AccountId: 011433970860
ContactId: 0abd017f-a0a5-4c53-bac1-eb21b31c297e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 740619 ms
Total Talk Time (AGENT): 65518 ms
Total Talk Time (CUSTOMER): 101548 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/0abd017f-a0a5-4c53-bac1-eb21b31c297e_20250327T20:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing good. Um, I have a, um, insured on the other line who asked to speak to someone. She, um, well, you want me to give you the policy number first?
[AGENT][POSITIVE] Yeah, give me one second. OK, I'm ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. It's 222.
[CUSTOMER][NEUTRAL] 4557.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um it's claim number 3576873.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was denied because the plan year um benefits were exhausted, but she's stating that it's uh
[CUSTOMER][NEUTRAL] Different plan here since it's after [PII]. And I went over it with her, but um now she's asking to speak to someone else um for clarity on it.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] The data service.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I say it's gone.
[AGENT][NEUTRAL] See it's a different plan here.
[AGENT][NEUTRAL] Alright, it's send to run over.
[CUSTOMER][NEUTRAL] Alright, hold on one moment.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Good afternoon. Sorry.
[CUSTOMER][NEUTRAL] Hello Ms. [PII].
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] Thank you so much for holding. Um, I have claims on the line and [PII] will be assisting you further, OK?
[CUSTOMER][POSITIVE] Thank you, darling. You're welcome.
[AGENT][POSITIVE] Good afternoon. Thanks for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], um, my, I think in a mammogram, um, screening, and it was denied and the sweet girl was telling me that my policy renews in August.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my last group critical illness was in April of last year, so it did when it renewed in August of last year, so my one that I just sent in should be payable.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's what I can see.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, alright, yes ma'am, let me look at that for you. Give me one second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that was a full data service [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] One second reviewing your policy.
[AGENT][NEUTRAL] OK, give me one second. I'm having the examiner who processed this to look at it. Give me 1 2nd because I'm, I'm not seeing where that benefit has been met on this claim either. One second.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, thank you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] One moment
[AGENT][NEUTRAL] OK, OK, so it looks like that the.
[AGENT][NEUTRAL] Benefit for the mammogram is only payable once every 2 years.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so I claimed a mammogram in [PII].
[AGENT][NEUTRAL] Yes ma'am, um, but you say that one, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, sounds good. Thank you.
[AGENT][POSITIVE] You're welcome you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Alright bye bye.