AccountId: 011433970860
ContactId: a203289e-8bb3-4a3c-8c44-3d71a8e06bd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 444700 ms
Total Talk Time (AGENT): 142416 ms
Total Talk Time (CUSTOMER): 207074 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/a203289e-8bb3-4a3c-8c44-3d71a8e06bd7_20250404T21:09_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, uh, my account is number.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] I guess you go by group number or what do you do uh or the hospital certified certification number?
[AGENT][NEUTRAL] Yes, the certain number, yes.
[CUSTOMER][NEUTRAL] OK, 01986454.
[CUSTOMER][NEUTRAL] M as in Mary. L as in.
[CUSTOMER][NEUTRAL] Lima 7.
[AGENT][NEUTRAL] OK. Could I get your name and your date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] [PII].
[AGENT][NEUTRAL] OK, and I just need to verify a few other pieces of information. What is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what's your telephone number just in case I lose this call?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, how can I help you?
[CUSTOMER][NEUTRAL] OK, uh, there's a, there's a some, some kind of form that if you're trying to claim the, the gap payment.
[CUSTOMER][NEUTRAL] Um, and, uh, I, I, I was gathering all the information the last time I talked to you. You need an ELC, got everything. So what was the, uh, I'm trying to see what happened with this form. Uh, what, what is the form that you normally use to, to make the application? It's gotta be done by fax?
[AGENT][NEUTRAL] Um, you can do it by fax, by mail, or on our online portal. Do you want me to send you a claim form through?
[CUSTOMER][NEUTRAL] Oh, but I, my, but my account is no longer active. Can I still do it online?
[AGENT][NEUTRAL] Yes, yes, you can still do it online. You'll need the Medlink claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll, I'll be able to find it there bed link.
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] And that's the one that affects, right?
[AGENT][NEUTRAL] Uh-huh, yeah, so fill out that form and then attach the appropriate documentation and then um we can review your claim.
[CUSTOMER][NEUTRAL] And what and what is the fax number again?
[AGENT][NEUTRAL] Uh, fax number is [PII].
[CUSTOMER][NEUTRAL] Just in case in case I can't access, do you think you could email me the Medins claim form?
[AGENT][POSITIVE] Yeah, absolutely. I'll email it back to you right now. It'll just take me a few minutes. And is there anything else I can help with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK then also uh there was, so I have I had insurance [PII].
[CUSTOMER][NEUTRAL] 2 and 23 and 24, correct? When did it start?
[AGENT][NEUTRAL] Uh, it looks like it started [PII].
[CUSTOMER][NEUTRAL] OK, so I've got 21, 22, 23.
[CUSTOMER][NEUTRAL] And 24.
[AGENT][NEUTRAL] Yes, and then uh looks like it terminated [PII].
[CUSTOMER][POSITIVE] Right, OK, good.
[CUSTOMER][NEUTRAL] Alright, so, uh, the other question is there was a claim.
[CUSTOMER][NEUTRAL] Uh, where you all made a payment.
[CUSTOMER][NEUTRAL] And I called before $1700 to Bethesda Hospital in uh I think it was September of last year.
[AGENT][NEUTRAL] OK, yes, I see that.
[CUSTOMER][NEGATIVE] OK, I don't know what's those good people are kind of messed up because the last time I talked to so since I've got you on the phone, I don't know if you could look up what the they're saying that they never got it and they're still sending me messages. So what is the check number that was used?
[AGENT][NEUTRAL] Check number is 2021739.
[CUSTOMER][NEUTRAL] And that would send out when?
[AGENT][NEUTRAL] That was sent out, let's see.
[AGENT][NEUTRAL] And that was sent out on [PII].
[CUSTOMER][NEUTRAL] OK and um.
[CUSTOMER][NEUTRAL] Let me see what else, uh, for what amount?
[AGENT][NEUTRAL] Uh, you want me to see if the check.
[AGENT][NEUTRAL] Do you want me to see if it's outstanding?
[CUSTOMER][NEUTRAL] Oh yes,
[AGENT][POSITIVE] Yeah, let's do that.
[CUSTOMER][POSITIVE] Yeah, that'd be great.
[AGENT][NEUTRAL] That way we can if it's outstanding I'll just put in a request and have it make sure it hasn't cleared we'll get it reissued.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] 021
[AGENT][NEUTRAL] Now I show they cashed it. Looks like they cashed it on.
[AGENT][NEUTRAL] 116 2025, and it was for 1734.
[AGENT][NEUTRAL] 37.
[CUSTOMER][POSITIVE] Got it perfect question, so the my maximum benefit for this type of uh it's like.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, to cover my out of pocket is what, 2000 per calendar year?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Um, anything I quote won't be a guarantee of payment, just a basic outline of your policy, um, outpatient 2000, that's correct.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] What about inpatient?
[AGENT][NEUTRAL] For inpatient it is also 2000, a separate 2000.
[CUSTOMER][NEUTRAL] But it's uh there's a maximum for the year, right?
[AGENT][NEUTRAL] Yes, 2000 per calendar year for inpatient and then 2000 per calendar year for outpatient.
[CUSTOMER][NEUTRAL] Oh they're separate.
[AGENT][NEUTRAL] Yes, they're separate.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] So it's conceivable you could if you have two different events, one inpatient, one outpatient, you could, you could claim 4000.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, wonderful. What is your name, ma'am?
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] Where are you asking from?
[AGENT][NEUTRAL] Oh, I'm in [PII].
[CUSTOMER][POSITIVE] Wonderful. Uh, [PII], I just want to congratulate you. Of all the people I've talked to in the last few weeks for anything related with insurance or anything like that, you're the most professional and really fast and to a point. Congratulations.
[AGENT][POSITIVE] Oh, thank you, sir. I appreciate that. I try hard.
[CUSTOMER][POSITIVE] I'm serious. I mean, no, really, because some people don't, oh, I don't know this what I don't know, but you're, you're with it and uh congratulate you.
[AGENT][POSITIVE] I appreciate you. Thank you so much.
[CUSTOMER][POSITIVE] Thank thank you very much, appreciate it.
[AGENT][NEUTRAL] OK, I'll be emailing you that.
[CUSTOMER][POSITIVE] So then and if you send me the med med link form I'd be really even more grateful thank you.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, sending that your way, sir.
[CUSTOMER][POSITIVE] Nice talking to you, thank you.
[AGENT][POSITIVE] Thank you for calling APL. Have a good weekend.
[CUSTOMER][NEUTRAL] OK bye.
[AGENT][NEUTRAL] Bye.