AccountId: 011433970860
ContactId: 0a112016-1ed6-4dc6-9f6c-90dd3cdd86cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203479 ms
Total Talk Time (AGENT): 96011 ms
Total Talk Time (CUSTOMER): 78659 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/0a112016-1ed6-4dc6-9f6c-90dd3cdd86cd_20250424T16:50_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Uh hi, um, I have a question, um, regarding, well, I haven't filed a claim, but I was wondering if I could file a claim um if, if a claim can be filed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, go ahead and give me your name and your policy number, please.
[CUSTOMER][NEUTRAL] The policy number is 179 by heart.
[CUSTOMER][NEUTRAL] 179 1998.
[AGENT][NEUTRAL] And I'm, I'm sorry, I can I can barely hear you, but I did not hear the last four numbers.
[CUSTOMER][NEUTRAL] 1998.
[AGENT][NEUTRAL] 1998 and I'm so sorry I did not catch your name.
[CUSTOMER][NEUTRAL] Pres. [PII].
[AGENT][POSITIVE] Alrighty, Precious. Thank you for all that information. Now while I'm pulling your file up, go ahead and give me a good return telephone call number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, Precious. Thank you for that information. I verify your date of birth and address for me, please, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] In what town?
[CUSTOMER][NEUTRAL] I'm sorry, ma'am, what was that?
[AGENT][NEUTRAL] I'm sorry, and what town was that in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alrighty, thank you for all that information, Precious. OK, now how can I help you? You want to know how to file a claim? Is that correct?
[CUSTOMER][NEUTRAL] No, no, no, I know how to file a claim. Um, I'm just not sure if the claim is payable for me, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I was just looking at my, uh, estimation of benefits from the
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Insurance company and like, like my, like my doctor visits with my uh psychiatrist.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, like, like, are those, are those claims payable? Like whatever my responsibility is?
[AGENT][NEUTRAL] Alright, well, let me get your benefit pulled up. Let me look at it. Let's see. OK, under this.
[CUSTOMER][NEUTRAL] Yeah, I'm not sure if I ever.
[AGENT][NEUTRAL] Yes, ma'am, that's OK. OK, under your benefit plan, uh, now it looks like you don't have office visit coverage here, but you have office treatment coverage. So what that means is the actual office visit is not covered here at.
[AGENT][NEUTRAL] All, but anything else done in the office for a sickness or an injury that is applied towards your deductible co-pay or co-insurance at your primary, uh, that would be considered for a benefit here.
[AGENT][NEUTRAL] Have you sent your claims in? Uh-huh.
[CUSTOMER][NEUTRAL] Oh yeah, no, no, it wasn't in.
[CUSTOMER][NEUTRAL] No, it wasn't an injury related uh claim.
[AGENT][NEUTRAL] Or illness.
[CUSTOMER][NEUTRAL] Uh, no, it's just like a, well, a virtual tele.
[CUSTOMER][NEUTRAL] Telehealth that I have in my psychiatrist mostly.
[AGENT][NEGATIVE] Oh, OK. Yeah, OK, now for telehealth, that's not a covered benefit here at all.
[CUSTOMER][POSITIVE] OK. OK. I'll be fine. Thank you.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. Now is that all I can help you with today, Precious?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you.