AccountId: 011433970860
ContactId: 1bec36d2-1ade-4d3f-9643-c841f25431bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 365640 ms
Total Talk Time (AGENT): 69008 ms
Total Talk Time (CUSTOMER): 133749 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/1bec36d2-1ade-4d3f-9643-c841f25431bf_20250213T19:52_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yeah, same.
[CUSTOMER][NEUTRAL] Hi [PII], um, I am calling because I had a policy in [PII] that was for $3000.
[CUSTOMER][NEUTRAL] And then I signed up in December for [PII] effective date for a policy this year for $5000 because we had to during open enrollment I had to choose a new insurance policy and it had a higher deductible.
[CUSTOMER][NEUTRAL] Um, I believe that my new policy just went into effect because they said it was on a.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] What the heck did they call it a.
[CUSTOMER][NEUTRAL] Something renewal processing hold I think is what they said so.
[CUSTOMER][NEUTRAL] Um, I think it just went into effect, so I had a claim from [PII]. I had surgery, so they told me that since my other claim was active for the $3000 to go ahead and submit it, which I did, and then once the $5000 plan became effective, that they would be able to reopen my claim to pay out the rest of the money that I paid out because I paid out almost $4900 for my surgery.
[CUSTOMER][NEUTRAL] So I was calling to find out what I needed to do to do that and I do have my policy number now for the new, the new policy for [PII], which I did not have before.
[AGENT][NEUTRAL] OK, and can I have the policy number, please?
[CUSTOMER][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] Yeah it's 259-736-3.
[CUSTOMER][NEUTRAL] Ruger, [PII] down.
[AGENT][NEUTRAL] OK. And
[AGENT][NEUTRAL] Can I get your name, date of birth, and email address?
[CUSTOMER][NEUTRAL] [PII] [PII]. [PII].
[AGENT][NEUTRAL] OK, so you just need to know what to um how to file the claim.
[CUSTOMER][NEUTRAL] Yes, because I already filed one this year, so I didn't know like you just reopen the one that I already filed or do I have to resubmit the paperwork again and open a new claim.
[AGENT][NEUTRAL] Oh, so we already have the info. OK, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because she said there was like $1800 and some odd dollars that hadn't been paid out for it yet.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Am I making sense to you? I feel like that.
[CUSTOMER][NEGATIVE] I'm confusing myself.
[AGENT][NEUTRAL] No, it's making sense basically so we processed it under the.
[AGENT][NEUTRAL] The old plan, but we need to process it under the new plan, but.
[AGENT][NEUTRAL] Not pay all of it, we just gonna pay the difference.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Because we've already given you 3000 so you just need.
[AGENT][NEUTRAL] The $1,841.23.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, let me.
[AGENT][NEUTRAL] OK, so I have all the information I have the claim sent back, um, to be reprocessed under the correct policy number, um, if you could just allow 7 to 10 business days for that process to be completed.
[CUSTOMER][NEUTRAL] Oh, they have to redo it all?
[CUSTOMER][NEUTRAL] I didn't. OK, I was, I didn't know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We don't need you to send anything. We just have to reprocess the claim. We don't need you to send anything else. We just need to move the claim over and have it reprocessed.
[CUSTOMER][NEGATIVE] Because when they messed up the
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, well, was there anything else I could assist with today?
[CUSTOMER][POSITIVE] No ma'am, that's all thank you so much.
[AGENT][POSITIVE] Well thank you for calling APL you have a good day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][NEUTRAL] Mhm. Bye-bye.