AccountId: 011433970860
ContactId: 0f1fe48c-8c6f-4783-ad75-8d5621b3917a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436359 ms
Total Talk Time (AGENT): 201762 ms
Total Talk Time (CUSTOMER): 127105 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/0f1fe48c-8c6f-4783-ad75-8d5621b3917a_20250414T13:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I need to verify um if I already used the 4 specialists.
[CUSTOMER][NEUTRAL] That I am entitled to reimbursement for.
[AGENT][NEUTRAL] Oh, OK. Well, I'll be more than happy to check the um appointment. So you want to see if you've used like your 4 office visits for the year?
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][POSITIVE] OK, I can check for you. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you, and [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] 01842070 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII] and it's [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment, I'm just looking through your benefits.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] To see what was used already.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold? I'm just pulling up your policy and what um benefits have been used.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] It depends if it's 100, I mean if it's 25 and she's already paid out 100, she's used that for. I don't know how much it is, so that's what I need to figure out.
[AGENT][NEUTRAL] He certificate any certificate.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, specialist is city purpose that she's used to.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, thank you so much for holding. So you've used 2, you have 2 more for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For the specialist.
[CUSTOMER][NEUTRAL] OK, do you tell me the ones that I that I've used and, and tell me if there's anything pending.
[AGENT][NEUTRAL] Um, OK, hold on one second, let me look through your claims. Do you like
[AGENT][NEUTRAL] Alright, so, let me see how I can do this.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just tell me which one has been paid out already, the two that have been paid out.
[AGENT][NEUTRAL] Right, there's just no way for me to search, so I have to go through each of the claims to see which one is the specialist to see what, so I'm just trying to, hold on one moment.
[CUSTOMER][NEUTRAL] Doctor [PII].
[AGENT][NEUTRAL] Right, but you've had claims since January. So let me just go through each of these to see which one. Do you remember when you went to the doctor? that'll help.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] No, I don't have it right now at this moment.
[AGENT][NEUTRAL] OK, so hold on one second. I just got to go through these to see which one is the specialist.
[CUSTOMER][NEUTRAL] If you could find that one
[AGENT][NEUTRAL] So there's one
[CUSTOMER][NEUTRAL] They're all specialties, all of them.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So all of the claims since January are from the specialist?
[CUSTOMER][NEUTRAL] Yes, from different specialists, yes.
[AGENT][NEUTRAL] Right, so I have to go through these to see which ones were paid. Hold on one second for me, OK?
[CUSTOMER][NEUTRAL] Oh my god, I'm at the doctor's office. I just need to, yeah, OK, I'll hold on.
[AGENT][NEUTRAL] There's no, I'm sorry, there's no way for me to search unless I have a date. I have to go through each of them. I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's, so you're wanting me to give you the date and what was used?
[CUSTOMER][NEUTRAL] Yeah, I just need to know which ones who, who you paid out the $50.50 dollars payments. Can you look through your payments?
[AGENT][NEUTRAL] OK, so
[AGENT][NEUTRAL] It's not that easy, ma'am, but yes, I understand what you're asking. So [PII] there's a payment. Let me see who the doctor is. Hold on one moment.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] It says South Florida sports and Spine.
[AGENT][NEUTRAL] Does that help?
[CUSTOMER][NEUTRAL] OK, and yeah, yeah, uh huh.
[AGENT][NEUTRAL] OK, let me search the next one. Hold on one moment. So that one was $50 and there's one for [PII], cardiovascular specialist was paid $50.
[CUSTOMER][NEUTRAL] Yes, you don't have any other pending claims?
[AGENT][NEUTRAL] OK, so the
[CUSTOMER][NEGATIVE] Cause I'm here and they should have, they, they should have actually put through um more claims cause I've been to this cardiologist.
[AGENT][NEUTRAL] Well, if you're there, can you ask them for a data service so that we can search effectively because I'm literally going through each date from [PII] to today.
[CUSTOMER][NEUTRAL] OK, what you're going through are the are the claims or you're going through what they paid out?
[AGENT][NEUTRAL] So, so what I'm trying to explain to you, hold on, so what I'm trying to explain to you is there's no way where I can just see what's been paid. I have to go to click each claim to then see what was charged and what was paid. So that's why I'm asking these questions. So the two claims that were paid was January and [PII] that I just gave you, there's no more pending, there's nothing pending as of right now.
[CUSTOMER][NEUTRAL] Like, because, yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] But if you want to ask them for a data service, I can search and see if they've submitted something for you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, give me a minute because someone got in front of me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi, can you tell me the last time I was here?
[CUSTOMER][NEUTRAL] I was here for um an echo, a stress test.
[CUSTOMER][NEUTRAL] And then the next day um.
[CUSTOMER][NEUTRAL] that was [PII] and I came back on the [PII]. OK, thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. So there's nothing here for [PII]. Let me look for the [PII].
[AGENT][NEUTRAL] And nothing here yet for the [PII], so they haven't filed them yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, no, that's it.
[AGENT][POSITIVE] All right. Well, thanks so much for calling APL Ms. [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] OK thank you you too bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.