AccountId: 011433970860
ContactId: fe997233-c9de-4fa2-a966-a60262c7f2e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1763560 ms
Total Talk Time (AGENT): 620930 ms
Total Talk Time (CUSTOMER): 943132 ms
Interruptions: 13
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/fe997233-c9de-4fa2-a966-a60262c7f2e3_20250403T14:25_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes ma'am, um, I wanted to verify um the amount of coverage I have on my plan. I know I've, I've tried to kind of read uh about what everything covers but I filed some things that I probably shouldn't have that, you know, didn't show that anything uh was paid on those and I wanna make sure what I'm supposed to be filing.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. Do you have a callback number in case we get disconnected? I can get right back to you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. And do you happen to have your policy number available?
[CUSTOMER][NEUTRAL] Um, let me see, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I'll find it here.
[AGENT][NEUTRAL] You're fine.
[CUSTOMER][NEUTRAL] Let's see. Um,
[CUSTOMER][NEUTRAL] Policy number 02088763.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your name, date of birth, and current mailing address, please, ma'am?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII] [PII].
[AGENT][NEUTRAL] Alright thank you and while I've got you we've got an AOL email. Can we just verify that while I've got you on the line?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Perfect. Thank you.
[AGENT][NEUTRAL] And I see that you do have that online account. Have you clicked on your policy number to review your benefits and we can look at that together if you're in front of a computer.
[CUSTOMER][NEUTRAL] Um, I'm not, but I can get my computer. Um, I don't mind going in there and getting it, so, um, hold on.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] It's, it's completely up to you however you wanna do it. If you, if you just want me to tell you, that's fine, or if you'd like to look at it together.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, I, what I did was I had saved the policy so I could get kind of look at it and then when I went to pull down the list of things I thought OK well there's some things in here that it shows that I might can file that I wasn't sure about so um maybe it's just you know my individual policy and um that didn't cover but.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, if I, I can go get my computer and I'll just click on the policy number.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I think, OK, hold on just a moment hold on.
[AGENT][POSITIVE] Sure. Take your time.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, I see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, I'm, I'm on my account and just go to uh one of the.
[CUSTOMER][NEUTRAL] Claim forms I guess let me see.
[AGENT][NEUTRAL] So if you're on your dashboard, you're gonna go to my coverage and then when you see your policy number, the 2088763, you can click on that number.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And it will upload your specific policy certificate for you.
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Go on.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK, why can I get.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Do you, do you see your policy number?
[CUSTOMER][NEUTRAL] Well, I'm
[CUSTOMER][NEUTRAL] I'm at the main thing that says contact us claim forms and help and I'm thinking how do I get back to my dash real dashboard um.
[AGENT][NEUTRAL] Do you see a sign in option?
[CUSTOMER][NEUTRAL] Right, and it looks like I'm signed in already, um.
[CUSTOMER][NEUTRAL] I'm under my account that's not gonna be it. I'm just looking to see.
[CUSTOMER][NEGATIVE] Help. OK, no.
[CUSTOMER][NEGATIVE] That's not help.
[AGENT][NEUTRAL] So did you go to [PII]?
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] Secured a [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And log in
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I did.
[CUSTOMER][NEUTRAL] I'm just trying to figure out where I am on the whole thing because if it got if I got it.
[AGENT][NEUTRAL] Me too.
[AGENT][NEUTRAL] Now you don't need to go to the same ones.
[CUSTOMER][NEUTRAL] If I go to claim form.
[CUSTOMER][NEUTRAL] It may make me sign in again I guess. I don't know that's kind of strange.
[AGENT][NEUTRAL] Well
[CUSTOMER][NEUTRAL] And maybe I'll better sign in again. I don't know it looks like I'm already signed in.
[AGENT][NEUTRAL] Maybe it's signed you out. Maybe it signed you out and you need to sign it again.
[CUSTOMER][NEUTRAL] OK, well, here, I don't know when I said sign in it's coming in. OK, so I'm gonna click on my policy number. I'm sorry, that was weird. I just brought it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, you are fine.
[AGENT][NEUTRAL] You are fine.
[CUSTOMER][NEUTRAL] OK, and I have you on speaker because I don't do very good. OK, so I'm bringing up uh my policy, OK, downloading my policy, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm OK, I'm on that now.
[AGENT][NEUTRAL] OK, so within the policy certificate, there's a page called a schedule of benefits page.
[AGENT][NEUTRAL] In my documents, it's, it's on page 21. It may be just a little bit different in your document.
[CUSTOMER][NEUTRAL] OK, let me go that 21.
[AGENT][NEUTRAL] And this page is gonna kinda give you what's covered and.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][POSITIVE] Schedule benefits, yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So this is going to be the list of the covered benefits under your policy and the benefit amount.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if you look, so you're if you're under the chemotherapy, radiation therapy, immunotherapy, it's a $20,000 benefit per 12 month period.
[CUSTOMER][NEUTRAL] OK, so, so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so then when I go down to the cancer screening, the mammograms are covered at $50 I assume.
[AGENT][NEUTRAL] And that's one test per person per per calendar year.
[CUSTOMER][NEUTRAL] There uh.
[CUSTOMER][NEUTRAL] OK, OK, right, which that makes sense, um.
[CUSTOMER][NEUTRAL] And I, they're not requiring me to have Pap smears. I mean, OK. So then when um
[CUSTOMER][NEUTRAL] OK, so the.
[CUSTOMER][NEUTRAL] I think where I was probably getting confused when I was going to file my claims and went to pick what I could pick, it had all these other things and I guess those didn't necessarily apply to me like um.
[CUSTOMER][NEUTRAL] I'm not sure with the dental.
[CUSTOMER][NEUTRAL] Uh, with a dental, um, preventative, anything like that be covered?
[AGENT][NEUTRAL] This is for a screening, so if you were interested in what type of diagnostic testing would be covered, then there is a definition portion in your policy as well. Let me see if I can find that screening.
[AGENT][NEUTRAL] And I can
[AGENT][NEUTRAL] Let's see, on about page 14, it has the ovarian cervical cancer screening. It explains that, um, cancer blood test, Pap smear screening.
[AGENT][NEUTRAL] And other tests, let's see what else we've got.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sometimes they'll have kind of a list that's what I'm trying to and then around page 33, it kind of gives you a list of some of the covered screenings.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That would be on a page that says cancer screening benefit rider.
[CUSTOMER][NEUTRAL] OK, let me
[AGENT][NEUTRAL] So that is about halfway through the policy. It could be at the end as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK, OK, so I see, I see that. OK, so.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK. So all that has to do with cancer. Um, and, um,
[CUSTOMER][NEUTRAL] I guess when I don't know why those drop downs that had like preventative vaccines and I thought, OK, well I didn't realize that might be on there but that could be on somebody's just not on mine.
[AGENT][NEUTRAL] Exactly. Some of our policies do cover that, so that, that's just a comprehensive claim form for all the policies. Yeah, and I can understand why you would think that. Well, yeah, I did that, and I did that.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK. Well, I was like, yeah.
[AGENT][NEUTRAL] I would do the same thing.
[CUSTOMER][NEUTRAL] I know and I think like on the general um.
[CUSTOMER][NEUTRAL] OK, so the dental would only cover if they were screening for cancer, is that correct?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] What up all the different things I filed. I'm like, OK, I, I've wasted too much time looking stuff up, uh, the one that, the one that my the one that's gonna be hard, my husband passed away in January and he had a lot of medical bills and unfortunately I have been negligent about filing stuff in the past, but like he had ambulance calls.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, and I see that, you know, I, I was thinking on my rider, that's going to be covered, uh, his, his ambulance transportation. Uh, does that sound correct?
[AGENT][NEUTRAL] Well, let's take a look. So you have the heart attack and stroke and intensive care rider. Let me look at that ambulance.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, he was, he was actually in intensive care and then he was in the, the reduced, the one that's just a step below intensive care also. And I'm trying to figure out how when I get ready to file those things, um, that's just a regular hospital stay, he went in November, he had an ambulance, had different kinds of heart tests and stuff, but now that one, he was just in the regular hospital.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it's only covering the intensive care, correct?
[AGENT][NEUTRAL] That's right. Did he actually have a heart attack?
[CUSTOMER][NEUTRAL] Uh, they, they determined that he had, they think he had a heart attack at some time right when he first got to the hospital or right before he got to the hospital. And I wasn't sure how you document that.
[AGENT][NEUTRAL] Or was it just the first.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, they wouldn't
[CUSTOMER][NEUTRAL] How I document that.
[AGENT][NEUTRAL] Yeah, you can, um,
[AGENT][NEUTRAL] So the heart attack, they will need like the EKG report showing the arrhythma and everything, um.
[AGENT][NEUTRAL] So if he had it prior to, they're probably not even gonna have that unless there's some documentation that they, the medical records, the medical notes for his ER visit, you know, that could document.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] The medical finding of a heart attack.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I know he had a like echoes. He had a whole bunch of tests while he was, he went in like on [PII], and he'd been in November. And anyway, he went in on [PII] and they went through test after test trying to figure out what was going on with him. And um
[CUSTOMER][NEGATIVE] And finally, he was there a week. Finally, after about 3 days, they came in and said, apparently, based on his test we've done, he must have had a heart attack right before he came in.
[CUSTOMER][NEUTRAL] And so because of the damage to his heart from November till January, so they said he must have had a heart attack then. And basically, um, you know, his heart went from a 50% refractory rate to a 25%. And they said that, that is based on our tests that we've done that we believe happened. And so it became harder for them to get him.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Out of that and with different things going on, but um I don't, I'm not sure would that, would that type of a claim go to the doctor or the hospital or?
[CUSTOMER][NEUTRAL] Um, I'm not sure exactly how I would show that or would I have to get the doctor involved, or how would that work?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] So what
[AGENT][NEUTRAL] If you can get the medical notes from the attending physician,
[CUSTOMER][NEUTRAL] Which there were thousands of them.
[AGENT][NEUTRAL] Um
[AGENT][POSITIVE] Yeah, I got you I got you. What about the one that, OK, here's what I would suggest.
[AGENT][NEUTRAL] I would submit the claim for your husband.
[AGENT][NEUTRAL] Um, with the itemized bills from the hospital, the ambulance.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Now the ambulance can just be separate, right? I, I mean those came, those came on separate bills so I could just send those separate to different companies. I could send those, go ahead and send those, the ambulance separate, correct? OK.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] That's right. So for your husband, there is the, you would need to complete the cancer claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then include any of the itemized bills with diagnosis codes.
[AGENT][NEUTRAL] Now you can just upload that information on his on the policy online.
[CUSTOMER][NEUTRAL] Diagnostic.
[CUSTOMER][NEUTRAL] OK, see how do I get.
[CUSTOMER][NEUTRAL] Those diagnostic codes and my, I mean, I have what was filed with Aetna and Medicare, um,
[CUSTOMER][NEUTRAL] I guess that's just gonna, I have to ask the hospital for that.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So ask the hospital for that itemized bill.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um.
[AGENT][NEUTRAL] With the diagnosis codes.
[AGENT][NEUTRAL] And complete the claim form and the reason I'm stating this um I would submit that and let the adjusters review that now they're gonna.
[AGENT][NEUTRAL] Reply to that, they, they're probably going to need additional information and they can reply to that and give you specific information that's needed for the claim, and in that way.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You'll know exactly what to ask for.
[CUSTOMER][NEUTRAL] Right, um, OK, so, um.
[CUSTOMER][NEUTRAL] If
[CUSTOMER][NEUTRAL] The hospital consignment benefit.
[CUSTOMER][NEUTRAL] Normally it's just for cancer.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] But the uh but the um.
[CUSTOMER][NEUTRAL] OK, that's not considered a dread disease, I guess. So,
[CUSTOMER][NEUTRAL] The um
[CUSTOMER][NEUTRAL] I don't know what dread disease is, but anyway, um, but then the intensive care.
[CUSTOMER][NEUTRAL] Can be for something else.
[AGENT][NEUTRAL] That's right. As long as you are in intensive care and it's medical, of course, it's gonna be medical, but for the guidelines of the policy, if it is for medical reason, then that intensive care benefit can be utilized. Now, for that, we will need the itemized bill from the hospital showing the intensive care charges.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that will give us the dates that he was in intensive care.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I should, should those be all, should those um be on individual claim forms like, OK, the, the ambulance would be on one, the heart attack would be on one, the intensive care would be on one. Would each one of those be on a separate claim form?
[AGENT][NEUTRAL] So once you have submitted one claim form we don't need any any you don't need to resubmit that claim form for addition for any billing so um.
[AGENT][NEUTRAL] We get the claim form once and then any itemized bills that you receive, you can just upload those along the way without the claim form.
[CUSTOMER][NEUTRAL] OK, so in other words, I'm gonna put a hospital stay.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Um, like when I'm, OK.
[AGENT][NEUTRAL] You can upload them. You can upload them separately, um, first of all, you know, you can upload the claim form and then if you wanna upload the hospital bill showing the item, the intensive care room charges, and then if you want to upload the um if you can get the medical records for.
[AGENT][NEUTRAL] January from the hospital, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can do that.
[AGENT][NEUTRAL] For the heart attack and stroke, you can just upload that separately and then the ambulance bills separately. That way,
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] It's a little bit easier for you two to keep them separate.
[AGENT][NEUTRAL] To keep up with and then.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And then you'll get an EOB if additional information is needed for specific documents.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So that they can process it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and the um.
[CUSTOMER][NEUTRAL] When I'm looking at.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm trying to think, I'm trying to keep from having to call you back if I have any other questions.
[AGENT][POSITIVE] No, and you're fine. You are fine. You know, we are here to help you and I'm so sorry for your loss. I really am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Well, thank you.
[CUSTOMER][NEGATIVE] It wasn't, it was not expected.
[CUSTOMER][NEUTRAL] Um, but I mean, he had some heart problems, but we for sure thought we were bringing him home. Now, on, it seems like maybe I'm trying to think of where I read this, I'll have to go back through everything and highlight it. but different tests that he had to have.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, why he was there like.
[CUSTOMER][NEUTRAL] EKGs, I can't remember what I saw that um
[CUSTOMER][NEUTRAL] Might be covered.
[CUSTOMER][NEUTRAL] Um, let me see. The diagnostic test, let's see. No, maybe thinking of something else.
[AGENT][NEUTRAL] Uh, the diagnostic testing is for the cancer diagnosis.
[CUSTOMER][NEUTRAL] OK, OK, so um.
[CUSTOMER][NEUTRAL] OK, so the, the hospital intensive care, OK, um.
[AGENT][NEUTRAL] I'm trying to find the page in your document that might help and just I'm looking to so.
[CUSTOMER][NEUTRAL] OK, so that covers.
[CUSTOMER][NEUTRAL] Yeah, I think page 31 talks about that, but I, I didn't know if there were any other tests that diagnostic tests that he had to have done for his heart were covered or is it just gonna be the hospital stay and possibly the heart attack? Um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Are you looking under the heart attack and stroke first occurrence benefit riders?
[CUSTOMER][NEUTRAL] Fine.
[CUSTOMER][NEUTRAL] The hospital stay.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I, I see that. I don't know. I'm not sure where that is. I see the sur the surgical benefit, OK.
[AGENT][NEUTRAL] I understand. OK, so mine is.
[AGENT][NEUTRAL] Yeah, it's around page 28.
[AGENT][NEUTRAL] Heart attack and stroke, first occurrence benefit rider.
[CUSTOMER][NEUTRAL] OK, I'm going to.
[CUSTOMER][NEUTRAL] OK, 2.
[CUSTOMER][NEUTRAL] Pardon, OK, OK, page 28, OK.
[CUSTOMER][NEUTRAL] Heart attack, OK.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] And this is a first occurrence benefit which means that it's a like a lump sum payment.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] So it only pays that benefit amount.
[AGENT][NEUTRAL] For the heart attack, uh, heart attack diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, no, in other words, if he, if they say he had a heart attack, then they would just pay the flat 2500.
[AGENT][POSITIVE] That's right. And we'll have, of course, yes, ma'am. That's right. And that's with the supporting medical documents.
[CUSTOMER][NEUTRAL] Is that what you're saying, that's what you're saying.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] So that's, that's just a benefit upon the diagnosis of a heart attack as long as it meets the definition.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I'll have to look back and see what that exactly understand what that is, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then of course the page after that is gonna be your intensive care provider.
[CUSTOMER][NEUTRAL] Yes ma'am, OK.
[AGENT][NEUTRAL] kind of explain that.
[CUSTOMER][NEUTRAL] OK, well, you know, I'll just, I'll just do what I think I'll do the best I can and then see what they say.
[AGENT][NEUTRAL] You know, the
[CUSTOMER][NEUTRAL] Say that to me, um.
[AGENT][POSITIVE] Actually our opinion is it's better for us to have documents that we cannot pay versus documents not having documents we can pay so if you think it's payable according to the guidelines of your policy please submit it and let them review it because we're gonna look at everything and try to pay any benefit we can to help you.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Sure. I understand. OK, well, I'll go.
[AGENT][NEUTRAL] Don't hesitate just to, just to put it in there if you think it's payable.
[CUSTOMER][NEUTRAL] I know well this is kind of one of those things. I mean I look at the explanation of benefits, you know, the EOB and I'll go through and they'll have doctors and tests and stuff, but then I go, OK, but that's not notes and codes and all that stuff and um.
[AGENT][NEUTRAL] That's right. So it's gonna have to come from the providers.
[CUSTOMER][NEUTRAL] And so
[CUSTOMER][NEUTRAL] Right. So probably just have to call the hospital and say I need all those records for all of his stay. Now, the one in November, yes, he went, he had to go with uh
[CUSTOMER][NEUTRAL] He had to go with, but I, I don't think that the only thing I think about November, he didn't have any intensive care. He just went to the hospital. They were doing some diagnostic stuff on his medicines. And I don't think that that day other than the ambulance, he didn't go to in intensive care, and he didn't have a heart attack. So I don't think any of that is gonna be covered under anything.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] For November, it's just this [PII], so.
[AGENT][NEUTRAL] Yes, ma'am. So I would just submit the ambulance charges from November.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, did he go by ambulance in January or?
[CUSTOMER][NEUTRAL] Uh-huh, uh-huh.
[CUSTOMER][NEUTRAL] Yes, yes, both of them he did.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um I think he might have gone sometime, I'm trying to remember last year, but I can't remember what you, what it says on here.
[CUSTOMER][NEUTRAL] On the ambulance visits if that's limited to.
[CUSTOMER][NEUTRAL] One a year or what that was? Was that limited to
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I'm not sure. That's OK. I can just.
[CUSTOMER][NEUTRAL] I don't remember if he went any other time.
[AGENT][NEUTRAL] It's a ground per trip. It's $200 and that's a verification of coverage and not a guarantee of payment. Looks like it's a maximum of 2 trips per person per hospital confinement.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so he had the hospital confinement in November and he had one in January and then the one I think he went.
[CUSTOMER][NEUTRAL] Maybe last spring or something. I've got to go look that up and I, I can't remember for sure because I got
[AGENT][NEUTRAL] Well, you've been through a lot.
[CUSTOMER][NEUTRAL] Yeah, well, it was just that he had some, you know, different things going on and um so we're, we're about 30 miles from the hospital and we just decided that, hey, you know, I had an ambulance policy because I just thought if he, if I use that once a year, you know, it, it, it's gonna, you know, pay for me to do that. So, um anyway.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, well, um, [PII], you've been a lot of help and hopefully I'll get through this and if I have any more questions then I will call back.
[AGENT][POSITIVE] Well, I'll tell you what, it has been such a pleasure to assist you, Ms. [PII], and if you have any questions along the way or hesitations or concerns, don't hesitate to call us. We're here to help you through it, OK?
[CUSTOMER][NEUTRAL] OK, now I don't do, I mean, can I call you directly back or do I just take who I get when I call back?
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] I'm sorry, I've never heard it feel like that. Take who I get. I like that. Um.
[CUSTOMER][NEUTRAL] I know, well, I mean, you're just a random person. I don't know how to say it nicely.
[AGENT][POSITIVE] No, but I love it.
[AGENT][POSITIVE] I needed that laugh, thank you.
[AGENT][NEUTRAL] Well, any of
[CUSTOMER][NEUTRAL] Oh good. Well, I mean, because sometimes people say, well, I'll give you my extension and you, I mean, sometimes you're like.
[AGENT][NEUTRAL] And you never can get back to them. Yeah, I get it. I understand.
[CUSTOMER][NEUTRAL] Well, right, and so I thought, well, but it's not like y'all are a little bitty outfit in a one office business, so I, you know, I understand. I, I was.
[AGENT][NEUTRAL] That's right. That's right. So any of our
[AGENT][NEUTRAL] Yeah, any of, any of our representatives will be more than happy and able to assist you, but if you have any problems, you just tell them to say, hey, is [PII] available?
[AGENT][POSITIVE] And if I'm available, I'll be happy to assist you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, well I appreciate it thank you so much for your help.
[AGENT][POSITIVE] Oh it's been such a pleasure, Ms. [PII], and thank you for calling APL. If you need anything else, you just give us a call, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right, thank you and thank you for calling EPL. Hey, and be safe with all these storms that keep rumbling through, so take care.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I know. I had so far.
[CUSTOMER][NEUTRAL] Uh, where I am, I'm just south of some of it and we're supposed to get all this rain and so far I've gotten very little rain and now it looks like it's going north and, and we kind of needed the rain. I didn't want the storms but you know we needed the rain so I'm kind of like, oh no, but it keeps you on your toes all day long. So you go, well, do we have ball games? Do we not have ball games? Where are you located? Are you in [PII]? 000 OK.
[AGENT][NEUTRAL] It does.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm in [PII]. So, uh, I'm in [PII], so I get what you, what you got through with.
[CUSTOMER][NEUTRAL] Yeah, I know my daughter's in [PII] and it goes through there and then it comes here so um.
[CUSTOMER][POSITIVE] Anybody, well, I appreciate your help and I will work on both.
[AGENT][NEUTRAL] And we'll just keep our fingers crossed and.
[AGENT][POSITIVE] It's been a pleasure and let us know if we can be of further assistance.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Ms. [PII], thank you for calling APL. Take care.
[AGENT][NEUTRAL] Bye bye.