AccountId: 011433970860
ContactId: 848fa740-ec5e-4cd5-9ae2-9303ea332ae4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 440720 ms
Total Talk Time (AGENT): 164475 ms
Total Talk Time (CUSTOMER): 194477 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/848fa740-ec5e-4cd5-9ae2-9303ea332ae4_20250616T18:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yes, hello. Um, I was trying to make a claim online because I'm in the hospital.
[AGENT][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] And did you need help with the
[CUSTOMER][NEUTRAL] I just needed some help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, I'll be more than happy to help you with your claim. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII].
[CUSTOMER][NEUTRAL] And my contact number is [PII].
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] Policy number, you?
[CUSTOMER][NEUTRAL] It's 253-513-5.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] All right, now I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII].
[CUSTOMER][NEUTRAL] Date of birth, uh, uh, address?
[AGENT][NEUTRAL] Mhm. Address and mailing address.
[CUSTOMER][NEUTRAL] Was it at
[AGENT][NEUTRAL] I'm sorry, I just an email address. I'm sorry.
[CUSTOMER][NEUTRAL] Address is
[CUSTOMER][NEUTRAL] Address is [PII].
[CUSTOMER][NEUTRAL] [PII] and
[CUSTOMER][NEUTRAL] Email is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and the hospitalization is it in reference to cancer treatment?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] I'm just waiting for the benefits to populate here.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, maybe I don't know.
[AGENT][NEUTRAL] All right, so you can send it electronically, you can fax it or you can um mail it to us, which one would you prefer? Or I can give you all three if you like.
[CUSTOMER][NEUTRAL] Well, we were working on it online, but we had some questions.
[AGENT][NEUTRAL] Oh, OK, and what questions did you have?
[CUSTOMER][NEUTRAL] OK, so when we went online, uh, we had some blanks uh because uh right now, um, since they found um cancer on my spine.
[CUSTOMER][NEUTRAL] Um, they did a spine surgery and they fixed, uh, they, I, they did a spine surgery on it and removed some tumors from my spine. So, because of the spine surgery, I am, I'm not able to walk right now. So the doctor recommended me to go to a, what is it called? To go to tier in [PII] to get physical therapy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, what we were trying to do is go to Ter in [PII] so they can do our, continue with my rehab.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, but my question is, um, I'm still here in the hospital where I live in [PII].
[CUSTOMER][NEUTRAL] Um, they, they still haven't released me, but, um, social services already told me that, uh,
[CUSTOMER][NEUTRAL] Tier already accepted us, but I needed to make a claim.
[CUSTOMER][NEUTRAL] So the claim and the claim there's uh what were, what was the blank that we still need to put?
[CUSTOMER][NEUTRAL] Just the the non-local transportation and the date of like when we're leaving.
[CUSTOMER][NEUTRAL] Cause I don't know that information yet. Would the policy cover transportation to the other hospital?
[AGENT][NEUTRAL] So the claim
[AGENT][NEUTRAL] OK, so, so there's two things here. So, does the, does the um registration office have this policy for the claim because they're supposed to be filing the claim. I mean, you can if you'd like to, but if you're still in the hospital, the claim is not, we're not at the claim part yet, that comes after billing, um, they'll submit all the billing to us.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Right, so if we are request, well, they're trying to get her here in [PII], so that means here we have to file with you guys.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Or the hospital we're in right now.
[AGENT][NEUTRAL] Both, wherever you, wherever you're trying to file the claim or you want the claim to be filed for. So your hospital stay where you are now, you give them this policy number and our phone number and they'll call us to verify benefits. The tier place will do the same thing and let you know. Um, I mean, you guys do have the option to file the claim, but for the most part, they're supposed to handle that for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well she told me that we had to call that's why I was trying to open a claim because she said she need to open a clean first. Well, let, let's talk to her first.
[AGENT][NEUTRAL] See if they because they because because for us, you can't open a claim without the documents, but you won't have the documents until the bills come out, which is after your discharge. So we, we need to see what type of claim they're saying you need to file and if it's with APL, we don't come in until there's a bill to pay.
[CUSTOMER][NEUTRAL] So we can give her.
[CUSTOMER][NEUTRAL] I think, but what we
[CUSTOMER][NEUTRAL] How do we get uh.
[CUSTOMER][NEUTRAL] So how do we get some of the financials so we can pay to go to that but uh no, she mentioned that we pay upfront for that.
[AGENT][NEUTRAL] That would be the other.
[AGENT][NEUTRAL] If you have other insurance, this because this is like a supplemental cancer policy. So your major medical insurance, that's what takes care of things like the uh other treatment facility you're getting ready to go to. It's not to say that we won't either, but we come in on the back end.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] OK, so then we give this information to her so she knows.
[AGENT][NEUTRAL] Yes, everywhere you go, if you give them your regular insurance cards, go ahead and give them this policy and let them know you have a supplemental um cancer policy, and then they'll call us to verify what your benefits are, so they'll know what, you know, you can use there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Well, was there anything else I can help you out with today? You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] That's it, ma'am. Thank you.
[AGENT][POSITIVE] All right, thanks for calling APL. Have a good day. Bye-bye.
[CUSTOMER][POSITIVE] Good afternoon.
[CUSTOMER][POSITIVE] Thank you. Bye.