AccountId: 011433970860
ContactId: b7e88427-667e-4a83-895d-4e6848e56375
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1024170 ms
Total Talk Time (AGENT): 280095 ms
Total Talk Time (CUSTOMER): 403677 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/b7e88427-667e-4a83-895d-4e6848e56375_20250106T20:53_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. This is A tell us [PII]. How can I help you?
[CUSTOMER][NEUTRAL] And your name is what?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], OK. [PII], um, my name is [PII].
[CUSTOMER][NEUTRAL] And uh I have a couple questions about my uh my policy. Can I give you the certificate number?
[AGENT][NEUTRAL] Yes, ma'am. What is that number?
[CUSTOMER][NEUTRAL] 58895
[AGENT][NEUTRAL] And can I get a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Can you verify your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And lastly your email address.
[CUSTOMER][NEGATIVE] Well, my email address ain't working.
[AGENT][NEUTRAL] Oh, we just have to verify because it's, it since it's on the policy.
[CUSTOMER][NEGATIVE] But it don't work.
[AGENT][NEUTRAL] OK, well that's fine. OK, um, all right, miss, thank you for that. You said you had a few questions?
[CUSTOMER][NEUTRAL] OK, yeah, um.
[CUSTOMER][NEUTRAL] Now does my policy cover.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, skilled nursing.
[AGENT][NEUTRAL] OK, let me go ahead and pull up your policy and I can verify that. Give me one second.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, the policy you gave me was for your intensive care policy. Let me look on your other policy to see if that one,
[AGENT][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] I'm just looking for, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, which shows that it's covered on the policy. Uh.
[AGENT][NEUTRAL] So it's yes, ma'am. So it's covered on your, your cancer policy.
[CUSTOMER][NEUTRAL] Oh, I thought it was under the, uh, intensive care, but
[AGENT][NEUTRAL] I'll go and look at that one, but normally the intensive care just normally doesn't, so let me go ahead and just verify on that one just to.
[CUSTOMER][NEUTRAL] They don't matter as long as it's cool.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] 82.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] And that one.
[AGENT][NEUTRAL] Yeah, so the intensive care just covers for um if you're in intensive care in the hospital, it doesn't show any um skilled nursing visits.
[CUSTOMER][NEUTRAL] OK, I know it covers sit down.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] But anyway, it covers step down. I do know that, but anyway, um, but I do have skilled nursing, right? Um
[AGENT][NEUTRAL] You have still nursing under your, under the cancer policy, um, but not the intensive care one.
[CUSTOMER][NEUTRAL] I know I did, but I just want to be.
[CUSTOMER][MIXED] OK, but still the 58895.
[AGENT][NEUTRAL] No, ma'am. It's not that policy. It's the, the policy 638108.
[CUSTOMER][NEUTRAL] 5638.
[CUSTOMER][NEUTRAL] Well, I guess I, I've got a few copies here of what I've turned in and they've been with that 58895, but anyway, I guess I'll changed it when y'all got it or something I don't know. But anyway, um.
[AGENT][NEUTRAL] Let me see what you have submitted on that one,
[CUSTOMER][NEUTRAL] No, no, I haven't since [PII].
[AGENT][NEUTRAL] OK, so all the claims that you have submitted on that 58895 was for um intensive care visits. They were not for skilled nursing.
[CUSTOMER][NEUTRAL] Oh, that's right, that's right. That's right. I'm sorry. I'm, I'm sorry. Uh, OK. Well, um, I'm gonna, I did, I just didn't think fast enough, uh.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] On my skilled nursing, uh,
[CUSTOMER][NEUTRAL] This is, um, let's see.
[CUSTOMER][NEUTRAL] My 3rd time in a skilled nursing facility, but how far back will y'all go?
[AGENT][NEUTRAL] We don't have any deadlines, so I mean you can go as far back as when that policy started um on that side, so it looks like.
[AGENT][NEUTRAL] The cancer policy started in [PII], so she can go that far back.
[CUSTOMER][NEUTRAL] So, if I, if I was in a nursing, uh, skilled nursing facility back,
[CUSTOMER][NEUTRAL] And, um, say 2 years ago.
[CUSTOMER][NEUTRAL] I can get that information and, and still file it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right then. Well, could you do me a favor then?
[CUSTOMER][NEUTRAL] Could you send me some claim forms? Uh, I'm, I'm in a skilled nursing place right now. And so I've been here since [PII]. Do you want me
[CUSTOMER][NEUTRAL] OK, I got two others to file that are in the past, OK? But do you want me to file like from [PII] through the end of the year?
[CUSTOMER][NEUTRAL] Uh, and then we start this time, I mean, this, we'll start over, um.
[AGENT][NEUTRAL] So what you can do to be um um just whenever you're um like gonna be released.
[AGENT][NEUTRAL] Um, you can submit that information then, or I mean if you wanna send in for the previous ones and then do that, I mean, it's basically up to, but you don't have to break it up, um, if you don't want, you can do it all at one.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] OK. Alright then. And it's 300 a day, is that correct?
[AGENT][NEUTRAL] Uh, that's what I was trying to look to see what the amount is.
[AGENT][NEUTRAL] Let me go back over there and see what it shows.
[CUSTOMER][POSITIVE] OK. I'm sorry.
[AGENT][NEUTRAL] Oh, that's OK. I was just flipping back between policies, so I have to go back to that policy to see what that amount is.
[AGENT][NEUTRAL] I think it said 125 a day, but let me see.
[AGENT][NEUTRAL] Uh, nursing, yeah.
[AGENT][NEUTRAL] So yes, it says it's not to exceed 125 per day.
[CUSTOMER][NEUTRAL] Yeah, payment's not to exceed that.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. OK. OK. Well, if you will just send me some um claim filings, I will appreciate it. Um.
[CUSTOMER][NEUTRAL] And then I can get this back in the mail or get this in the mail and use um the policy uh certificate number is 638106.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] OK. Um, also, um,
[AGENT][NEUTRAL] I'm sorry it's 638-108.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 108, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, also, I just have this question. Uh,
[CUSTOMER][NEUTRAL] Is there any way we can change the name?
[CUSTOMER][NEUTRAL] Me still being the person that would benefit, but that it be in my daughter's name.
[CUSTOMER][NEUTRAL] And it come out of her checking account. I mean, I would be paying her, but come out of her checking account in a sense we're trying to get everything out of my name, OK?
[CUSTOMER][NEUTRAL] Um, so,
[AGENT][NEUTRAL] So your question is um if the payments can be coming out of our account instead of yours?
[CUSTOMER][NEUTRAL] Oh, I don't mean the payments. I mean, after we do the payments, can we change the name uh on the account to be my daughter's name but yet cover me?
[CUSTOMER][NEUTRAL] Be like she bought me this part.
[AGENT][NEUTRAL] So that's what I'm saying, so you're wanting the premiums to come out of her instead of yours?
[CUSTOMER][NEUTRAL] Well, yeah, but I want her name on the uh
[CUSTOMER][NEUTRAL] The policy
[CUSTOMER][POSITIVE] But it covered me. It, it's like she bought me this.
[CUSTOMER][NEUTRAL] For [PII] or something, you know.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] OK, so you want her like as uh some like fisher or something um on the policy.
[CUSTOMER][NEUTRAL] No, she's, should be already that, but um
[CUSTOMER][NEUTRAL] Like, OK, where the policy is in my, my name, [PII]. I want the policy to be in her name, [PII].
[CUSTOMER][NEUTRAL] And uh but yeah.
[AGENT][NEUTRAL] OK, so I don't think that they can change the policy to her name. I mean, um, since you're the policy holder, um.
[AGENT][NEUTRAL] So I don't think that, that changed.
[CUSTOMER][NEUTRAL] OK. I just wondered, we, uh, we, we're just kind of thinking here, so, uh, just wondered, so, uh, anyway, um, OK, all right then. Well, well, I appreciate all your help and everything and um
[AGENT][POSITIVE] I promise
[CUSTOMER][NEUTRAL] Huh.
[AGENT][POSITIVE] No, I'm saying that's no problem.
[CUSTOMER][NEUTRAL] OK, well, this will help, but if you get me out some, um, like I say, I'm in the facility so I can't make copies. So if you can get me out like 4 or 5 well maybe go ahead and just give me 6 just in case I mess with uh, uh, claim forms.
[AGENT][POSITIVE] All right, no problem. I'll go ahead and get that sent out to you. Was there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] OK. I do wanna ask a question on the back.
[CUSTOMER][NEUTRAL] Uh, I'm looking at another one. It asked something about um.
[CUSTOMER][NEUTRAL] From the doctor or something like that?
[CUSTOMER][NEUTRAL] What, what do I do about that? Because there's not a doctor.
[AGENT][NEUTRAL] OK, so are you in the facility, uh, let me see, hold on, let me, let me just look to see what your policy says.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] So were you um diagnosed with cancer or you were um this in the facility?
[AGENT][NEUTRAL] So what was the reason for you being in the facility?
[CUSTOMER][NEGATIVE] Well, this time, cause I fell and I broke my leg and I had to have
[CUSTOMER][POSITIVE] Yeah nursing.
[CUSTOMER][NEUTRAL] And rehab.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let me read your policy to see what, what it says about um skilled nursing.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So since you're not diagnosed with cancer, then it wouldn't cover. So the way that the skill nourishing um benefit covers it, it says uh if as a result of cancer.
[AGENT][NEGATIVE] So in that case, it wouldn't, it wouldn't cover it.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I thought
[CUSTOMER][NEUTRAL] I don't have my policy with me, but um.
[CUSTOMER][NEUTRAL] OK. OK. Uh,
[CUSTOMER][NEUTRAL] Well, I'll have to get my policy and me read it then cause I, I.
[CUSTOMER][NEUTRAL] I understood that.
[CUSTOMER][NEUTRAL] Like if I was in the hospital after surgery or something and had to go to a skilled nursing facility, that uh it would be covered.
[AGENT][NEUTRAL] No, ma'am, it just, um, I said this particular one it just says as a result of cancer, then it would pick it up um for that and like I looked, and that's probably why you might have gave me the intensive care one.
[AGENT][NEUTRAL] Um, policy, but like I looked under that, it doesn't cover that, but, but yes, ma'am, um, it has, had to be as like as a result of cancer.
[CUSTOMER][NEUTRAL] OK, OK. All right, well.
[AGENT][NEUTRAL] Like, um, you're probably like your maybe, I don't know if the Medicare or your regular policy, they would probably have a benefit under that that covers um for that reason, um.
[AGENT][NEUTRAL] Since you fell and you were in the facility.
[CUSTOMER][NEUTRAL] Yeah, yeah. OK. All right. Well, OK, well, um thank you for your information and uh.
[CUSTOMER][NEUTRAL] Um, still go ahead and send me.
[CUSTOMER][NEUTRAL] You know those uh claim forms, OK?
[AGENT][NEUTRAL] All right, no problem, Ms. [PII]. Um, was there anything else that I can help you with today?
[CUSTOMER][POSITIVE] That's all. That's all. I appreciate your help, OK?
[AGENT][POSITIVE] No problem. Well, [PII]nks for calling April. You have a wonderful day.
[CUSTOMER][NEUTRAL] OK, bye bye you too.
[AGENT][NEUTRAL] Uh bye.