AccountId: 011433970860
ContactId: a782d4d0-d60d-47ca-9d8d-46dc8e33d725
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456459 ms
Total Talk Time (AGENT): 184910 ms
Total Talk Time (CUSTOMER): 162976 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/a782d4d0-d60d-47ca-9d8d-46dc8e33d725_20250228T21:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Yes, uh, check my, uh, check my coverage. I'm trying to file a claim and it doesn't let me get in.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I guess it depends if it's in hospital or on hospital. I've got, I've got both, but let's try one. OK, 01986.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 454
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then what is your name, sir? [PII], OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] To pray. OK, let me look it up real quick, sir.
[AGENT][NEUTRAL] OK, [PII], can you verify your date of birth for me please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then what is your address, the phone email address that we have on the policy for you, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then your your email address, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the one month verification, can you give me your phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, sir. And then
[AGENT][NEUTRAL] Hey, get disconnected, is that a good number to call you back on, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, thank you. All right, so I am looking at your policy and I do show that your policy is no longer active, so in order to work online service center, you have to have an active policy so if you need to submit a claim, let me give you the claim's mailing address.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The mailing address?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Is there a place to fax it?
[AGENT][NEUTRAL] Uh, you can fax it too, yes sir, let me give you the fax number.
[CUSTOMER][NEUTRAL] Is there an email where you can send it?
[AGENT][NEGATIVE] No, we don't accept them by email just because it's not secure.
[CUSTOMER][NEUTRAL] OK, so fax number I have here on my card is [PII].
[AGENT][NEUTRAL] That's correct. That's that's the fax number for claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then it says uh uh submit claims to American Public Life PO Box.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes sir, that is the claims mailing address.
[CUSTOMER][NEUTRAL] Is there a way also to log in? There's no longer a way to log in.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so, but
[CUSTOMER][NEUTRAL] The policy was active from [PII] until I think end of last month.
[AGENT][POSITIVE] Yes, you're right until today actually.
[CUSTOMER][NEUTRAL] OK, so I, I can make claims. I've got, uh, I don't have anything in [PII], but [PII].
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] There was what's the maximum per year? 2000?
[AGENT][NEUTRAL] Let me check your benefits real quick and this is just to verify your benefits it's not a guarantee of payment, uh, for inpatient is $2000 and let me check for outpatient if you have outpatient.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] And outpatient is also $2000.
[CUSTOMER][NEUTRAL] But it's a maximum of 2000 a year.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, so what do you need? I've, I've got, um, hospital like a record that is an invoice with the diagnosis, uh, the admission date, uh.
[CUSTOMER][NEUTRAL] The discharge date all on one is that sufficient to to file the claim?
[AGENT][NEUTRAL] Yes, you'll need that and then you'll also need the explanation of benefits from your primary insurance carrier.
[CUSTOMER][NEUTRAL] Oh, OK, and how, how in what format do you get that?
[AGENT][NEUTRAL] Uh, you'll have to call your major medical insurance that you have.
[CUSTOMER][NEUTRAL] Can you just show, can you just show a card?
[AGENT][NEUTRAL] No sir, we have to have the explanation of benefits to show what they paid.
[CUSTOMER][POSITIVE] OK, explanation of benefits perfect then uh.
[CUSTOMER][NEUTRAL] Is there a specific form or we use the same form?
[AGENT][NEUTRAL] You're going to use the Medlink claim form and I can give you the website to get that at.
[CUSTOMER][NEUTRAL] OK, Medlink.
[AGENT][POSITIVE] Yes, sir. You're gonna go.
[CUSTOMER][NEUTRAL] Let me, let me see if I can get in there right now. Let me get, is there, uh, what's the website Medlink?
[AGENT][NEUTRAL] No, you're gonna go to [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Got it. A public I'm in there. OK, I'm there.
[AGENT][NEUTRAL] OK, you're gonna up in the right hand corner you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] Got it from there.
[AGENT][NEUTRAL] And I believe the Medli claim form is on page 2. Let me go in there and make sure.
[AGENT][NEUTRAL] If you scroll down to the bottom and hit page 2.
[AGENT][NEUTRAL] It's gonna be the 3rd 1 down.
[CUSTOMER][NEUTRAL] Well she.
[CUSTOMER][NEUTRAL] Bed link claim form OK download form.
[AGENT][POSITIVE] Yes sir, that's the one you need.
[AGENT][NEUTRAL] So if you send your itemized statement that you were talking about with your explanation of benefits and your med link claim form, we will need those three documents to file the claim.
[AGENT][NEUTRAL] On any claim that you do.
[CUSTOMER][NEUTRAL] OK, wait, wait, wait, wait, the mid like claim form, is that, isn't that the explanation of benefits?
[AGENT][NEUTRAL] No, that's the claim form.
[CUSTOMER][NEUTRAL] OK, and then what, how do I get the explanation of benefits? I thought you said there was one.
[AGENT][NEUTRAL] The explanation of benefits would come from your primary insurance, your medical insurance?
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're so welcome, Mr. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] We should
[CUSTOMER][POSITIVE] Thank you, that's it.
[AGENT][POSITIVE] All right. Well, you have a good weekend and thank you for calling APL, sir.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Bye-bye, sir