AccountId: 011433970860
ContactId: d331e101-4719-4951-9ad6-beebe1ced419
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 669719 ms
Total Talk Time (AGENT): 267938 ms
Total Talk Time (CUSTOMER): 297263 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/d331e101-4719-4951-9ad6-beebe1ced419_20250604T13:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, Ms. [PII], how you doing?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][NEUTRAL] I'm [PII]. You remember speaking to me about my husband [PII]?
[AGENT][NEUTRAL] Um, you know, was it a few days ago?
[CUSTOMER][NEUTRAL] Oh, it's like a couple of weeks almost.
[AGENT][NEUTRAL] Yeah, I, I apologize, Miss [PII], I don't recall.
[CUSTOMER][NEUTRAL] I'm sorry. Maybe you're not, maybe you're a different lady. You're not the one that lost your husband recently, right? About 2 years.
[AGENT][NEUTRAL] No, it's not me. I'm sorry. Uh uh.
[CUSTOMER][NEUTRAL] OK, so I'm sorry. OK, well.
[CUSTOMER][NEUTRAL] OK, I'm calling about [PII]. His birthday is [PII].
[AGENT][NEUTRAL] OK, do we have by chance a policy number for him or no?
[CUSTOMER][NEUTRAL] I do, but I don't have it with me. I'm at work.
[AGENT][NEUTRAL] OK, let me put in his name.
[AGENT][NEUTRAL] OK. I've got the policy here. Um, let me just verify the address on file, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. OK, how can I help today?
[CUSTOMER][NEUTRAL] OK, they, I, they told me I needed some.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] I, I mean some uh itemized bills.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I sent faxed it in Monday morning. So I was trying to see if y'all received it.
[AGENT][NEUTRAL] OK, yeah, I do show we received something on Monday. I can pull it up here. Give me just a moment.
[CUSTOMER][NEUTRAL] And uh, and if I'm not mistaken, you're supposed to receive something like a Monday before or Tuesday after that or something with the gas receipts, but they not receipts, but they just told me to write down the the the the destination from from [PII] going to wherever the hospital will.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I did that. So I sent something else in, so they say they will help with the gas. So how do all this work? I mean, do they, do they pay the rest of the the the maining bill the insurance don't pay, how do this work, ma'am?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so I do see all.
[AGENT][NEUTRAL] On Monday it looks like you uploaded like 6 different pages it looks like so I do see that.
[CUSTOMER][NEGATIVE] And the last time I think it was like 3 pages.
[AGENT][NEUTRAL] Yeah, so as far as what was sent on Monday, there's, that's still, um, it hasn't been quite looked at yet, so that just needs a little bit more time to be processed as far as the additional information that you sent over to us. Uh, the plan itself has a benefit for, um, it looks like surgery. It does have an anesthesia benefit.
[AGENT][NEUTRAL] So, what it will do is it looks like there was some surgery charges submitted.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] If there was any sort of hospital confinement, the plan pays $300 a day for each day that um confined in the hospital.
[AGENT][NEUTRAL] Uh, the surge
[CUSTOMER][NEUTRAL] No, he didn't, he didn't stay. He, they said there was so many germs in there that they thought it would be best for him to come home and I thought that was nice for them to tell us that.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, it
[CUSTOMER][NEUTRAL] So he didn't say
[AGENT][NEUTRAL] OK. Um, it
[CUSTOMER][NEUTRAL] They told me I need to send an autoized bill of all this stuff or something, a lady, I can't think of her name. I know it's uh Miss [PII] and Miss [PII]. Then there was one more lady that I spoke to and
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And uh, but before then, she told me that they would pay for the gas. They would send money for the gas mileage. So I sent that in prior to that, like we went like 100 times, we ain't got no 100, but at least by 13.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So the
[CUSTOMER][NEUTRAL] So you see that one what?
[AGENT][NEUTRAL] The transportation and lodging is um reimbursed by mile. So they figure 50 cents per mile and the maximum payout is 1500.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] So that's how they figure mileage.
[CUSTOMER][NEUTRAL] So, can you tell, have they looked at the mileage payment and the mileage that we sending?
[AGENT][NEUTRAL] Did you submit that on the original claim, or did you add that on the stuff for the 2nd?
[CUSTOMER][NEGATIVE] I didn't, the, the, now I don't understand this. The lady told me I didn't have to do another claim form. She said, I did the claim form when he first found out he had to cancel. She said we had to wait till we do this and do this, so I, I, I only did the one, all the one filing the paperwork and, and I sent all that in. Can you see the, the time before that I faxed something in early one morning.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Doesn't
[CUSTOMER][NEUTRAL] This is my husband calling now can you hold on one minute, please?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you, Ms.
[CUSTOMER][NEUTRAL] Miss [PII], I'm back.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] Let me see what was submitted.
[CUSTOMER][MIXED] It was like 2 papers it was maybe like 3 or 4, but one of them was on a, like a piece of paper at the house that I had to write on cause there wasn't enough room on the farm thing. And that, and I called and the lady just told me to get another piece of paper and just write my address to where the hospital we had to go to. And then we had to go like so much time they had they had to pay, they had, it was, it's a lot, but I thank God, I just thank [PII], I just thank [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So I see that uh transportation was originally submitted and then we said that we needed an address.
[CUSTOMER][NEUTRAL] So that should have been like.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It was, and then you're saying that you wrote the address on the [PII]. Let me see.
[CUSTOMER][NEUTRAL] I wrote address like from [PII] going my address and what the lady told me to whatever the address I was going to with two different doctors over there.
[AGENT][NEUTRAL] Mhm I see that OK so yeah that's still that's on the one that they're still it looks like processing because you sent the additional information on Monday, so what I can do is um just send a message, [PII] over to the examiner and just make sure that they see the street address because I see the [PII].
[AGENT][NEUTRAL] Your street in [PII]. I do see that.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And it's different. It's another doctor, it's another different one too. What's the other different address? All of them make you some another one is somewhere else over there.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, no marketers now.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Looks like one is on [PII], um.
[CUSTOMER][NEUTRAL] No, no, [PII] is my address, my address, but the ones in [PII], uh, it's another one. It was uh [PII] and it's another street beside you. It's, it's supposed to be like one whole paper like y'all gave me and then it was like a paper that I had at home that I read on, so they should have got like two forms.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, I see that.
[CUSTOMER][NEUTRAL] I mean one form and and one that was on a blue and white piece of paper. It might don't look blue and white since I faxed it though.
[AGENT][NEUTRAL] Yeah, it doesn't look blue and white, but I mean, I see 42325 says car and then 43051. So I see all that from and to. We have the addresses.
[CUSTOMER][NEUTRAL] OK, so that, so do, can the other people tell all the addresses cause I mean I, I try to see what y'all ask me to, you know, and I try to do it like they say do it.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Yeah, so it looks like we've gotten everything from what I can see, [PII]. It just needs a little bit more time to be processed um for the transportation and then the additional information it looks like.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well, can you just let them know cause somebody asked me, told me that I need to send the addresses to them, and I told them that I, I did send all the addresses. So can you just kinda let them know that, you know that it'll say [PII], which is my address, and all the ones that say like [PII] or whatever the other addresses, that's the places we went to.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] And that's like 70 miles from, from me.
[AGENT][NEUTRAL] Yep, so I can send the claims examiner a message and then if you want you can give me a call back number they can call you if they have any questions or concerns.
[CUSTOMER][NEUTRAL] Yeah, please get if they do uh my number is uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so I will go ahead.
[CUSTOMER][NEUTRAL] And my name is [PII].
[CUSTOMER][NEUTRAL] I'm, yeah, I'm [PII].
[AGENT][NEUTRAL] OK, Miss [PII], so I will send a message to the examiner. I'm also gonna notate the policy as far as what we spoke about today just to have them take a look at the um mileage that you submitted and then also those extra documents on Monday.
[AGENT][NEUTRAL] And then I'll just tell her if she has any questions or concerns to reach out directly to you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so what they, OK, so, so they'll just call and let me know something after they get done or after they review the policy or they don't know how that go.
[AGENT][NEUTRAL] They'll call you if they need any sort of additional information or have questions or concerns, um, otherwise just give it a couple of days for the claim to be processed out.
[CUSTOMER][POSITIVE] OK then, OK, OK, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Hi, honey.