AccountId: 011433970860
ContactId: f7c96e98-3979-4742-9362-23c009b76890
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 791109 ms
Total Talk Time (AGENT): 230832 ms
Total Talk Time (CUSTOMER): 146078 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/f7c96e98-3979-4742-9362-23c009b76890_20250425T13:35_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh yes ma'am, can you hear me?
[AGENT][NEUTRAL] Yes, I can hear you now.
[CUSTOMER][NEUTRAL] Yeah, I've got Medlink and I uh I want to check on a claim.
[AGENT][POSITIVE] OK, sure, I can assist you with that.
[CUSTOMER][NEUTRAL] Or semanticline
[AGENT][NEUTRAL] Oh, you're trying to submit a claim or you already submitted it and you want to check claim status?
[CUSTOMER][NEUTRAL] No, no, I need to know how to submit it because I'm in the hospital. I hope I get out today.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK. Yes, sure. I can go ahead and give you instructions. And may I have uh your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] Last name is [PII]
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] 2880. Do you have the policy number with you?
[CUSTOMER][NEUTRAL] I sure do. It's the.
[CUSTOMER][NEUTRAL] 01194612.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I've got two others. I don't know what they're for. I've got multiple policies, I guess.
[AGENT][NEUTRAL] OK. I can check on it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so you have an accident policy. You have a secondary policy which is the one you provided to me. And it looks like this may be an intensive care probably. Let me just pull that one up and see.
[CUSTOMER][NEUTRAL] And I have one that hospital.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm, OK. Do you need instructions for the accident or it was not an accident?
[CUSTOMER][NEUTRAL] I wasn't an accident. I got admitted to the hospital.
[AGENT][POSITIVE] Very cool. OK. All right.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so it looks like it's gonna be um basically on your MetLink, which is your secondary that helps with the co-payments coinsurance and deductibles from your major medical. And OK, and it was not due to cancer either because the other one is a cancer policy.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. All right, so that's just gonna be this one then. OK, so for the secondary supplemental plan, um, we're gonna need 3 documents. Um, the first document is the claim form.
[AGENT][NEUTRAL] And the claim form you can find it through our.
[CUSTOMER][NEUTRAL] And what now a claim form.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you can find this
[CUSTOMER][NEUTRAL] You can send that
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, I can find it on, on your website.
[AGENT][NEUTRAL] It is on the website if you need me to send one to your email, I can't um if I get an email, but if not you can just go to our website at [PII].
[AGENT][NEUTRAL] And you can click on claims and forms and look for the mailing claim form.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] So, can you send to my email for me?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, what is the email?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, so you said it's [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. All right, I can go ahead and send that. um, OK, the first page.
[CUSTOMER][NEUTRAL] And when you need a copy of the.
[CUSTOMER][NEUTRAL] Bill from the hospital.
[AGENT][NEUTRAL] Yes, uh, the first page is gonna give you instructions, but what we're gonna need together with the claim form is an itemized bill with the diagnosis code which you can get from the hospital. And then we need a copy of the explanation of benefits from your primary.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Insurance indicating uh the amount they apply towards the deductible co-payment and co-insurance. Now, if you need um if you, if you don't want to go to all the trouble of sending your own claim, you can always give the card to the um.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] No, well, that's, that's what I'm doing. I'm spending this time I'm paying for it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK, so you just want to reimbursement. OK, it's just fine. OK, so.
[CUSTOMER][NEUTRAL] And so,
[CUSTOMER][NEUTRAL] Yeah, that way you just reimbursement, you know.
[AGENT][NEUTRAL] Yeah, uh, OK, um, if you don't mind holding for me, I'm gonna go ahead and send that email with the claim form to you. Um, I'm gonna put you on a brief hold so I can send it before I let you go. Is that OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. One moment, Mr. [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. Um, to check and see if you got that email.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Oh, let me see.
[CUSTOMER][NEUTRAL] Yeah it looks like it from the care team.
[AGENT][POSITIVE] Yes, mhm, correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] It's opening slow, but I, yeah, I, I've got it. So I just need to complete that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, complete that and then attach the.
[CUSTOMER][NEUTRAL] And then you have the
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Uh, I'll just complete it and email it back.
[AGENT][NEUTRAL] Um, we don't take any claims by email. It has to be either mail, fax, or uploaded to your account if you register.
[CUSTOMER][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, no, like on the phone like we're doing now.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, we don't take claims over the phone and we don't take claims by email for security.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, all right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me see. I think uh it's holding now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got it. State of the insured. OK, claim form.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] Yeah, OK, so I'm just fill it back out and once I get released from the hospital, put everything on it and just mail it to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, you can do that. And again, just uh follow the instructions on the first page which is the two documents that I just requested included with that claim form, OK?
[CUSTOMER][POSITIVE] OK. All right. Thank you.
[AGENT][POSITIVE] All right. You're welcome and thank you for calling APL. I hope you get better.
[CUSTOMER][POSITIVE] All right, thank, thank you, bye.
[AGENT][POSITIVE] You're welcome. Bye bye.