AccountId: 011433970860
ContactId: 1e58c376-a9b1-4731-ad2b-80bfa324008e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243320 ms
Total Talk Time (AGENT): 89139 ms
Total Talk Time (CUSTOMER): 81767 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/1e58c376-a9b1-4731-ad2b-80bfa324008e_20250509T13:37_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes ma'am, um, I filed a claim recently and I, I guess it might have gotten denied and I'd like to try to find out why.
[AGENT][NEUTRAL] OK, sure. I can assist you with claims. And may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And may I have a callback number just in case we get disconnected Mister [PII].
[CUSTOMER][NEUTRAL] I'm sorry, what was that?
[AGENT][NEUTRAL] A callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] Um, yes, 359-844-6.
[AGENT][NEUTRAL] OK. Bear with me just a second. That was um the claim number?
[CUSTOMER][NEUTRAL] Oh OK that was must have been the claim number let me see uh.
[CUSTOMER][NEUTRAL] I don't actually have that with right now on this. I can't find it on the, oh, OK, um, let's see.
[CUSTOMER][NEUTRAL] 224-444-49
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. And for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Address [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Email address is [PII].
[AGENT][NEUTRAL] OK, looks like we have your work email. Is that OK?
[CUSTOMER][NEUTRAL] Uh, yeah, yeah, I don't check it that often, but that's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Uh, so let me go ahead and um pull your benefits. It looks like it was denied because it's not a cover service. So let me just go ahead and get the benefits pulled for a minute. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so this particular policy, and this is not a guarantee of payment, just a verification of coverage and also a disclaimer, it has benefits only for hospital admission, hospital confinement, intensive care, and rehabilitation only. So any other services besides that are not gonna be covered under the policy.
[CUSTOMER][NEUTRAL] OK, so, um, uh.
[CUSTOMER][NEUTRAL] Like, uh, an MRI that wasn't covered then, correct?
[AGENT][NEGATIVE] Yeah, it's not covered. It's not covered service under the benefit.
[CUSTOMER][NEUTRAL] OK, OK, that's all I need to know. Yes, I heard, uh, uh, I heard it was, I heard it wasn't, so I tried to submit and I, I wasn't sure, so, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] It's OK. No problem. Is there anything else I may help you with today? You have any other questions or concerns, Mr. [PII]?
[CUSTOMER][NEUTRAL] Um, not right now. That should do it for me.
[AGENT][POSITIVE] All right, well thank you for calling APL. You have a good day and a happy weekend.
[CUSTOMER][POSITIVE] Thank you very much, ma'am. You too.
[AGENT][POSITIVE] You're welcome. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.