AccountId: 011433970860
ContactId: cc16748c-1756-417a-b7a7-a3bdf73a8327
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 708299 ms
Total Talk Time (AGENT): 266834 ms
Total Talk Time (CUSTOMER): 279947 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/cc16748c-1756-417a-b7a7-a3bdf73a8327_20250314T19:30_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. I need to initiate a claim for my hospital indemnity policy.
[AGENT][NEUTRAL] OK, so you can file a claim online, you can fax it or you can mail it to us, but we can't do claims over the phone. Did you need help with how to file it?
[CUSTOMER][NEUTRAL] I guess so.
[AGENT][NEUTRAL] OK, um, well, I can help you with how to file your claim. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And Mr. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] 02346368
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have your policy here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] What was, what, what did you say the email address?
[AGENT][NEUTRAL] Yes, sir, email and mailing address.
[CUSTOMER][NEUTRAL] Uh, mailing is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 3202
[CUSTOMER][NEUTRAL] Um, emails, I don't know if it's [PII] or [PII]. It's one of those two.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] This one is [PII].
[CUSTOMER][NEUTRAL] Yes, it's fine for.
[AGENT][NEUTRAL] OK, can you provide that email address?
[CUSTOMER][NEUTRAL] Uh, we
[CUSTOMER][NEUTRAL] What's your email address?
[AGENT][NEUTRAL] The email address that we have on file is is [PII].
[CUSTOMER][NEUTRAL] Oh, I didn't know that would be under me, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] Um, so there, there are 3 ways that you can file. Um, which of the 3 do you think you'll be using?
[AGENT][NEUTRAL] Mail.
[CUSTOMER][NEUTRAL] Depends on what you need. Yeah, I mean they don't have EOBs yet. I was hospitalized on the [PII] or [PII], so I haven't seen any of the.
[CUSTOMER][NEUTRAL] Printed paperwork.
[AGENT][NEUTRAL] Did you
[AGENT][NEUTRAL] Did you give the hospital your insurance card for APL?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No, I, I, no, I, I didn't.
[AGENT][NEUTRAL] OK, so you have two options. Either you can call the hospital and let them know that you have an um a hospital indemnity policy as well, and they'll take the policy number and probably our phone number to call us to verify the benefits. Um, if not, you're going to have to wait until the bills come out. So if you have other insurance, they'll be billing them first. If this is your only insurance, it will come to us, um.
[AGENT][NEUTRAL] Well, if they haven't billed it, then you'll need your claim form.
[AGENT][NEUTRAL] Your itemized bill.
[AGENT][NEUTRAL] Which you'll have to wait till the billing comes out.
[CUSTOMER][NEUTRAL] Well, I just know the plan provisions so I've got to notify you within so much time and I know they take a lot to give us anything in writing but I mean I what you're saying is I can.
[CUSTOMER][NEUTRAL] Uh, I'm not sure who to contact.
[AGENT][NEUTRAL] It was just, well, was it like a hospital or was it like a doctor's office? It was a hospital, right?
[CUSTOMER][NEUTRAL] I don't know
[CUSTOMER][NEUTRAL] Hospital, yeah, yeah, I had a procedure and was kept, uh, I was there two days in the hospital.
[AGENT][NEUTRAL] I would just call the billing department.
[CUSTOMER][NEUTRAL] had a cardiac um issue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just give them the
[AGENT][NEUTRAL] Um, and just
[CUSTOMER][NEUTRAL] They they've never issued a card for our policy. I just know we have it so um.
[AGENT][NEUTRAL] Let me see if there's a digital copy available. I can email it to you. Hold on one second.
[CUSTOMER][NEUTRAL] Because if I had, yeah, if I had a card I would provide it to him.
[CUSTOMER][NEUTRAL] Um, you know, my Blue Cross, I, I gave them obviously the scanner, but.
[AGENT][NEUTRAL] OK, so I have your ID card here. I'll go ahead and email it to you as well. Did you want to update the email address that we have here or is this OK?
[CUSTOMER][NEUTRAL] So you got uh micro wholesale?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Email
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, because that's not on my phone it'd be better to send it to one of my personal emails so I can.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] more easily attach it because I got a, you know, it's the hospital, they use an online system called MyChart so it's.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK. Well, that's no problem at all. What's your um personal email?
[CUSTOMER][POSITIVE] Yeah, it'll be easier on the phone.
[CUSTOMER][NEUTRAL] Um, [PII] so it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] All right, so I just sent that to you. Did you want to wait to make sure you received it?
[CUSTOMER][NEUTRAL] Yeah, let me just double check.
[AGENT][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] And so either that or what I have to do is wait for the.
[CUSTOMER][NEUTRAL] Billing statements.
[AGENT][NEUTRAL] Yeah, you're definitely gonna have to wait until the billing comes out because you'll need that to file the claim.
[CUSTOMER][NEUTRAL] If I do it directly or otherwise they'll contact you.
[AGENT][NEUTRAL] Right, if they, if, if the provider files the claim, they still, they still send the same information, um, they just send it on your behalf.
[CUSTOMER][POSITIVE] Got you. All right.
[CUSTOMER][NEUTRAL] Yeah, main thing I guess part of the reason I was calling was just to provide notice that.
[CUSTOMER][NEUTRAL] I I don't know that.
[CUSTOMER][NEUTRAL] I, I can't remember what I read, but I, I guess you have to let you know within so much time and then get the EOBs over to you.
[AGENT][NEUTRAL] Yes, that's how it would work and then the, well, so you said Blue Cross, so you do have a major. OK, so you, you'll need your explanation of benefits from primary, the itemized bill from the hospital, and then your claim form for us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, but am am I officially notifying you guys now or?
[AGENT][NEUTRAL] Um, I
[CUSTOMER][NEUTRAL] As far as that I'm gonna file a claim.
[AGENT][NEUTRAL] That's really usually made, go ahead.
[CUSTOMER][NEUTRAL] that there
[CUSTOMER][NEUTRAL] Well, no, they've got two different dates. I'm looking through. You've gotta get your EOBs sent to you by 90 days and then, but to notify you of the claim. So I guess that's.
[AGENT][NEUTRAL] Right, but is that for your primary though? Because APL doesn't have those types of rules, that's more like a primary type of thing because they have timely filing limits and we don't, we're your secondary.
[CUSTOMER][NEUTRAL] I can't get to EOBs right now.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[AGENT][NEUTRAL] So for APL you don't have to, um, you don't have to worry about that. That's more so for Blue Cross.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, yeah, they, they have that on file so they.
[CUSTOMER][NEUTRAL] Um, I'm not seeing the, um, let me see if I got it in the trash.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It should um say from care team, it may, um, oh, that's what you're saying, the junk, the trash, it may be in there, yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, I haven't seen anything come in.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] As far as uh a new email, so I'm checking the junk.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm not in there either.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] That through yesterday.
[CUSTOMER][NEUTRAL] Yeah, I'm not seeing anything.
[AGENT][NEUTRAL] Hold on one moment, let me check my end.
[AGENT][NEUTRAL] Um, refresh your, um,
[AGENT][NEUTRAL] Your inbox and your junk, because for some reason so it's just showing that mine's just like the time on the email says [PII]:38, so I don't know if that means it just went through.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, I've refreshed it. I haven't seen anything and I give you [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me redo it.
[CUSTOMER][NEUTRAL] Sure yeah.
[CUSTOMER][NEUTRAL] Oh, here it is.
[AGENT][NEUTRAL] Oh, you see, OK.
[CUSTOMER][NEUTRAL] Yeah, I guess it's just, it just takes, you know.
[CUSTOMER][NEUTRAL] I like
[AGENT][NEUTRAL] So that's your ID card and then if they have any, I would just present that to them and then if they have any questions, our numbers on the back of the card, so that they can go ahead and file the claims for you, but if they do like give pushback or anything, you do have the option to file for yourself as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, I just gotta wait for them to.
[AGENT][NEUTRAL] The bills.
[CUSTOMER][NEUTRAL] Yeah, you said bills and the OBs?
[AGENT][NEUTRAL] Mhm. The bill's gonna come out first and then they're gonna send the bills to Blue Cross and then Blue Cross is gonna do their thing and apply for their policy, then the explanation of benefits is gonna come out, they're gonna send it back to the hospital, and the hospital is gonna send us their bill, the explanation of benefits, and anything, you know, if anything is left over or something.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, I haven't even seen anything from um Blue Cross yet, OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] We switch this that we switched policies so I'm not as familiar with say them before so I'm not as familiar with them, OK.
[AGENT][NEUTRAL] Well, insurance is confusing even when you had it for years, so that's what we're here for.
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] Yeah, and I, and I'm one of the guys that had an insurance license. I was a securities broker, so.
[CUSTOMER][NEUTRAL] Um, but not major medical on his life and all that.
[CUSTOMER][NEUTRAL] OK, alright, well I got I've got the form so.
[AGENT][NEUTRAL] Well, was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK, probably sent.
[CUSTOMER][NEUTRAL] No, basically what you're saying is probably if I can if I can get a contact for the hospital.
[CUSTOMER][NEUTRAL] Uh, just send it to them and this I hope I don't do this again, but you never know. So in the future, if I, if, if I have the digital card, which is what I'll say, could I have provided that to the admissions team in addition to Blue Cross? Got you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, um, with the Blue Cross and then just so they know you have the additional policy and so the bill so that you don't have to.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Got you, got you.
[CUSTOMER][POSITIVE] Alright, yeah, I I should have known that. I just didn't know I had a a digital, but that makes sense. I just knew we had a plan.
[CUSTOMER][NEUTRAL] That's about it. OK, very good. Well I'll, um, I'll see if I can get it forwarded to them properly. If not, I guess I'll be waiting and see what's left over and uh send it over. OK, well thank you very much.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] You too take care.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] That