AccountId: 011433970860
ContactId: 8a439820-76f8-4853-bd7a-b7c583b6fe9e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 488350 ms
Total Talk Time (AGENT): 130923 ms
Total Talk Time (CUSTOMER): 208772 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/8a439820-76f8-4853-bd7a-b7c583b6fe9e_20250610T15:48_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], how are you doing?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] Good good. I have the claim number.
[AGENT][NEUTRAL] OK, is it for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Do you have your policy number by chance?
[CUSTOMER][POSITIVE] Yeah, I do.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Membership number right?
[AGENT][NEUTRAL] Uh, your, uh, policy certificate number?
[CUSTOMER][NEUTRAL] Yeah, the membership, that's the 683.
[CUSTOMER][NEUTRAL] 799829
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, is that your is that your social?
[CUSTOMER][NEUTRAL] No, no, that's the part, the membership, the, the, the card, the insurance card.
[AGENT][NEUTRAL] OK, um, um.
[CUSTOMER][NEUTRAL] Policy number here. Oh, hold on, I have the policy number, one second. 02 is in the, the, yeah, 0262.
[CUSTOMER][NEUTRAL] 858 9.
[AGENT][NEUTRAL] OK. And then what is your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, then, Mr. [PII], can you verify your address and your email address?
[CUSTOMER][NEUTRAL] [PII]. Email [PII].
[AGENT][NEUTRAL] OK, and you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, the [PII] yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and are we checking on a claim for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you have the claim number?
[CUSTOMER][NEUTRAL] Claim number 3605929.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we requested itemized statements. Let me see if we did you send that in?
[CUSTOMER][NEUTRAL] Talking about the hospital bill, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Looks like we received.
[AGENT][NEUTRAL] We received it and then sent a check on 64 for $300.
[CUSTOMER][NEUTRAL] You send me the check for $300?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, but I'm, I'm talking about the bill, the hospital bill. I didn't open the, I didn't check the mail yet, but I'm talking about the, the hospital bill is 4400.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] When I, when I signed with the policy, they say they cover 70% from the, you know, for the ER and the 30% is in my pocket.
[AGENT][NEUTRAL] OK, this policy is, uh, this policy is just a limited hospital plan. It's very limited, as very limited coverage. If there's some other major medical coverage through your employer, you'd have to check with them. But for this policy, it's just, it's a very small limited policy.
[CUSTOMER][NEGATIVE] But I don't think this.
[CUSTOMER][NEUTRAL] Yeah, but you know, even cover enough is like 4400 now we cover only 1100 from the whole.
[CUSTOMER][NEUTRAL] And they pay $750 or whatever a month. I mean, I don't know.
[AGENT][NEUTRAL] Um, this policy, that's what I'm saying you might have a different policy that I don't know what it is.
[AGENT][NEUTRAL] Um, that we don't have access to. We just render supplemental policy.
[CUSTOMER][NEUTRAL] No, I have only
[CUSTOMER][NEUTRAL] I have only 11 insurance, you know, the, yeah, and they ask me for the code because.
[CUSTOMER][NEGATIVE] I went to the hospital because it was really emergency was weakened, you know, and my heart was not doing good. I didn't go like other people. If they have flu, they go to the ER. I didn't do that.
[CUSTOMER][NEGATIVE] So, so what, what else you can help me with this bill because like it's like too much for my part.
[AGENT][NEUTRAL] I, like I said, we, we just, this plan is a hospital indemnity plan. Let me pull up what it covers.
[AGENT][NEUTRAL] Looks like it
[AGENT][NEUTRAL] So this is the only insurance you have?
[CUSTOMER][NEUTRAL] Yeah, that's only insurance yeah.
[AGENT][NEUTRAL] I mean, you would have to check with the hospital to see if they can make arrangements or we, we just process the claim according to what your policy is. Let me see.
[CUSTOMER][NEGATIVE] Yeah, but, but my question, I'm not happy with, I know it's not yours, but I'm talking about when I before I sign, I ask about the policy for the ER and they told me 70% maybe they just want me to to sign and start with them, you know what I mean? But this is not true what they say. I know it's not yours. I mean talking about whatever who who was with me and this sign.
[CUSTOMER][NEUTRAL] And they asked like 2 or 3 times and they promised me 70% on the hospital bill.
[CUSTOMER][NEUTRAL] And I was like, OK, but now I didn't get what you promised me.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Might check with your, so did you sign up through your job, through your work?
[CUSTOMER][NEUTRAL] No, no, no, I just make it private.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, because this shows it's through Business Workers of America, that your employer.
[CUSTOMER][NEUTRAL] No, I have, uh, no, let me show you what I have the card here. The card is uh PHCS limited benefit plan.
[CUSTOMER][NEUTRAL] That's what I have here.
[AGENT][NEUTRAL] OK, with the policy number that you gave me?
[CUSTOMER][NEUTRAL] Well, no, the member I have the member is different number here, the, the one on the card.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I have 683-799-829.
[AGENT][NEUTRAL] Yeah, that and that's not one of our numbers, so I'm not sure what that's from.
[CUSTOMER][NEUTRAL] You can
[AGENT][NEUTRAL] So that's
[CUSTOMER][NEUTRAL] Anyway, I have to call them again.
[AGENT][NEUTRAL] Yeah, I would give them a call if this like I said, this is a very limited policy. It just pays small dollar amount like 300 VR $500 for outpatient hospital, um, so it's a, it's a very limited plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and just, just ask you this question in case if nothing's work in my side, so I have to call the, the hospital and it was like, can you give me like break 5% 50% for the bill I can make payments with them. So most of the time they do that, right?
[AGENT][NEUTRAL] Yeah, you'll have to check with them, but I mean usually they'll make payment arrangements, so yep.
[CUSTOMER][NEUTRAL] Depends.
[CUSTOMER][POSITIVE] OK. All right, thank you.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] Bye bye.