AccountId: 011433970860
ContactId: ad65307e-9859-4a94-b7ba-6b13a6e08073
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 714580 ms
Total Talk Time (AGENT): 292710 ms
Total Talk Time (CUSTOMER): 190649 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/ad65307e-9859-4a94-b7ba-6b13a6e08073_20250401T20:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], this is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I forgot all about this American public life. Well, APR card that I have, all the insurance that I took out. Tell me.
[CUSTOMER][NEUTRAL] What is, what does it entail though? What does it cover?
[AGENT][NEUTRAL] OK, [PII], I can help you with your benefits. Do you have uh your policy number?
[CUSTOMER][NEUTRAL] My policy number.
[CUSTOMER][NEUTRAL] It's 11
[CUSTOMER][NEUTRAL] 22654
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just need to verify just a few pieces of information. What's a good call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 598
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. What's your birthday?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then what is your address?
[CUSTOMER][NEUTRAL] Now it's [PII].
[CUSTOMER][NEUTRAL] Ray, R A E Street.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, looks like I have.
[AGENT][NEUTRAL] A different address. Is this your current address, the one you just gave me?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You have [PII]?
[AGENT][NEUTRAL] No, I've got a different one.
[CUSTOMER][NEUTRAL] OK, do you have, wait a minute, wait a minute, what was that [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, that's the one we have.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, so we need to get
[CUSTOMER][NEUTRAL] Oh yeah. Um.
[AGENT][NEUTRAL] Can you get it changed
[CUSTOMER][NEUTRAL] Yes ma'am, we need to change that.
[AGENT][NEUTRAL] OK, let's do that first.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so repeat that back to me one more time if you don't mind.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Because
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Make sure that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Let's see what, what you've got on your policy.
[AGENT][NEUTRAL] Um, let's see. So whatever we talk about today is not a guarantee of payment. It's just a basic outline of your policy.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Pulling it up. Just give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so if you are inpatient in the hospital, it'll pay up to $1000 per calendar year.
[AGENT][NEUTRAL] And then let's see.
[AGENT][NEUTRAL] And then if you're outpatient.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEGATIVE] Sorry, it's being a little bit slow.
[CUSTOMER][NEUTRAL] That's OK. That's OK.
[AGENT][NEUTRAL] Yeah, it looks like that is the benefit. So it's $1000 per calendar year in the event that you went inpatient in the hospital.
[CUSTOMER][NEUTRAL] Oh, OK, because I had this car, I had this insurance ever since.
[CUSTOMER][NEUTRAL] Um, let me look it back on the date.
[CUSTOMER][NEUTRAL] But I've never ever.
[CUSTOMER][NEUTRAL] Look at this card and so one of the one of my co-workers today.
[CUSTOMER][NEUTRAL] Effective date
[CUSTOMER][NEUTRAL] That's [PII] [PII].
[AGENT][NEUTRAL] Yeah, looks like that's when you're affected.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah. So let me ask you this.
[CUSTOMER][NEUTRAL] If I was in the hospital a year ago, I think it was a year or two, will, will this, will it pay?
[AGENT][NEUTRAL] Yes, we just need you to submit a claim, um.
[AGENT][NEUTRAL] You can go online. Do you have access to um a laptop or desktop?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK, um, you can create an account on our online portal where you can download our claim forms and then you can submit there's, it'll outline exactly what we need in a claim.
[AGENT][NEUTRAL] And then you can submit that to us and then we can process it under your policy according to what it'll pay out.
[CUSTOMER][NEUTRAL] OK, so, um, so everything is on the card, where, where do I go on the computer?
[AGENT][NEUTRAL] Yes, you'll go to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] So from there if you've never set up your account you'll you'll set up your account as a new user, your individual.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it will ask for several different pieces of information. It will require your social security number.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and then.
[AGENT][NEUTRAL] And keep in mind this, you, you don't have a timely filing limit. So if you've been inpatient in the hospital.
[AGENT][NEUTRAL] Any time since [PII].
[AGENT][NEUTRAL] You can submit any claims going all the way back to them, so.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, well it only.
[AGENT][NEUTRAL] If you
[CUSTOMER][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] I stayed in [PII], I think it was 3 days.
[CUSTOMER][NEUTRAL] And that was for a year or two ago.
[AGENT][NEUTRAL] OK, yeah, not too late to submit that, so, and like I said, you can go all the way back to [PII]. There'll be a claim form on there.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Uh, there's a claim form on there and then like I said, you're gonna need to, do you have, so you have primary insurance?
[AGENT][NEUTRAL] Like through uh United Healthcare, Blue Cross Blue Shield or something like that.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I will note one thing we have to have to process the claim is an explanation of benefits from your primary health care. So we have to see what they paid.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] That will be required. Um, a lot of the times hospitals will submit this for you, um, but if, if you have access to that information.
[AGENT][NEUTRAL] What you need to do is get through, who's your insurance through?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Blue Cross Blue Shield.
[AGENT][NEUTRAL] Blue Blue Cross Blue Shield. OK, so what you'd want to do is call Blue Cross Blue Shield or log on to your account if you have one.
[AGENT][NEUTRAL] Um, and pull and ask them for the explanation of benefits from that hospital stay a few years back.
[AGENT][NEUTRAL] Because we're gonna need that in order to process this claim and pay out up to that $1000.
[CUSTOMER][NEUTRAL] So what, what does it have to do with what they pay versus what you all?
[CUSTOMER][NEUTRAL] Got to pay. So, I mean,
[CUSTOMER][NEUTRAL] If you see what they pay, then is it?
[CUSTOMER][NEUTRAL] Uh, a possible chance like, OK, they paid this so you don't get the 1000, maybe get 500.
[AGENT][NEUTRAL] Right, so we won't pay more than what your patient responsibility was with your Blue Cross Blue Shield. So for example, if that's all you owed after Blue Cross Blue Shield paid was 500, we would pay you 500.
[AGENT][NEUTRAL] Now, if you owed, say, 1500, 2000, we would pay you 1000.
[AGENT][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] Well, um, I'll see because the young lady, uh, she didn't explain it to me like that.
[CUSTOMER][NEGATIVE] She just said if you're in the hospital, you know, they gotta pay you $1000. She didn't say anything about my other insurance because she said, you know, she, she got paid, but she didn't say anything about my husband's, it's my husband's insurance.
[AGENT][NEUTRAL] Oh, OK, yeah. Yeah, sure.
[CUSTOMER][NEUTRAL] Well, you know,
[CUSTOMER][NEUTRAL] Uh, yeah, work.
[AGENT][NEUTRAL] Yeah, so yeah, this, this policy works like that. um, let me make sure you don't have anything else with us that might work differently.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] I don't.
[AGENT][NEUTRAL] Yeah, I just showed the Medlink policy, um, so, so yeah, this is a policy where we do have to have your primary explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, well, it seems to me.
[CUSTOMER][NEUTRAL] Um, like I got some time to get it in.
[AGENT][POSITIVE] Yeah, yeah, there's no timely filing limit and again feel free to be sure and set up that online account and if you need any help walking through any of it, feel free to call us and we'll we'll help you through it.
[CUSTOMER][POSITIVE] OK, thank you so much I appreciate it.
[AGENT][NEUTRAL] OK, anything else I can help with, Ms. [PII]?
[CUSTOMER][POSITIVE] No, ma'am, you did a great deal.
[AGENT][POSITIVE] OK. All right. Well, I hope you have a terrific afternoon and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][NEUTRAL] All right, bye.