AccountId: 011433970860
ContactId: f0ffbc11-ec64-4c3b-9773-139c72b3bc06
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 484179 ms
Total Talk Time (AGENT): 255225 ms
Total Talk Time (CUSTOMER): 122930 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f0ffbc11-ec64-4c3b-9773-139c72b3bc06_20250213T20:25_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] Hey, [PII], um, I have a couple of um
[CUSTOMER][NEUTRAL] Bills to turn in, uh, I was terminated, uh, this past Tuesday, I'm sorry, this past Monday, um, but I have a couple of bills with APL that were, um, handled prior to that and also the APL took money out of my check on my last check, um, and I spoke to someone yesterday and they said that these should still qualify if turned in.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you just want to make sure the claims that you're um wanting to submit, you can still submit them if the policy is not active.
[CUSTOMER][NEUTRAL] Yeah, I, I still should be able to because like I said, they still, they took out money this past week and uh this was before the termination.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, as long as the policy was active on the data service, you can file the claim at any time. But um may I have your name and a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] That I don't have, but I can give you anything else you need.
[AGENT][NEUTRAL] Um, I can look your policy with your social.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here. Hold on one moment.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] I see.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And this is for your medical policy, critical illness or accident?
[CUSTOMER][NEUTRAL] Uh, it, I went to the ER.
[CUSTOMER][NEUTRAL] for headaches and um
[CUSTOMER][NEUTRAL] I went to the uh.
[CUSTOMER][NEUTRAL] Um, urgent care for uh COPD.
[CUSTOMER][NEUTRAL] For a doctor visit and ER visit.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] 81,870 mailing is [PII] and email is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And let me check for your medical first. Hold on one moment.
[AGENT][NEUTRAL] OK, so yeah, you have you have emergency room coverage on your um hospital indemnity policy. The policy will pay up to $100 for your emergency room visit, um, one time.
[AGENT][NEUTRAL] Oh, no, that one doesn't have it. So $100.00 1 time per calendar year. I'm sorry, I was looking at the line below it. And then um for your office visit, the policy would pay up to $50 per visit with a max of 2 visits per calendar year. So you have coverage for both on your hospital indemnity policy. And then um let me see on your others if you have coverage for
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I had a, I had a CAT scan done. I don't know if that makes a difference too as well.
[AGENT][POSITIVE] Oh, I can definitely go back and see the diagnostic testing for you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Since the accident.
[AGENT][NEUTRAL] OK, yeah, it would be the hospital indemnity policy. And let me go back to that because this one is these uh services are if they're in reference to or from an accident, so it wouldn't be these other ones.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But let me check the diagnostic testing.
[AGENT][NEUTRAL] Yes, um, for diagnostic tests in the policy would pay up to $100 for your first, um, image, and then if there's a follow-up needed, it would pay, hold on one moment, it would pay $100 for one follow-up per calendar year as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How would I submit these?
[AGENT][NEUTRAL] Well, um, you really,
[CUSTOMER][NEUTRAL] Because uh the, the, the company has always done it for me, um, so I don't really know how to do it on my own.
[AGENT][NEUTRAL] Um, so you have two options. You can reach out to the provider and have them file the claim, just give them your policy number and our phone number, or you can, um, on our website, there's a, um, well, our website is [PII]. When you go to claims and forms, you would go to um hospital indemnity and Everyday Solutions, that's the name of the form.
[AGENT][NEUTRAL] And you'd fill that form out, um, and provide the itemized bill for, you know, whatever you're filing the claim for, and we'll go ahead and process it for you. You can fax the claim,
[CUSTOMER][NEUTRAL] OK, what's that
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's that site? I'm sorry, let me, uh, let me write this down please.
[AGENT][NEUTRAL] Uh-huh, sure.
[CUSTOMER][NEUTRAL] OK, what is the uh exact.
[AGENT][NEUTRAL] Um, so it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're gonna go to claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then from claims and forms, um, you're looking for the hospital indemnity and Everyday Solutions, that's the name of the claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you can fax the claim to us, you can mail it or you can send it electronically on the online service center.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so when you go to the [PII], where you see the um claims and forms, you'll also see sign in. um, it's a few options next to the um claims and forms. Once you click on sign in, that takes you right to the online service center and you'll just follow the prompts as a new user if you do want to submit it online.
[CUSTOMER][NEUTRAL] OK, OK, alright, well I'll figure out one of those three ways and uh go from there. What is a fax number if I need to fax?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], you know what, hold on one moment because let me make sure for you. Hold on one second.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Mhm. There's different versions of the policy and I just want to make sure for yours. OK, so it's um [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, awesome um yeah I'll do one of those 3 and uh go from there.
[AGENT][NEUTRAL] All right, well, was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, ma'am, thank you very much.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You