AccountId: 011433970860
ContactId: b55aae46-5434-481d-9381-a9e37d56c3c7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 630099 ms
Total Talk Time (AGENT): 288816 ms
Total Talk Time (CUSTOMER): 245441 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/b55aae46-5434-481d-9381-a9e37d56c3c7_20250423T17:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], I am trying to file a claim right now. Um, I was told that I should probably do it from my end rather than the hospital, so I'm just trying to see how to do that. I'm on my laptop.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I can help you file a claim. Can I please get your name and your callback number just in case the call dropped I'll be able to call you right back.
[CUSTOMER][POSITIVE] Yes, ma'am. It's [PII].
[CUSTOMER][NEUTRAL] And then the phone number is [PII].
[AGENT][NEUTRAL] OK, Ms. [PII]. And then what is your policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02552172
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Ms. [PII], I'll need for you to verify your policy for me. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number, and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] OK, my address is [PII]. Um, my phone number is the phone number, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it's [PII] and the email address that you'll have should be [PII].
[AGENT][POSITIVE] OK thank you I appreciate you verifying that information for me so the easiest way for you to file the claim is gonna be through the online service center.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] When you get into the online service center you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna choose the hospital indemnity form.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, hospital identity claim form.
[AGENT][NEUTRAL] Yes, ma'am. On that claim form,
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] That very that very first page of the hospital indemnity claim thank you I appreciate it um.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] That first page is
[CUSTOMER][NEUTRAL] Oh, I see. OK.
[AGENT][NEUTRAL] Is a cheat sheet um up at the top of it you'll see complete the statement of insured, um, you'll need an itemized bill with the diagnosis codes from the provider.
[AGENT][NEUTRAL] And your signature and I would go ahead and complete section E.
[AGENT][POSITIVE] Even though it says you don't have to, I would do it anyway just because it makes the claim process faster for you.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Alrighty, oh, I see here, OK.
[CUSTOMER][NEUTRAL] OK, and then that's it. I just reupload that back to were you gonna wait for me to fill it out or um.
[AGENT][NEUTRAL] Um, you can do it online, you can do it online, and what you'll do is you'll, um.
[CUSTOMER][NEGATIVE] You definitely don't have.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, you'll make sure your itemized bill with the diagnosis code um is downloaded on your computer so you can upload it into the online service center.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and when it asked for my email address should I put in my personal or the one that is associated with the account?
[AGENT][NEUTRAL] The one that is associated with the account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I just upload this back to where it says.
[AGENT][NEUTRAL] To upload files on there.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, like back on my home page it says my claims and then upload documents is that where I would upload the claim itself?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, and then I have a question real quick about the wellness claim.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is that like what, what benefit is that to filing those?
[AGENT][NEUTRAL] So wellness um is.
[AGENT][NEUTRAL] Like preventative care.
[AGENT][NEUTRAL] Um, let me pull up your policy to get the policy pulled up itself so I can tell you what your wellness benefits are.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I was just, I was in the hospital for 71 days and so I'm trying to recoup as much as much as I possibly can.
[AGENT][POSITIVE] Oh my [PII]. Gosh, that's a long time. Bless your heart.
[CUSTOMER][NEUTRAL] Yeah, it was quite a while.
[AGENT][POSITIVE] Yes. You're very welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] OK, let me find your benefits on this page real quick so I could tell you what your wellness.
[AGENT][NEUTRAL] Let me just a minute while I scroll through and find it for you.
[CUSTOMER][POSITIVE] OK, you're totally fine.
[CUSTOMER][NEUTRAL] I did try to read through my policy, but I'll be honest, I do not do insurance, so it was not.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Yeah, it can be a lot.
[AGENT][NEUTRAL] It could be a lot.
[CUSTOMER][NEUTRAL] Yes, ma'am. Yes ma'am.
[AGENT][NEUTRAL] OK. I am seeing on your schedule of benefits.
[AGENT][NEUTRAL] Did you just have a hospital admission benefit and a hospital confinement benefit um let me keep scrolling and see if I see any uh wellness or outpatient benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I don't see any wellness or outpatient benefits on your policy. It just looks like it's for hospital confinement.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's perfect. And then I had one, well, I guess, I guess two more questions and then I'll, I'll be, I'll be done, um.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I was in the hospital for um a pregnancy-related condition, and I had my son while I was there. And then he was admitted to the NICU for a week. Um, I know that some policies cover babies after they're born up to [PII]. Is this 11 of those or would it just, I'm the only patient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like um at this time you are the only patient but what you can do is add your son to your policy with the effective date of the date that he was born and you would have to do that through your employer.
[AGENT][NEUTRAL] If they can send us an email, add him to the policy, and then your coverage would be instead of individual it would be a single parent coverage.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or yeah, for just you and him, it would be under single parent, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But they would have to send us an email stating that baby needs to be added to the policy and give us the effective date the baby needs to be added.
[CUSTOMER][NEGATIVE] OK, OK, and then very last question it's asking me to put a signature and I'm unable to click that box.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have everything filled in.
[AGENT][NEUTRAL] Right, you should be able to click the box and do an electronic signature.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Maybe I can just
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or you can use the pen, get your pen and then try to write it in.
[CUSTOMER][NEUTRAL] I can try to
[CUSTOMER][NEUTRAL] Yes, and
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] It's not, yeah, yes, ma'am. It's just not, it's not letting me, it's like not letting me click on the box at all. It's kind of weird. So, OK.
[AGENT][NEUTRAL] It might need you to download the claim form and then you may need to print it and then upload it, scan it and upload it um it should though, you know how you get that pin and that highlighter.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] When you, um.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] You should be able to get that pin, click on that pin and then go down there and I know that it looks like a kindergartner wrote it, but it's a signature, right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Without pin it does not, it never looks the way that your signature is.
[CUSTOMER][POSITIVE] No, no, but OK, I, I, I will just download it and go from there. And that sounds perfect. Thank you so much for your help.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome. Is there anything else that I can help you with, Miss [PII] um, Miss [PII], I'm sorry, I almost called you [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You're fine, you're fine. No, this is perfect. Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome and congratulations on your new baby also.
[CUSTOMER][POSITIVE] Oh thank you, thank you.
[AGENT][POSITIVE] You're welcome, you're very welcome. Well, I hope you have a blessed day and thank you very much for calling APL.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, ma'am. You have a blessed day as well. Thank you.
[AGENT][POSITIVE] Thank you. bye bye.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Bye-bye.