NEUTRAL] The bill
[AGENT][NEUTRAL] OK, so I show that.
[AGENT][NEUTRAL] OK, so on 35 this is for the hospital that you're checking on, do you know how much your bill is for?
[CUSTOMER][NEUTRAL] 2,226.
[AGENT][NEUTRAL] 222 6.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I don't, I don't see a claim on file for you for that amount.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let's see. Hold on just.
[CUSTOMER][NEUTRAL] There was an ambulance.
[AGENT][NEUTRAL] OK. That's for an ambulance?
[CUSTOMER][NEUTRAL] It's um it's an ambulance for tomorrow, yeah.
[AGENT][NEUTRAL] You had to get, OK, for an ambulance charge, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Is this for North Memorial Ambulance Service?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we did receive a claim from them.
[CUSTOMER][NEUTRAL] What do
[AGENT][NEUTRAL] And on this claim, we did pay a $50 benefit to them.
[CUSTOMER][NEUTRAL] Only $50?
[AGENT][NEUTRAL] Yes, sir, because this limited benefit plan.
[AGENT][NEUTRAL] That is the amount of the benefit for an ambulance service.
[CUSTOMER][NEUTRAL] So how about a hospital bill, all the hospital bill.
[AGENT][NEUTRAL] There was a benefit paid to the facility for data service 35 in the amount of $50.
[AGENT][NEUTRAL] And there was also another benefit paid in the amount of $500.
[AGENT][NEUTRAL] Those were for 36. Yes, sir.
[CUSTOMER][NEUTRAL] And that's it.
[CUSTOMER][NEUTRAL] And what kind of server is that?
[AGENT][NEUTRAL] So again, you do not have a major medical insurance plan with APL. This is a limited benefit plan, Mr. [PII].
[AGENT][NEUTRAL] And that is the maximum benefit. Again, on the ambulance service, the calendar year maximum for this benefit has been exhausted with this claim.
[AGENT][NEUTRAL] Then for the hospital, for the hospital, that was just processed the end of March on the [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on that claim that was for North Memorial Health.
[AGENT][NEUTRAL] And we did pay a hospital admission benefit of $500.
[AGENT][NEUTRAL] And a daily hospital benefit for your confinement of $50.
[AGENT][NEUTRAL] And on this limited benefit plan.
[AGENT][NEUTRAL] Again, this states that the calendar, your maximum for this benefit has been exhausted with the payment of this claim. That was for your hospital admission.
[CUSTOMER][NEUTRAL] OK, that's
[AGENT][NEUTRAL] Now have you ever set up, well, one more question for you Mr. [PII]. Have you ever set up your profile in our portals called the online service center where you can actually have access to this claims information online?
[CUSTOMER][POSITIVE] All right thank you.
[CUSTOMER][NEGATIVE] No, I'm not interested cause it doesn't get that.
[AGENT][NEUTRAL] OK, you don't want to, you said that you're not interested in setting that up?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, if you should change your mind, you.