AccountId: 011433970860
ContactId: c1375f8e-1b42-4646-91ed-1d3f66741c98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 788530 ms
Total Talk Time (AGENT): 411790 ms
Total Talk Time (CUSTOMER): 408805 ms
Interruptions: 16
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/c1375f8e-1b42-4646-91ed-1d3f66741c98_20250407T19:30_UTC.wav
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[AGENT][POSITIVE] Good. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, I'm sorry, I missed your name. What was it?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII] OK, uh, this is [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And how may I assist you today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, I talked to a couple of people last week about what I needed from the hospital to file a claim on my intensive care policy. Um, do you need to look that up or?
[AGENT][NEUTRAL] Mhm, yes, um, let me have a callback number just in case we get disconnected and the policy number.
[CUSTOMER][NEUTRAL] It's 580421.
[CUSTOMER][NEUTRAL] 754 2
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And what's the policy number?
[CUSTOMER][NEUTRAL] 58,570.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] All right. For security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And what was the 3rd thing you needed?
[AGENT][NEUTRAL] The email address on file.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] All right. Thank you, Miss [PII]. OK. So let's see, you're trying to send a claim. Um let's see. OK, so you just need um
[CUSTOMER][NEUTRAL] I haven't filed anything yet.
[AGENT][NEUTRAL] Mhm. OK. So you just the instructions, correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] Yes, I went to the Shawnee Hospital Friday and came home with 200 pages and I'm pretty sure you don't want 200 pages. Uh, about, about 14 of it is, uh,
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Each day summary of cost because one of the things I was told I needed was.
[CUSTOMER][NEUTRAL] Um, the charges for the ICU.
[CUSTOMER][NEUTRAL] So I think that 4, well, that 14 includes all the pills I took off the oxygen whatever, but it does every day have the.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The room charge. So is that enough? Do I need discharge papers? Do I need?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, it shouldn't need anything from skilled nursing, should I?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, uh, um, just, uh, um.
[AGENT][NEUTRAL] Yeah, the discharge summary will let us know how many days um completed days you were there. And then, um, the charges for the intensive care will let us know how many days you were in the intensive care. So, um, those two are the main ones and then the one that has the diagnosis codes and procedure codes.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Hm, did you say discharge is one you'd like to have?
[AGENT][NEUTRAL] Yeah, the discharge summary will help us know exactly how many days it was.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that looks like that's about 5 pages long.
[AGENT][NEUTRAL] Hospitalized for
[AGENT][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] What kind of codes did you need?
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Is it the REV code or the procedure code?
[AGENT][NEUTRAL] Yeah, it's gonna be procedure codes and diagnosis codes. So, ICD 10 codes or um procedure codes, which is a CBT.
[CUSTOMER][NEUTRAL] I see uh on that detail expenses list that includes the charge for the intensive care. Every single one of those items has procedure code. Is that going to be enough?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, the procedure code will let us know uh what they did, but they will not let us know why. Um, so if, I don't know if in those documents you see anything that says diagnosis code, but if you don't.
[AGENT][NEUTRAL] Just send us what you have and let us look into it and see if that's enough to uh process. If it's not, we'll let you know and then you can just go ahead and get uh something else based on what we find or we didn't find on those documents. um, because it looks like based on what you're telling me, most of the information is there. So maybe the diagnosis code is somewhere there.
[AGENT][NEUTRAL] Um, that we can locate, um, yeah, so the best thing is to just go ahead and send them what you have with the form and let us look into it. Do you have the claim form?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] You know, I don't because they suggested I do it online but I wasn't sure if that was an easy way to.
[CUSTOMER][NEUTRAL] To scan in all these pages online.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well, if you have registered online, you can upload the claim online, um, but you still need that um form.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Yes, um, I.
[CUSTOMER][NEUTRAL] I think I, I, I think I did register online last week after I talked to her I'd have.
[AGENT][NEUTRAL] OK. Let me check on it. Let me see. Let me make sure. Bear with me just a second. Let me look into that.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Yeah, you are registered, so you just need to go in and you just can upload the documents. If you have a scanner, just scan them in and uh upload it to your account.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim form, you can click where it says claims and forms in the website and you can get that claim form, which is the critical illness form.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, just a second, write that down.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Claim form clear critical illness. OK, I don't think anybod[PII] told me that last week.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is there a way on the website to take a photo and upload it right then of each one of each pages?
[AGENT][NEUTRAL] You can, but um sometimes with pictures it's a larger file, so it will take a lot longer to uh to get it to come through, um, so it, it may take for you to do it one by one if you're gonna pull pictures because pictures is a large file.
[CUSTOMER][NEUTRAL] That's, yeah.
[CUSTOMER][NEUTRAL] I was trying to fill out some other insurance and that's what it was having me do was just make a picture and upload each one separate uh.
[AGENT][NEUTRAL] Mhm. Yeah.
[CUSTOMER][NEUTRAL] I'm saying.
[CUSTOMER][NEUTRAL] Position progress notes like.
[CUSTOMER][NEUTRAL] Why I was
[CUSTOMER][NEUTRAL] At the hospital in the first place.
[CUSTOMER][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And that was done on the day I left. I was there 2 weeks.
[AGENT][POSITIVE] Mm wow.
[CUSTOMER][NEUTRAL] 2 weeks and a day, I guess.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] Discharge somewhere that might have somewhere or else maybe the very first haven't looked at these 180 pages.
[AGENT][POSITIVE] Yeah, either the first pages. Oh boy.
[CUSTOMER][NEUTRAL] I thought she was gonna print me 2 or 3. And I was standing there and the printer kept going and kept going. I said, is all that for me? Oh my God.
[CUSTOMER][NEUTRAL] Oh yeah. There's the admission records. Yeah, there's admission records. They're the very first thing.
[AGENT][NEUTRAL] Yeah, a lot, yeah.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, especially when you're there a week or two, yes, a lot of paper.
[CUSTOMER][NEUTRAL] Uh, uh, but there should be, uh, yeah, 2 weeks, yeah, so there should be a diagnosis code of some sort somewhere, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah. I'm thinking that it's going to be because of uh based on what you're reading to me, it may be somewhere in there. Uh, so if you can just send us a copy and let us look into it, we can probably find it and it probably will be enough. If we cannot find it, we'll let you know that we did not find it and that we need it. Um, but, um, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Would you recommend I mail the pages or try to do it online?
[AGENT][NEUTRAL] I will say it will probably be easier for you to mail it since it's a large file and the the best thing to do is to send every paper that you have. Let us look into it. It doesn't matter if it's 50 pages. Let us look into it like that, we can locate all the information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] About 200.
[AGENT][NEUTRAL] 200, we have had many, many.
[CUSTOMER][NEUTRAL] Are you sure you really want 300?
[CUSTOMER][NEUTRAL] I believe she told me 184 and then she ran off about a different lady ran off like 14 more.
[AGENT][NEUTRAL] We have a
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Oh, that's why I'm saying 200. I think it's gonna hit 200. My husband's shaking his head. He sat and looked at us and while I was getting a CAT scan the other day, so.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Yeah, he might. OK, so are you in [PII] or you're somewhere else?
[AGENT][NEUTRAL] Oh boy.
[AGENT][NEUTRAL] No, we're in [PII].
[CUSTOMER][NEUTRAL] Oh, are you that first lady I talked to last week was in [PII] because we talked about bad weather.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh yeah
[CUSTOMER][NEUTRAL] I said, well, yeah, [PII], we're sending it your way, but I think you all got it worse than we did, so we just missed the snow yesterday though.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Yeah, yeah, last week, yeah. Oh really? You still have snow? Oh wow.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, yesterday it was in [PII]. Yes, we live an hour from [PII], so.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] We didn't get it, but we were prepared like the windchill was 22.
[AGENT][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] When we went to church.
[CUSTOMER][NEGATIVE] Yes, it was a miserable cold day.
[AGENT][NEGATIVE] Yeah, no. Yeah, that's too cold for me.
[CUSTOMER][NEUTRAL] Yeah, I'm surprised I didn't trigger some more weather today, but I don't know who got, probably somebody's getting the effect of that somewhere east of us.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] So we're supposed to have spectacular weather the rest of the week. It's shaping up to be in the 70s all week, yes.
[AGENT][POSITIVE] Yeah, for sure.
[AGENT][POSITIVE] Really? Oh, that's so good.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][POSITIVE] After, after the 22 inch show yesterday, we're ready. Yeah.
[AGENT][NEUTRAL] Oh yeah, I bet.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, so do these, where do these go? Are they going to the City they're going to you?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] To [PII]. No, they're going to [PII]. Uh-huh, yes, I just.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] Yeah, I, I even know where that office is up there.
[CUSTOMER][NEUTRAL] O on the city, yeah, I do. So, OK, well, I will work on it one way or the other then and get that done since I can find that and you said I could just print the claim form off.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Mhm, yes, you can just print it out.
[CUSTOMER][NEUTRAL] Look for the one that said critical care.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK. All right, I haven't done that yet, so I'll do that and uh see what I come up with on this diagnosis thing.
[AGENT][NEUTRAL] Yeah, print it out online.
[AGENT][NEUTRAL] Uh, all right, but yeah, if you cannot find it for any reason, just send everything and let us look into it. It's fine. We have had larger files, trust me, we have.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Oh goodness.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][MIXED] I mean, we don't like, it's not the best thing to have so many paperwork for one person, but if I had, it has happened before.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Don't worry. We'd rather have everything than miss everything.
[CUSTOMER][NEUTRAL] At least you probably know what to do, so.
[CUSTOMER][NEUTRAL] I think they.
[CUSTOMER][NEUTRAL] They actually emailed.
[CUSTOMER][NEUTRAL] One of those to me later. I wonder, hmm I don't guess there's any way I can email that back to you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] And you cannot email it back to me to us, but what you can do is save the file in your computer and that will be one file and more than likely that will go through the website way faster than pictures.
[AGENT][POSITIVE] So if you can save that file to your computer and then upload it to your account, that will help a lot.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm, OK, I might, I'm not too good at this stuff. I think 79, but I might be able to do some of it.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, yeah, I noticed they, they actually sent me a text and it was in this text, the whole file that they had just printed me.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Oh wow. Oh, OK. But yeah.
[CUSTOMER][NEUTRAL] So called detailed bill or something.
[AGENT][NEUTRAL] Oh, OK. Yeah, you probably just need to right click it and save it to your computer, um, just save it as a PDF or save it to your computer and see if you can upload it from there, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah. OK, I do, yeah, I do everything pretty much on my iPad, but I can do that kind of stuff, I think, so, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm. All right. Well, if you have any other questions, you, you're welcome. If you have any other concern, you run into any other trouble, just feel free to call us back, OK?
[CUSTOMER][POSITIVE] All right. Well, thank you. We'll see how I do.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Have a good afternoon.
[CUSTOMER][NEUTRAL] All right, same to you, bye.
[AGENT][POSITIVE] OK. Thank you. Bye-bye.