AccountId: 011433970860
ContactId: a5b5a11e-3c49-446d-9326-9a7422b7282a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 337769 ms
Total Talk Time (AGENT): 179615 ms
Total Talk Time (CUSTOMER): 156211 ms
Interruptions: 4
Overall Sentiment: AGENT=1.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/a5b5a11e-3c49-446d-9326-9a7422b7282a_20250131T15:22_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII]. I have uh insurance with APL and I went online um this morning and created an account and filed a claim, but it didn't tell me.
[CUSTOMER][NEGATIVE] If I don't know if I, I sent the hospital bill, the itemized hospital bill, but was there other things that were needed? It just said upload your files, but I don't know what files were needed.
[AGENT][NEUTRAL] I can help you with that, Ms. [PII]. Do you have your policy number available?
[CUSTOMER][POSITIVE] Thank you, thank you.
[CUSTOMER][NEUTRAL] I do, it's 02155891.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Date of birth [PII]. Address is [PII].
[AGENT][POSITIVE] All right, thank you. And what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Let's see, bear with me just one second.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So with this policy, well, when you're submitting a claim through APL.
[AGENT][NEUTRAL] There is a claim form. It's called the Hospital indemnity claim form.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that does have any um any time you're submitting uh regardless of the type of policy, it will have instructions on that claim form that you need to submit.
[CUSTOMER][NEUTRAL] Oh, OK. So can I, can I go, can I log back in or and, and fill that form out? Do I start over or do I just do that form and you already have my, my, the hospital bill? What tell me that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're just
[AGENT][NEUTRAL] That is correct. So you would just submit that claim as a new document. They will put the documents together.
[AGENT][NEUTRAL] Under one claim. Let me just check this information real quick, this hospital billing for you while I've got you on the line. Let's make sure we have the diagnosis code as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A lot of times on their itemized billing, they don't put the diagnosis code.
[AGENT][NEUTRAL] But let me just check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I am not seeing a diagnosis code listed on this. Do you have your um
[AGENT][NEUTRAL] Discharge papers maybe where it shows what you were in the hospital for?
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Uh, I, uh,
[CUSTOMER][NEUTRAL] It says up at the top procedure code and it has the code and then it has the description of what I had done is that not what you're looking for?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is actually uh the, in the procedure code that says what they did, but it does not indicate why it was done. For example, your policy pays towards sickness.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Or, um,
[AGENT][NEUTRAL] Injury. So it, we don't
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And I know it's evident that it is for sickness, but they have to have that diagnosis code.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, so, so then in my, in my, so if I, uh, go home and look at my release papers, uh, what is it I'm gonna be looking for? So I know that I get that.
[AGENT][NEUTRAL] That should
[AGENT][NEUTRAL] Mhm. That should show the reason that you were admitted into the hospital or discharged with, you know, uh, migraine, you know, and your instructions, and it will also give us the exact amount of time, your admission and discharge information as well.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Oh got it OK.
[CUSTOMER][NEUTRAL] Got it. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ah, got it. OK, so then what I'm going to do is I will go home and take that out and then I will bring it and then can I wait till Monday and or over the weekend and then that way send everything together.
[AGENT][POSITIVE] Absolutely. That's not a problem at all.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] OK, all right, I will do that. I thank you. I'm glad I called because I thought I, it didn't tell me. I just uploaded what I had and didn't know what I was supposed to upload, so I do thank you. I appreciate it very much.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] It's my pleasure, and if they process the claim, they're just gonna request that information so it's no big deal if you, if they do happen to process it before you get that other information in, um, that's not a problem at all. And also I was also checking there's a direct deposit option in the portal if you would prefer benefits to go directly to your bank account, you can add that direct deposit information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Oh, OK. OK. Thank you. That's, that makes it easy.
[AGENT][NEUTRAL] Yeah, then you, you never know if, if we pay it a check may go from [PII] to [PII] before coming to you.
[CUSTOMER][POSITIVE] All right then I will get all that too.
[CUSTOMER][NEUTRAL] Take the scenic route.
[AGENT][NEUTRAL] You never know.
[CUSTOMER][NEUTRAL] I think
[AGENT][NEUTRAL] I would like to do that, but
[CUSTOMER][NEUTRAL] I know it. You send me where the check is [PII]. Let's go.
[AGENT][POSITIVE] That's right. I'm gonna pick it up.
[CUSTOMER][POSITIVE] Oh yes, oh, I appreciate it very much. I appreciate your time and your help. You have a wonderful day.
[AGENT][POSITIVE] Such a pleasure.
[AGENT][POSITIVE] I hope you do too, Ms. [PII]. Thank you for calling APL. If you need any further assistance, don't hesitate to give us a call.
[CUSTOMER][POSITIVE] OK. Thank you.
[CUSTOMER][POSITIVE] OK, I sure will thank you so much bye bye. hm.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mm.