AccountId: 011433970860
ContactId: a782da4b-8253-446b-b840-28fd30ba9d6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 754049 ms
Total Talk Time (AGENT): 305319 ms
Total Talk Time (CUSTOMER): 354581 ms
Interruptions: 7
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/a782da4b-8253-446b-b840-28fd30ba9d6a_20250228T22:44_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] In the hospital
[CUSTOMER][NEUTRAL] Hi, this is [PII]. Um, I'm gonna give you my policy slash certificate number or group number.
[AGENT][NEUTRAL] Go ahead, Mr. [PII].
[CUSTOMER][NEUTRAL] It's 02515176.
[AGENT][POSITIVE] OK, thank you. And let me have it.
[CUSTOMER][NEUTRAL] And I'm, I'm here, I'm here with my wife, yeah, I'm here with my wife's [PII] and she said she called and I had to correct my phone number or something.
[AGENT][NEUTRAL] OK, let's see what we need. May I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] [PII]. That's the phone I'm on right now, which is my wife's phone.
[AGENT][NEUTRAL] OK, thank you. And let's see. Let me have your date of birth, mailing address and email address on file.
[CUSTOMER][NEUTRAL] Alright, my date of birth is [PII]. My mailing address is [PII].
[CUSTOMER][NEUTRAL] And my email address is [PII].
[AGENT][NEUTRAL] Thank you. Um, so the phone number we have here is [PII]. Is that your phone number?
[CUSTOMER][NEUTRAL] No ma'am, I don't even know where y'all got that number from, um, that number, Lord, that's been.
[AGENT][NEUTRAL] OK, we can update that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it's been over 12 years ago.
[AGENT][NEUTRAL] OK, we can update it. What is the new number now?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] My, my new number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 491.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me, let me change that really quick. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Did you get a confirmation on those clothes? Yeah, that's one awesome. They said did you get this?
[CUSTOMER][NEUTRAL] I'm gonna be checking on both of them, see what she says. Yeah, let me see.
[AGENT][NEUTRAL] OK, I went ahead and updated that information. Um, is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] We're checking on the claims that were sent in yesterday. I'm understanding y'all received one, but you didn't receive the other, and we got confirmation sheets here that it went through with the fax. So, um, checking to see if y'all might have got that second one.
[CUSTOMER][NEUTRAL] Just check on the hospital plan.
[AGENT][NEUTRAL] OK. And, and is this for [PII] or who is it for?
[CUSTOMER][NEUTRAL] in the world.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEGATIVE] They're both curing.
[CUSTOMER][NEUTRAL] Yeah, a hospital claim and a wellness claim.
[AGENT][NEUTRAL] OK, so they were both sent by fax, and there are 2 different claims and they're both for [PII].
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, um, let me look at the paperwork we received with the one yesterday. OK, one moment.
[CUSTOMER][NEUTRAL] What number did you call?
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Mm, let's see.
[AGENT][NEUTRAL] Do you know how many pages was each fax?
[CUSTOMER][NEUTRAL] That one had 12 pages. That was the hospital claim had 12 pages.
[CUSTOMER][NEUTRAL] The other one had 9 pages and that's the wellness check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. Bear with me just a second. Let me make sure it was not applied to any other of your policies because you have more than one. So let me just check and see if I can find it, OK? Um, do you mind holding for me?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] His phone number it's actually I'm double checking the phone number.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for you, Mr. and Mrs. [PII]. OK, so yes, I did find the other one. The other one was put under the cancer claim, which is where you get that wellness benefit. So yes, it was both put in the right policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, let me ask you this question. Can I put
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, my home email address on here as well as my personal email address. Can you all put two email addresses or you can only do one?
[AGENT][NEUTRAL] No, we have got for one.
[CUSTOMER][NEUTRAL] OK, I'm gonna give you the because that's the email address I have on file there. Can I change it to my home email that comes to my home computer?
[AGENT][NEUTRAL] Mhm, yeah, you can let me go ahead and go back to it. mhm.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][POSITIVE] Yeah, let's let's let's take I wanted to come to my home computer.
[AGENT][NEUTRAL] OK, what is the email address that you want to use?
[CUSTOMER][NEUTRAL] Alright, it is [PII].
[CUSTOMER][NEUTRAL] K as in Karen Dure D U P R E.
[CUSTOMER][NEUTRAL] 1012.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me read it back to you. So that is going to be [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] OK, I went ahead and updated that in the system as well.
[CUSTOMER][NEUTRAL] Alright, what do I need to do to.
[CUSTOMER][NEUTRAL] Um, give permission to my wife to deal with y'all on this?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Do I need to give you her name and give you permission so she could speak to y'all and and doesn't have to because I mean I work all the time so it's hard for me to get time to do this.
[AGENT][NEUTRAL] If it's related um to claim status, um, benefits, uh she already have permission because she's part of the policy. Now if it's related to making changes to the policy, like to change an address, to change the email, to change the phone to make any changes. If it's relating to changes, we need an authorization form. But if it's just to get claim status and get benefits, then
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Yeah you can.
[CUSTOMER][NEUTRAL] An authorization form.
[CUSTOMER][NEUTRAL] No, all you want is claim status. Yeah, they, they can talk to me because I'm on on the policy, but you can't make changes without filling out an authorization. Yeah, we don't need to change so we don't need to change anything then. OK, alright, I got one more question, um.
[AGENT][NEUTRAL] Mhm. Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] We used to have Guardian before we started with this APL, I mean colonial, I'm sorry, colonial before we went with APL, um, the young lady that came to our office, um, when at the time of our insurance renewal, um, I can't remember her name but I'm noticing that y'all.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Are y'all actually located in [PII]?
[AGENT][NEUTRAL] We have 2 offices, one in [PII] and one in [PII].
[CUSTOMER][NEUTRAL] And who am I, where, where are you at right now?
[AGENT][NEUTRAL] The care team is in [PII]. We have people in [PII], we have the, we have the office in [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, OK, so I'm just asking because I'm wondering, you know, where exactly are y'all at? So the other question I have is my wife says that we're supposed to submit this card at the hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Whenever, whenever one of us gets, goes to the hospital, we have to submit this card to the hospital. I don't understand why.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You, you can, you can if you want to. That's optional. That's not something that is obligated for you to do it. Uh that's optional because either they can submit the claim for you if you don't want to go to the troubles of submitting the claim and we'll go ahead and pay directly.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] Oh no, no, no, we don't, we don't trust anybody, yeah, we don't trust anybody with the claims because I pay personally for this insurance and I pay a lot of money for all the insurance I have with y'all and I wanna make sure that it, it, you know, we deal with the claims form so um you don't have to give it to any hospital, OK, alright, just checking to make sure because.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it's optional.
[CUSTOMER][POSITIVE] Alright, any other questions you have, [PII]? Oh, I guess. Alright, well I appreciate your help and um, uh, direct deposits, uh, everything's gonna go through direct direct deposit, correct?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let me check, make sure that you're set up for direct deposit, um.
[CUSTOMER][NEUTRAL] Yeah, OK, I did send in a form.
[AGENT][NEUTRAL] Did you send it now with this claim or did you send it separately?
[CUSTOMER][NEUTRAL] Yes, for both claims, for both claims we sent in a form.
[AGENT][NEUTRAL] I just
[AGENT][NEUTRAL] OK, um, yeah, if you send it together with the claim that you just submitted, um, then they need to just set that up, um, and they will go ahead and do that at the time they process the claim. Right now it's not showing this that that it's set up, OK?
[CUSTOMER][NEUTRAL] OK, how do we have, yeah, do we, do we have to do that every time with every claim, send a, uh, direct deposit form, or once they set it up it's set up, OK.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Correct, yes. Once it's set up, it's set up.
[CUSTOMER][NEUTRAL] OK, we just verify that we don't have to send that form. OK, alright, any more questions, right? Alright, OK, I think, I think we're good now let me ask you this this every time we go to how many times a year for the wellness that we get to file a claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, it's once a year. It's once a year, uh, for each one.
[CUSTOMER][NEUTRAL] Is it once or twice a year?
[CUSTOMER][NEUTRAL] OK, for the well.
[CUSTOMER][NEUTRAL] OK, so it's once a year just for the hospital also?
[AGENT][NEUTRAL] No, for the hospital it's different. The wellness is once a year and it's one per person per calendar year. The hospital is different. OK. Um, for the hospital, let me go ahead and get the benefits. One moment.
[CUSTOMER][POSITIVE] Don't get off the other. You're talking well.
[CUSTOMER][NEUTRAL] Yeah, what about the hospital?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I wanna find out.
[AGENT][NEUTRAL] OK. And this is not a.
[CUSTOMER][NEUTRAL] I'm gonna let you give that to her, OK?
[AGENT][NEUTRAL] OK, sure, no problem. And this is not a guarantee of payment, just a verification of coverage and let's see.
[CUSTOMER][NEUTRAL] We almost
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So the hospital confinement benefit, the confinement benefit, the admission, the first time that you're admitted, we pay $1500. So that one is just one time per year. And then if you are admitted again, we will not cover the admission that, that same year, but you will get that daily benefit, the daily confinement benefit of $100.
[CUSTOMER][POSITIVE] Oh, OK. All right, I got you. All right. All right, well then we kind of have a little bit better understanding. All right. Well, all right, well, surely, thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, OK, that's good. Is there
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that is it.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. You have a good afternoon, OK?
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Goodbye.