AccountId: 011433970860
ContactId: 8331e070-05c9-4a1f-8f1c-b14efd04e0a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 506170 ms
Total Talk Time (AGENT): 251212 ms
Total Talk Time (CUSTOMER): 225133 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/8331e070-05c9-4a1f-8f1c-b14efd04e0a7_20250205T15:51_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. Yeah, this is [PII], last name [PII]
[AGENT][POSITIVE] Thank you. And how may I assist you today, Mr. [PII]?
[CUSTOMER][POSITIVE] I've got, I've been with you guys, American Public like a long time. I've got the cancer policy. I paid for 3 different ones, and one of them is the MedLink. And I was in, in and out of the hospital in the last 2 weeks, and they finally did gallbladder removal. It took them a while to find out what the problem was. But anyway, when I, they get, when you're in pain, you give them the cards and you get your card back.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I didn't get my, I can't find my med link cord. I have the repub it says American Public Life and it's got uh cancer policy. That's not the one. So I need the other one, if I can get that replaced and also ask about, again, I know I was in before you gotta be in a certain amount of time and because I got a bill coming up and see I know I have some coverage there to see how that works.
[AGENT][POSITIVE] OK, no, sure, yes, I can assist you with that information. Let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And I have a, I called the employers. I have some, uh, numbers on each one, if that'll help you.
[AGENT][NEUTRAL] OK, yeah, give me one of those numbers.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see, may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, email address. I'm, I think I gave you my work one [PII] and address is [PII].
[AGENT][POSITIVE] Perfect. Thank you, Mr. [PII]. All right, let me go ahead and get the meddling policy pulled up.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, and this order a card.
[AGENT][NEUTRAL] OK, so I have ordered the card for you. So it should be there within 5 to 7 business days. And let me go over the benefits and before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I, I, I understand. Yeah, I understand. Yeah, every time.
[AGENT][POSITIVE] OK. OK, thank you.
[AGENT][NEUTRAL] All right. So let me see. I'm waiting on the breakdown of benefits so I can go over, um, over it with you, OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And what is the other one I have? I have the cancer policy the Medlink. Is the other one accidental policy?
[AGENT][NEUTRAL] Accident. Mhm. Correct, yes.
[CUSTOMER][NEUTRAL] Yeah, OK, and, and I I need a card for that one too?
[AGENT][NEUTRAL] Uh, no, we don't have cars for the accident or the cancer. It's only for Mali. Mhm.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh, so my cancer card is the old gold card then.
[AGENT][NEUTRAL] Yeah, yeah, yeah, because we don't have um cancer cards no more.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, let's see.
[AGENT][NEUTRAL] OK. So you said you've been in and out, so basically you've been um outpatient.
[CUSTOMER][POSITIVE] Uh, outpatient and then they put me in when it got bad. They put me in the hospital Saturday. Uh, actually, I went into one of the like a submethodist, like one of the ER, their outreach, I guess, or, and then they transported me, no charge for them, which was good. They transported me to the hospital and I was in there Saturday, Sunday, and they did the procedure Monday and they kept me till Tuesday, released me Tuesday sometime.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh, OK. All right, so you did use your inpatient as well. OK, and this was all for 2024?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] 2025, you said, right?
[AGENT][NEUTRAL] 2025.
[CUSTOMER][NEUTRAL] Yeah, they just, I just got out, yes, yesterday.
[AGENT][NEUTRAL] Oh, OK, so it was this year. Oh, OK. All right, got you, OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Let's see. OK, so looking at your policy, your claims, the history, and the benefits, it doesn't look like we have received anything just yet. Now, the benefits that you have.
[CUSTOMER][NEGATIVE] Oh, I haven't, I haven't, I haven't given him anything because I didn't have it.
[AGENT][NEUTRAL] Oh, OK. Right. So you have an in-hospital benefit of $3000 per consignment. So it's every time that you're hospitalized or every time that you're in the hospital, 18 hours or more is considered in hospitals. Um, so that's $3000.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And then you have outpatient benefits. The outpatient benefit is $500 per occurrence. Uh, per occurrence means that if it's related to the same treatment or condition, it needs to be separated by 90 days. So it's payable every 90 days, $500.
[CUSTOMER][NEUTRAL] OK, so yeah, so the 500, so seems like what's gonna work here is the confinement then or in pay in hospital, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In hospital, correct. Mhm.
[CUSTOMER][POSITIVE] Well, I was sure help. I'll tell you in a big, big way when it hit me with that bill.
[AGENT][NEUTRAL] Yes, yes. So yeah, you just need to call them and let them know that you have a secondary insurance to see if they can put it in the system so when they're ready to send in um the claim, and they can go ahead and have all the information so they can send in the claim to the secondary. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Which can you tell me which number I could give him?
[AGENT][NEUTRAL] OK, yes. The policy number is 01.
[AGENT][NEUTRAL] 19
[AGENT][NEUTRAL] 461 2.
[CUSTOMER][NEUTRAL] That's the one I have that one that's the med link, OK.
[AGENT][NEUTRAL] That's the middle link. Mhm, yes. And the date, mhm, yeah, the effective date on this one is [PII].
[CUSTOMER][NEUTRAL] OK, that's for that one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. It is active at the moment and they can send in the claims by fax or mail. The fax number is [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 9423.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The mailing address is [PII].
[AGENT][NEUTRAL] In the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, that's still [PII]? That's, that's not [PII] no more?
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] No, it's not [PII] no more. It's in [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK. I'm sorry, give me that [PII] again.
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. Ok [PII]. Mhm.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] [PII]. That helps. Thank you.
[AGENT][NEUTRAL] Yes. You're welcome. And if they have any questions or any, if they need to check eligibility, they can call the same number you just dialed the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Thank you so much. God, I forgot the bin. I was looking last night. I'm in so much pain. I'm home. I said, I know I got, I got it. I paid a supplemental every month. So I said I couldn't find it for it. I said, thank you so much. You said in about 5 days or so.
[AGENT][POSITIVE] OK, you're welcome.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, OK, yes, you will receive the card within 5 to 7 business days, OK?
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Hope you get feeling better. Bye-bye.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh.