AccountId: 011433970860
ContactId: 03633d6a-dce4-4130-b5f6-1424aa428846
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 283420 ms
Total Talk Time (AGENT): 164749 ms
Total Talk Time (CUSTOMER): 110362 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/03633d6a-dce4-4130-b5f6-1424aa428846_20250428T16:45_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, I needed to talk to someone, um, about my account if it was possible.
[AGENT][NEUTRAL] OK. Uh, you mean when you say account, are you referring to your policy?
[CUSTOMER][NEUTRAL] Well, my coverage. Yes, my policy, yes.
[AGENT][NEUTRAL] Yes, sir, I can help you. Uh, you have some questions on your coverage?
[CUSTOMER][NEUTRAL] Well, I actually, um, I was supposed to do a procedure with um.
[CUSTOMER][NEGATIVE] A hospital for Wednesday and I'm not gonna do it with them and they had called you, you all, I guess to use my $1500 which.
[CUSTOMER][NEUTRAL] That's another issue, but I didn't want I'm not gonna do the procedure, so they don't need to be using that so I just wanted to see what can I do.
[CUSTOMER][NEGATIVE] For them not to use it
[AGENT][NEUTRAL] OK, so yes, I can take a look at your coverage, um,
[AGENT][NEUTRAL] And who am I speaking with?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], what's a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And and what is your policy number?
[CUSTOMER][NEUTRAL] So let's see here let me give you the right one.
[CUSTOMER][NEUTRAL] Would that be the
[CUSTOMER][NEUTRAL] In, in the group or the uh in hospitals benefit number?
[AGENT][NEUTRAL] OK, you can look, if, OK, if you'll notice on the in hospitals and the outpatient number, they're exactly the same at the beginning of the number prior to the letters ML. So just give me that portion of the number, that's all I need.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it's 02164129 ML.
[AGENT][NEUTRAL] OK, thank you. One moment please while I get your information pulled up. Once I do, I will need to verify several things with you first for security, and any information provided will be a verification of benefits and not a guarantee of payment. So first off, if you will please verify your date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. The phone number we have for you, Ms. [PII] is, Mr. [PII], rather, I'm so sorry, is the same as the one that you gave me, so that is your best contact number. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Thank you and lastly your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying all of your information. So, on this policy, um,
[AGENT][NEUTRAL] I do see where someone called to check your benefits, but if you're not going to be using that facility, you would not be able, well, they won't be able to use your benefits.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I'm not.
[AGENT][NEUTRAL] Because the, wherever you go for your procedure, that is who will be filing the claim unless they don't, and then, you know, you could file it obviously, but um it has to be, your claim has to be filed initially with your primary health care insurance.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then with APL because we have to have a copy of your primary insurance company's explanation of benefits when we're reviewing claims on this policy, so just because they called to check your benefits, um, doesn't mean that, you know, without a claim being filed with your primary, they will not be using those benefits. Does that make sense?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEGATIVE] OK, perfect. Yeah, I, yes ma'am, because at at this hospital it was outrageous, so I'm gonna be going to somebody else because that's it was insane.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah, but I just wanted to double check with you all first just to to make sure.
[AGENT][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Yes, sir, you, they can't, your benefits can't be used until we receive a claim form, a claim, an official claim.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][POSITIVE] All right, I thank you so much. I appreciate that.
[AGENT][POSITIVE] Well, you're certainly welcome. Absolutely. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's it.
[AGENT][POSITIVE] OK. Well, thank you so much for calling APL. I hope everything goes well for you with your procedure and I hope you have a great afternoon.
[CUSTOMER][POSITIVE] Thank you. You too. I appreciate you.
[AGENT][POSITIVE] You're welcome, absolutely.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.