AccountId: 011433970860
ContactId: 09089f6b-cbaa-46ae-9457-590e7bd92345
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348100 ms
Total Talk Time (AGENT): 149212 ms
Total Talk Time (CUSTOMER): 153444 ms
Interruptions: 4
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/09089f6b-cbaa-46ae-9457-590e7bd92345_20250514T18:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yeah, um, good, good afternoon. How you doing?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] I'm doing good, yeah, I just called a while ago about my.
[CUSTOMER][NEUTRAL] I call you
[AGENT][NEUTRAL] I'm sorry, it's very difficult to hear you. Could you repeat that?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I called, uh, earlier on about my medical too.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] About a medical bill, um, you mean a, a claim?
[CUSTOMER][NEUTRAL] That's from uh yeah.
[CUSTOMER][NEUTRAL] No, I, I, I think.
[AGENT][NEUTRAL] OK, are we just needing to check on that?
[CUSTOMER][NEGATIVE] Yeah, because I sent um uh my, I give my, I give work from uh insurance and they said um something went wrong, so I need to call my insurance so I don't understand.
[AGENT][NEUTRAL] OK, I'm not quite sure what that means either. Sure, so we could definitely take a look to see if they have filed a claim with us and if there are any notes regarding that. What was your name please?
[CUSTOMER][NEUTRAL] And I'm paying my insurance.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And then, uh, can I get a callback number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then do you have your policy number?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] That's um 02.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 558-8899
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I just gonna verify some information really quick. Can I get your date of birth, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then can I get your mailing address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Last thing I need is the email address that we've got on file for you. uh, looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying all of that. OK, so I have a claim on file. Was this for the date of service of [PII]? Does that sound right to you?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] That's correct. That's correct.
[AGENT][NEUTRAL] That's it? OK.
[AGENT][NEUTRAL] All right, one moment.
[AGENT][NEUTRAL] OK, so we did receive two claims for this data service [PII], uh, the one that was from, um.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Wow
[AGENT][NEUTRAL] Is it Kenne Stone Hospital, I think is how you say that?
[CUSTOMER][NEUTRAL] I repeat that.
[AGENT][NEUTRAL] Kennesone Hospital, um, we did pay that benefit, um, however, the other claim we were unable to pay a benefit as that was the maximum amount payable for this policy, as this is a limited indemnity medical plan, it is limited to how much um it's per date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So for this policy, it's $50 max uh per day of service for that benefit.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, I really don't understand you said it's only $50.
[CUSTOMER][NEUTRAL] On my health insurance.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Yes, so this is your limited indemnity medical plan.
[CUSTOMER][NEUTRAL] We.
[AGENT][NEUTRAL] And it does pay a dollar amount per covered procedure or office visit.
[CUSTOMER][NEUTRAL] You.
[AGENT][NEUTRAL] And for this policy, it pays a benefit of $50 per day of service.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So what am I what am I paying for?
[AGENT][NEUTRAL] If you'd like, I can send you a copy of your policy so you can review those benefits.
[CUSTOMER][NEUTRAL] Yes, send me a copy. So why am I paying insurance like?
[AGENT][NEUTRAL] Sure, did you want me to send that to your uh email, [PII]?
[CUSTOMER][NEUTRAL] What am I doing?
[CUSTOMER][NEUTRAL] Yeah, but I'm saying what am I paying insurance for that's only the same like.
[AGENT][NEUTRAL] This policy again as it's a limited indemnity medical plan, it is different than traditional major medical. It does offer more benefits for uh hospital stays, um, things like that, or surgical benefits, but it is a bit different, so I can go ahead and send this to you. You can review that, uh, just to see what exact those benefits are for this policy.
[CUSTOMER][NEUTRAL] No, send it to me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, did you have any other questions for me at the moment, [PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] No, I have, uh, no more questions. I just wanna, I just, I'm just saying like.
[AGENT][POSITIVE] All right well thanks for giving us a call.
[CUSTOMER][POSITIVE] Alright, I will call back if anything.
[AGENT][POSITIVE] Absolutely give that policy a good look if you have any questions feel free to give us a call back.
[CUSTOMER][NEUTRAL] days
[CUSTOMER][NEUTRAL] Alright.
[AGENT][POSITIVE] All right, thank you. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Alright, thanks.
[AGENT][POSITIVE] Thank you. Bye-bye.