AccountId: 011433970860
ContactId: fc7e4f6b-cf1d-4111-bb16-788ed6dc2345
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 535750 ms
Total Talk Time (AGENT): 305313 ms
Total Talk Time (CUSTOMER): 172029 ms
Interruptions: 6
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/fc7e4f6b-cf1d-4111-bb16-788ed6dc2345_20250318T17:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, so, this is [PII]. How are you there?
[AGENT][POSITIVE] Hey, I'm good and you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I was trying to be all peppy and motivated earlier, but it's.
[AGENT][NEUTRAL] I think.
[CUSTOMER][NEUTRAL] Oh, OK, so.
[AGENT][POSITIVE] Yeah, well, at least it's better than yesterday, trust me.
[CUSTOMER][NEGATIVE] Oh, I, I don't know what was up with yesterday. I do not want to say that again. Oh my gosh.
[AGENT][NEUTRAL] Yes, me neither.
[CUSTOMER][NEGATIVE] It was horrible here so y'all were much worse than us.
[AGENT][MIXED] Yeah, it was. Yes, it was terrible yesterday. Today it's a little bit better.
[CUSTOMER][NEGATIVE] Oh, it was terrible.
[AGENT][NEUTRAL] Yes. Yeah, yeah.
[CUSTOMER][POSITIVE] Yeah, so far, knock on wood, let's don't jinx it. OK, darling, I.
[CUSTOMER][NEUTRAL] I have policy number 2,566,030.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Participant number one, [PII].
[AGENT][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] I have verified date of birth, address.
[CUSTOMER][NEUTRAL] Phone number and email address.
[CUSTOMER][NEUTRAL] He has some benefit questions, something about
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] nursing assistants or something. He just has questions on that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh boy, OK, let me pull his search.
[CUSTOMER][NEUTRAL] On, let's just leave that benefits. Yeah, let's just leave it that he has questions on benefits.
[AGENT][NEUTRAL] Yeah, that's.
[AGENT][NEUTRAL] OK, let me go ahead and um
[AGENT][NEUTRAL] Let me pull his benefit really quick before you transfer him.
[CUSTOMER][NEUTRAL] You go right ahead, dear.
[AGENT][NEUTRAL] OK, if this thing can work, OK, come on on this.
[CUSTOMER][NEGATIVE] Yeah, I always, whether y'all make me wait because I always rather make y'all wait instead of making the customer sitting there while I'm talking to myself trying to find what I'm looking for, you know.
[AGENT][NEUTRAL] Yeah, yeah, so I don't think I just lost.
[CUSTOMER][NEUTRAL] Oh Lord, that.
[CUSTOMER][NEUTRAL] Yes. Well, it puts so much more pressure on you.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah, um.
[CUSTOMER][NEGATIVE] It's like I overlook stuff because I get so pressured you feeling.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, let's see. OK, so here's the certificate. Let me have that open and then on base is slow today. Like yesterday was working just fine and not today it's like, OK, like I got tired from yesterday.
[CUSTOMER][NEUTRAL] Yeah, I've noticed
[CUSTOMER][NEUTRAL] Yeah, yeah, I got, it got burned up yesterday. It's like,
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Like good gravy people.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Alright, it's OK, I have it pulled up. OK, you can put it through. Thank you.
[CUSTOMER][POSITIVE] All right. Thank you, dear. Have a good day. Thanks, bye.
[AGENT][POSITIVE] You're welcome. You too. Bye.
[AGENT][NEUTRAL] Good afternoon. This is So on the care team. Is this Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am, it is.
[AGENT][NEUTRAL] OK. I do have your information pull. Ms. [PII] was letting me know that you have questions about your benefits.
[CUSTOMER][NEUTRAL] Yes, the one I feel like a nurse or something to look after me for I think it's like $100 a day. I just want to know how does that work.
[AGENT][NEUTRAL] OK, let me check on that benefit. Let's see.
[AGENT][NEUTRAL] OK. And you're talking about the home health care?
[CUSTOMER][NEUTRAL] Yeah, home healthcare.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, let's see. So it means professional nursing. OK, so it's basically a professional nursing service, a respiratory or inhalation therapy, or administration of drugs and medicines, um.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, this does not include medical social service, medical supplies.
[AGENT][NEUTRAL] Um, let's see, do medical equipment.
[CUSTOMER][NEUTRAL] We would do
[AGENT][NEUTRAL] OK, what type of service you're trying to get?
[AGENT][NEUTRAL] With the home health care.
[CUSTOMER][NEUTRAL] I think one like Mur
[CUSTOMER][NEUTRAL] Cooking cause I have gout in my feet.
[CUSTOMER][NEUTRAL] And cooking and stuff like that, washing.
[AGENT][NEUTRAL] OK, is it
[CUSTOMER][NEUTRAL] Take me to my doctor's
[AGENT][NEUTRAL] To take you to your doctor's appointment. So it's basically a person to take care of you during the time to take you to the, to the clinic and stuff, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So my tree was casts the tree.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, so it's not to give you medicine, is it?
[AGENT][NEUTRAL] To give you medication or therapy.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Just give me, hold on.
[CUSTOMER][NEUTRAL] I take daily pills up.
[CUSTOMER][NEUTRAL] It's just like I said, take me to like to cook and wash for me and take me to my appointments and stuff like that, grocery store.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Cause I live by myself, I'm separated man, but I'm separated. It's, it's stuff like that, man.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. This doesn't sound like, because this, this one is just for a nurse that is gonna go and give you treatments at home and give you like medications, injections and stuff like that. That's what it's for, the home health care, that's, that's what it pays for. It's for a nurse uh to go and give you service at your um place of home. So it's more like somebody that is gonna just give you medicine in home instead of going to the clinic.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But I know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's all.
[AGENT][NEUTRAL] Yeah, that's what it covers. It it's not for just the person to go and take care of you like uh um.
[AGENT][NEUTRAL] Like daycare, like a daycare professional. It's more like a professional nursing to give you medications and um therapies, administration of medicine.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, just the medication and therapy.
[AGENT][NEUTRAL] Yes, just for medication. So it's basically, so you don't have to go to the um to the office or go to the facility. They go to your home and they take care of you at your home. That's what it's for.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] What do I need to get, give me a minute.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I have a company called All Heart. They need to get in contact with you.
[AGENT][NEUTRAL] Yeah, if they want to call us to get the benefit of the policy to see if it covers or not we can do that um but based on the information that I'm reading it doesn't seem like it's something that is gonna be covered but if you want um us to speak to them and they can give us a little bit more information on how they work or how they process claims or you know have a little bit more information, we can probably give them information about if it's gonna be covered or not, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so just when I get there.
[AGENT][NEUTRAL] Yes. When you get there, just give them the um the [PII] number or do a three-way call so we can speak directly with the nurse and see exactly what type of service is the one that they're trying to charge for and see if it's something that is gonna be covered.
[CUSTOMER][NEUTRAL] OK, well, uh.
[CUSTOMER][NEGATIVE] OK, uh, another thing is I get all my paperwork back, so it takes 10 to 14 days before I hear from y'all.
[AGENT][NEUTRAL] For the claims, um, it does take up to 14 days for a claim to be processed and completed. Um, it looks like, um, you have some claims that are right now under review.
[AGENT][NEUTRAL] I'm waiting for medical records. It looks like.
[CUSTOMER][NEUTRAL] OK, and I know I see it.
[CUSTOMER][NEUTRAL] And I get something like $5000 out of pocket that I get to pay for my doctor's expenses and stuff.
[AGENT][NEUTRAL] We cannot guarantee any payments over the phone. Once the claim is processed, we'll go ahead and send this information over to you. If there's any payable amount, we'll go ahead and send the check out to you, um, but I can only give you benefits based on the policy, but I cannot tell you exactly how much they're gonna send out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today? Any other questions or concerns Mr. [PII]?
[CUSTOMER][POSITIVE] Oh, that's it. Thank you, ma'am.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.