AccountId: 011433970860
ContactId: d8ab798c-d30b-42ef-90e3-d3e3aae9fd50
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 501899 ms
Total Talk Time (AGENT): 311253 ms
Total Talk Time (CUSTOMER): 122506 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/d8ab798c-d30b-42ef-90e3-d3e3aae9fd50_20250113T19:59_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Who who am I, who am I talking to?
[AGENT][NEUTRAL] My name is [PII]. I'm in the claims department.
[CUSTOMER][NEUTRAL] Hey, [PII], how are you? I'm a, I am a
[CUSTOMER][NEUTRAL] Uh, Blue Cross Blue Shield, uh.
[CUSTOMER][NEUTRAL] Member for a Mustang Seal Solutions.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have a policy.
[CUSTOMER][NEUTRAL] I do believe it's gonna be the hold on trying to bring it back up oh boy now uh.
[CUSTOMER][NEUTRAL] It's gonna be the critical illness, I do believe.
[AGENT][NEUTRAL] OK, now, this is American Public Life, so that's what you trying to call American Public Life, is that correct? OK. What's your name?
[CUSTOMER][NEUTRAL] Yeah, yeah, because.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], give me your phone number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, [PII], you have your policy number for APL?
[CUSTOMER][NEUTRAL] I it's gonna probably be under uh.
[CUSTOMER][NEUTRAL] It's probably gonna be under uh.
[CUSTOMER][NEUTRAL] MetLife.
[AGENT][NEUTRAL] OK, no, we're American Public Life. We won't be MetLife. We're American Public Life, and you would have American Public Life policy number. I can look you up by your social.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] I'm actually I'm Blue Cross Blue Shield. I'm sorry.
[AGENT][NEUTRAL] OK, now we American Public Life and
[CUSTOMER][NEUTRAL] On Blue Cross.
[CUSTOMER][NEGATIVE] I know, but all this falls under y'all.
[AGENT][NEUTRAL] OK, no, yeah, but we wouldn't be with Blue Cross Blue Shield now. I'm just telling you, what's your mailing address, uh, [PII]?
[CUSTOMER][NEUTRAL] [PII]. I just, I spoke to somebody before I I have I have cancer. I have cancer.
[AGENT][NEUTRAL] OK, that's fine. That's, that's fine. OK, we have to just get the information from you. [PII], uh, let me give you your policy number that I pulled up with our company that you have with us. Tell me when you're ready to write down the policy number.
[CUSTOMER][NEUTRAL] OK, hold on, hold on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You ready?
[CUSTOMER][POSITIVE] OK, I'm ready I'm ready.
[AGENT][NEUTRAL] OK, that policy number with us, and it's a gap medical plan, Medlink, that policy number is 02553424.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, verify your date of birth for verification and your email address on file.
[CUSTOMER][NEUTRAL] [PII], my uh email is gonna be all lower case first and last name [PII].
[AGENT][POSITIVE] All right, thank you for that information, [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Uh, like I said, I've been in the hospital and I wanna file a claim with this before.
[AGENT][NEUTRAL] OK, so you want to file a claim, we can, you can go on our website and get the claim form, or we can mail you the claim form. You will submit your itemized hospital bill along with your primary explanation of benefits from your primary carrier.
[CUSTOMER][NEUTRAL] OK, so go to claims forms. I'm on your website right now.
[AGENT][NEUTRAL] Uh-huh, and you want, you want, you.
[CUSTOMER][NEUTRAL] So the claims and forms, OK.
[AGENT][NEUTRAL] Uh-huh, you want the meddling claim form.
[CUSTOMER][NEUTRAL] OK, I'm
[CUSTOMER][NEGATIVE] Well it's not giving me anything.
[CUSTOMER][NEGATIVE] Sign in register what if I'm not even signed in yet?
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] I know you have this, is this, is this your first time being on the website?
[CUSTOMER][NEUTRAL] I need to register and all.
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][NEUTRAL] Oh yeah, you're gonna have to follow the direction. You're gonna have to get your username and a password, have your apologist follow the direction and you should be able to get on. Yes, sir. Once you get on, you can uh get that claim form or I can email you the claim form if you want to email it to you also.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Yeah, why don't you email it it probably be easier for you to email it to me.
[AGENT][NEUTRAL] OK, now you can't email anything back to the adjuster. You either have to upload your claim forms or mail your claim forms or fax your claim form and that instructions on the claim form. So I can email it to you the address that we to the email address we got on file. So I will email you that. OK, and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I don't you do that.
[CUSTOMER][NEUTRAL] Yeah, email email me now.
[AGENT][NEUTRAL] OK, let me get the claim form. Hold on one moment.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, I can let me go to my email.
[CUSTOMER][NEUTRAL] Does it show what does it show what does it show what a policy I have with you guys?
[AGENT][NEUTRAL] You got a gap meddling policy with us. That's the only thing you have is your secondary policy. That's what it is and that's why we have to have your primary explanation of benefits along with your itemized bill if you filing the claim.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] And that's why if you get signed up with that website of ours, you can go out there and you can view your policy.
[AGENT][NEUTRAL] OK, let me go over here and get a claim form for you.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] client forms documents.
[AGENT][NEUTRAL] And I'm looking at the client on that link.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That link right here insert and put your name and your policy number on here.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh, link.
[AGENT][NEUTRAL] Claim forms and your policy number 02553424.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] All right. You should be getting it in a few minutes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Yes, sir. That's correct.
[CUSTOMER][POSITIVE] Oh, OK, I got it I got it.
[AGENT][NEUTRAL] All right, did you upload it, fax it in or mail it in. You can't email it back to to the adjusters, OK?
[CUSTOMER][NEUTRAL] If I can, I can upload it.
[AGENT][POSITIVE] Yeah, once you get set up on that website, yes sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, anything else I can help you with today?
[CUSTOMER][NEUTRAL] So basically what does that this policy cover I guess is what I'll ask you.
[AGENT][NEUTRAL] OK, this, this policy is your secondary policy and it depends on what the primary explanation of benefit for uh carrier pays towards any kind of medical condition that's covered on our policy. Inpatient calendar year max is a $15,000 I mean a $1500 benefit for inpatient.
[AGENT][NEUTRAL] An outpatient is $1000. So I can give you an example. Say you went, you was in the hospital, you said you was in the hospital, and say you were in there two days and the facility that you was in charged, say, uh, let's say $6000 for that hospital stay, then Blue Cross Blue Shield only paid $3000. The most we will pay is $3000 if it's something that's covered on our policy.
[AGENT][NEUTRAL] But we wouldn't even pay $3000 because you'll max your benefit out because your benefit for inpatient per uh calendar year is only 15,000 I mean $1500 per calendar year. So the max we'll pay with $1500 and that'll be it for the year to start over to the next year. Now this is just a quote of your coverage. There's never any guarantee of any payments over the phone.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] All right. If you need any other help with anything else, just give our office a call back and thank you, [PII] for calling American Public Life, and you have a wonderful day. Bye-bye.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] You as well bye bye.