AccountId: 011433970860
ContactId: a735417b-339f-43ef-8292-b14a39898764
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 639119 ms
Total Talk Time (AGENT): 180906 ms
Total Talk Time (CUSTOMER): 247310 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/a735417b-339f-43ef-8292-b14a39898764_20250428T15:33_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I filed a hospital indemnity claim, um, last month, 3-18, and I was calling to check the status of it.
[AGENT][NEUTRAL] OK, do you have your policy number?
[CUSTOMER][NEUTRAL] Um, my
[CUSTOMER][NEUTRAL] I have my member number is that what you need?
[AGENT][POSITIVE] Uh, yes, that should work.
[CUSTOMER][NEUTRAL] 681
[CUSTOMER][NEUTRAL] 981-932
[AGENT][NEUTRAL] I wasn't able to pull anything up under that number. What is your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], I was able to locate that. Do you have, um, what is your birth date?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, well, I guess, oh, my number this 1 [PII].
[AGENT][NEUTRAL] OK, thank you. I just need a few other pieces of information. What is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your email address?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] And did you submit that by mail or was that by fax or?
[CUSTOMER][NEUTRAL] It was um faxed.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't have any claims on file.
[AGENT][NEUTRAL] Don't show that we perceived that.
[CUSTOMER][NEUTRAL] You have it in the email?
[AGENT][NEUTRAL] Yeah, I don't, I don't show that we've ever received any claims.
[CUSTOMER][NEUTRAL] OK, if I were to send this to you again, how many days would it take for me to get this resolved?
[AGENT][NEUTRAL] Uh, typically takes about 7 to 10 working days to get a claim processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you wanna
[CUSTOMER][NEUTRAL] Do you have anything in email?
[AGENT][NEUTRAL] No, I don't, I don't show anything that we've received anything and we don't actually take claim submission by email, it's just by fax or mailing and uh like regular mail.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] It was sent.
[CUSTOMER][NEGATIVE] OK, if she doesn't have it I'm gonna send it again, but I've got a hospital breathing down my back for these payments on this and um I thought that I had taken care of it a month ago and I did send it, it was faxed over to you.
[AGENT][NEUTRAL] OK, do you wanna
[CUSTOMER][NEUTRAL] We scanned like, you know what we scanned everything and we sent it through the email. It was attached through the email.
[CUSTOMER][NEUTRAL] Can you go [PII] to our email and look to sent items?
[AGENT][NEUTRAL] I, I, do you know what email you sent it to?
[CUSTOMER][NEUTRAL] It was sent to um customer support at [PII].
[CUSTOMER][NEUTRAL] The one that's on the letter that was sent to me?
[AGENT][NEUTRAL] Um, I don't know what for member, this is American Public Life. I'm not sure what for member services.
[AGENT][NEUTRAL] I don't know, that's not our email, so I'm not sure where that would have went.
[AGENT][NEUTRAL] And we don't take claim submission by email.
[CUSTOMER][NEUTRAL] That's, this was
[AGENT][NEUTRAL] Do you want our fax number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, our
[CUSTOMER][NEUTRAL] What's the fax number?
[AGENT][NEUTRAL] Fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I will send it.
[CUSTOMER][NEUTRAL] Yes, everything was sent to [PII] at.
[CUSTOMER][NEUTRAL] [PII] [PII] is our advocate.
[CUSTOMER][NEUTRAL] Does [PII] work for you?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No, I, we don't have an [PII]. Is that maybe through your employer?
[CUSTOMER][NEUTRAL] No, I'm not employed. Um, there's a [PII] that was, I was dealing with with everything to do with APL.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Maybe the, was it maybe your broker?
[AGENT][NEUTRAL] Let me look it up. Let's see.
[CUSTOMER][NEUTRAL] This was like um.
[CUSTOMER][NEUTRAL] We are bill advocacy through Advantage PHC.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Alright, I'm gonna um resend this. They don't take it by email now that is strange. Why?
[AGENT][NEUTRAL] Uh, we don't have a secured email site and you're typically submitting like HIPA related information, so we wanna make sure that it's safe and we don't have it through email, so.
[AGENT][NEUTRAL] And I, I show this policies through Business Workers of America.
[CUSTOMER][NEUTRAL] It's THCS.
[CUSTOMER][NEUTRAL] Yes, Business workers of America.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That I don't have this as an individual policy. I show this is through an employer.
[AGENT][NEUTRAL] Business workers of America.
[CUSTOMER][NEUTRAL] I have it.
[CUSTOMER][NEUTRAL] Business workers of America.
[AGENT][NEUTRAL] This is like a, yeah, this is like a limited in hospital indemnity plan.
[CUSTOMER][NEUTRAL] Association.
[AGENT][NEUTRAL] Is there another coverage that you might have?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My coverage was all purchased through the PHCF limited benefit plan.
[AGENT][NEUTRAL] OK, like I said, I just show you're employed through Business Workers of America and that's who this policy is through.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] So you're telling me that's no good?
[AGENT][NEUTRAL] No, I, I show it's active.
[CUSTOMER][NEUTRAL] is that what you're trying to say?
[AGENT][NEUTRAL] No, I showed the policies.
[CUSTOMER][NEUTRAL] It's active. OK, I'm paying for it.
[CUSTOMER][NEGATIVE] But apparently I sent it to the wrong people.
[AGENT][NEUTRAL] Right, you just
[AGENT][NEUTRAL] Yeah, it, I don't know if maybe.
[CUSTOMER][NEUTRAL] Uh she follows her
[CUSTOMER][NEGATIVE] This says please complete the claim form and mail, email or fax it to claim support. I was told I could email this and now I'm calling and you're telling me no you can't.
[AGENT][NEUTRAL] What is that letter from?
[CUSTOMER][NEUTRAL] Business workers of America.
[AGENT][NEUTRAL] OK, uh, like I said, I don't know if this is what you have in your hand. I don't know if that's, it doesn't seem that that's related to this. This is through APL. We only have an option of mailing and faxing the information you provided that.
[CUSTOMER][NEUTRAL] This has been out since.
[CUSTOMER][NEUTRAL] She's this one.
[CUSTOMER][NEUTRAL] This was um.
[CUSTOMER][NEUTRAL] Sent to me
[CUSTOMER][NEUTRAL] They're the ones that sent it to me.
[CUSTOMER][NEGATIVE] OK, so apparently there was some screw ups here, um.
[CUSTOMER][NEUTRAL] So to move forward I need to fax my form, my APL form to the fax number you gave me. What else needs to come with it?
[AGENT][NEUTRAL] So what are you submitting? Is it a hospital claim?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so, um, do you have, it should state what date of service you were seeing, what you were seeing for.
[AGENT][NEUTRAL] What the diagnosis was.
[AGENT][NEUTRAL] Then how much the bill charges were?
[AGENT][NEUTRAL] So we need all those pieces of information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, I have all that that's what I sent before.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there someone that
[CUSTOMER][NEUTRAL] That I could call back to make sure that this was received?
[AGENT][NEUTRAL] Yeah, so if you fax it today, um, give us a call back Friday it should be entered in the system by then.
[AGENT][NEUTRAL] Um, and you can just call the same number, the [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, I've got it here. She won't take it by email, honey. She'll only take it by fax, and that was the problem. I was faxed. I, it said it could be emailed on this form, but she says it cannot.
[CUSTOMER][NEUTRAL] BWA sent us the form.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] With
[CUSTOMER][NEUTRAL] With indication that we to do it that way, but he's telling me they don't receive them that way. OK, I will fax it to you. Thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.