AccountId: 011433970860
ContactId: 0422e90a-6cb5-4f84-b780-f6b8c42ea57e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 295750 ms
Total Talk Time (AGENT): 89768 ms
Total Talk Time (CUSTOMER): 151904 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/0422e90a-6cb5-4f84-b780-f6b8c42ea57e_20250522T17:37_UTC.wav
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[CUSTOMER][NEUTRAL] Hello.
[AGENT][POSITIVE] Hello, thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hey, how are you? You sound a little choppy, but um, yes, so I got a letter from you guys from uh APL. Um, can I give you it, it's not a bill, but it says this is not a bill and um.
[AGENT][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, you know, it's, it, I don't know if this means that I, I, I, if you could explain to total benefits zero, but I like, I, um, I don't know how to, how do I address this with you guys because, oh, here's the claim number, can I give you the claim number because.
[CUSTOMER][NEUTRAL] I had a procedure in the hospital and I gave them my APL and I know the procedure was more money than the the $5000 you guys covered but I had a, uh, I had a phone call from the hospital saying that you guys would cover the $5000 out of pocket whatever that I pay. So can I give you the claim number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, um, first, sir, let me get your name and your callback number just in case the call is disconnected.
[CUSTOMER][NEUTRAL] My, my, my name is, sure, my, my name is [PII].
[AGENT][NEUTRAL] OK, thank you. And then [PII], what is your phone number, sir?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] My what?
[AGENT][NEUTRAL] Your policy number?
[CUSTOMER][NEUTRAL] What what number do you want, ma'am?
[CUSTOMER][NEUTRAL] Uh, the policy number.
[AGENT][NEUTRAL] The policy number
[CUSTOMER][NEUTRAL] Yes, it's 025102519628.
[AGENT][NEUTRAL] Or a certificate number?
[AGENT][NEUTRAL] OK, let me pull up your policy real quick, sir.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] OK, and then for security reasons I'm gonna need for you to answer a few questions for me. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It should be my my home address is [PII]. My cell number is [PII] and my email, you probably have, I think my, my personal one is [PII]. If not, you have my work one which is [PII].
[AGENT][POSITIVE] OK, thank you, [PII]. I appreciate you verifying your policy for me, sir.
[AGENT][NEUTRAL] OK, let me look real quick and you're calling about a claim and what was that claim number, sir?
[CUSTOMER][NEUTRAL] So the claim number was 3599247.
[AGENT][NEUTRAL] OK, let me look up that claim.
[AGENT][NEUTRAL] OK, the claim.
[AGENT][NEUTRAL] They did send in the claim but they didn't send the explanation of benefits from the primary insurance carrier, so in order for us to process the claim they need to submit the EOB explanation of benefits from the primary insurance carrier.
[CUSTOMER][NEUTRAL] From the primary, OK, so, so, OK, who do I, OK, the hos when I had this procedure done, the hospital called me and said, Mr. [PII], the, uh, APO will cover the $5000 thing because you have a whatever, a deductible, whatever. I don't know what I don't know these insurance things, but they said you don't have to pay anything. You you have a, you have this insurance APO and they'll come with the $5000 that covers everything now is are you trying to tell me that now you guys are not paying this and who do I have to turn to so this gets resolved?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, that's not what I'm saying. What I'm saying is.
[CUSTOMER][NEGATIVE] Can you call me back because this line sounds terrible. Can you please call me back because I, I'm hearing you in half cut words because it's choppy.
[AGENT][POSITIVE] OK, yes, I will do that.
[CUSTOMER][NEUTRAL] Could you call me back to my cell number, please?
[CUSTOMER][POSITIVE] Thank you, I'll wait for your call. Thank you.
[AGENT][NEUTRAL] Yes sir.