AccountId: 011433970860
ContactId: bd264296-fc6c-4d51-ac15-6e7e1e924b6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455279 ms
Total Talk Time (AGENT): 202019 ms
Total Talk Time (CUSTOMER): 192572 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/bd264296-fc6c-4d51-ac15-6e7e1e924b6c_20250227T16:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is speaking. May I help you?
[CUSTOMER][NEGATIVE] Yes, good afternoon. I was in the hospital in September. I went to the emergency room. And the day after I got out of the hospital, I called because I have the gap insurance, and nothing has changed on my bill. I don't see where there's any difference.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Uh, your name is? I'm sorry.
[CUSTOMER][NEUTRAL] That's OK, [PII].
[AGENT][NEUTRAL] And Ms. [PII], what is your policy number, please?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have a group number.
[AGENT][NEUTRAL] Uh, no, ma'am, at the bottom of your card, do you see an outpatient or in-hospital number?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes, yes, yes, um, the outpatient, well, I ended up staying in the hospital. The outpatient is 01337118 Mary [PII] 8.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Uh, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address, please.
[CUSTOMER][NEUTRAL] Sure. The uh date of birth is [PII].
[CUSTOMER][NEUTRAL] And you said home address?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And that's [PII] [PII], excuse me, [PII].
[AGENT][NEUTRAL] OK, and I do show a different address in our system, um.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What address?
[CUSTOMER][NEUTRAL] I haven't lived there in years. I haven't lived there since I got this insurance, so I don't know how you have that.
[AGENT][NEUTRAL] OK. So
[AGENT][NEUTRAL] OK, and so your address is [PII]?
[CUSTOMER][NEUTRAL] Yes, and there's a space between the [PII] and the [PII]
[AGENT][NEUTRAL] OK, um, [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, I'll correct that in our system. And do you have an email address, uh, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, my, I'm not sure, I might have it under my work, which is [PII]. My personal is [PII].
[AGENT][NEUTRAL] That's cute. Well, I don't show an email address. Which one would you prefer us to have in the system?
[CUSTOMER][NEUTRAL] The I am, it's [PII].
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Thank you. I've had it for a long time now. I'm just short and grumpy, so.
[AGENT][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] All right. And you said you had, uh, you were inpatient in the hospital in September?
[CUSTOMER][NEUTRAL] I went into the ER and they kept me there, I think it was 1 night. I can't remember if it was 1 night or 2 nights.
[AGENT][NEUTRAL] Well I
[AGENT][NEUTRAL] OK, because I don't show we received any claim information. Uh, did you give the information to the hospital?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] No, I was told to call you guys when I got out of the hospital.
[CUSTOMER][NEGATIVE] Which I did, and somebody asked me a whole bunch of questions, which evidently they didn't make any changes if you're asking me the same questions and making changes.
[AGENT][NEUTRAL] Oh, I'm sorry, but um,
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Either you can submit the claim information, we will need the um itemized bill showing the diagnosis and procedure codes and the primary insurance EOB or explanation of benefits.
[CUSTOMER][NEUTRAL] OK, and that should be.
[CUSTOMER][NEUTRAL] In my Florida blue.
[CUSTOMER][NEUTRAL] Website, right?
[AGENT][NEUTRAL] Oh, with, yes, ma'am, and with Florida Blue, um, theirs are different. It's called health statements.
[CUSTOMER][NEUTRAL] OK, see, I'm looking at.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm in the site now.
[CUSTOMER][NEUTRAL] And like I'm looking at Florida emergency physician.
[CUSTOMER][NEUTRAL] My claim breakdown?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know this is all see all my claims. This is all very confusing to me, so I'm sorry.
[AGENT][NEUTRAL] No, you're fine. Um.
[AGENT][NEUTRAL] I would say probably call Florida Blue and verify with them, but
[CUSTOMER][NEUTRAL] I did, and they said to call you.
[AGENT][NEUTRAL] Well, and like I said, as far as the health statements, um, they located on their website because those health statements are great and they show the data service, the diagnosis codes, procedure codes, as well as uh what was applied towards deductible, co-pay or co-insurance, and that's what we pick up at secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you and it looks like there's gonna, I mean I can print them out, but it looks like there's gonna be a bunch of them.
[AGENT][NEUTRAL] Oh, that's fine. Uh, anything in in relation to that inpatient confinement, uh, you can submit to us for review or like I said,
[CUSTOMER][NEUTRAL] And how do I submit it to you?
[AGENT][NEUTRAL] Um, we have, you can mail it, oh, excuse me, I have hiccups. You can mail it, fax it, or uh if you set up on our online service, in our account, you can um upload it into the system.
[CUSTOMER][NEUTRAL] OK, let me see if there's a thing on here.
[AGENT][NEUTRAL] And why you doing that I can.
[CUSTOMER][NEUTRAL] OK, I don't see anything. Oh, here we go. [PII].
[AGENT][NEUTRAL] Uh, that's for the website for the claim form, but the website is secured, [PII]
[CUSTOMER][NEUTRAL] Is that where I would go?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I will go there. I will save these things to my desktop then and see if I can break them down, get them on there.
[AGENT][NEUTRAL] OK. And once you get onto the site, you can check claim status, submit a claim, um, and they do have it to where you can give a cell phone number to where you can receive a text when a claim has been received and when it's been processed as well.
[CUSTOMER][POSITIVE] OK. All right, fantastic. Thank you very much. I appreciate your help.
[AGENT][POSITIVE] You are welcome, Miss [PII], and is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Nope, that should do it, I think.
[AGENT][NEUTRAL] OK. Well, uh thank you for calling APL.
[CUSTOMER][NEUTRAL] So yeah, I'll just print it looks like they've got 10 different ones for that same visit.
[AGENT][POSITIVE] Yeah, I would say to submit anything in regards to that inpatient confinement, that way you can get your full benefit.
[CUSTOMER][POSITIVE] OK. All right. Thank you very much. Have a beautiful day.
[AGENT][POSITIVE] Alright, you too, and thanks for calling APL. Bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.