AccountId: 011433970860
ContactId: 1e71b94f-5290-4eb8-88f6-1778fb4e3a87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392359 ms
Total Talk Time (AGENT): 114676 ms
Total Talk Time (CUSTOMER): 135119 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/1e71b94f-5290-4eb8-88f6-1778fb4e3a87_20250606T13:12_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, I'm calling because I got this, um,
[CUSTOMER][NEUTRAL] Statement I guess about this um
[CUSTOMER][NEUTRAL] Quote or on this uh payment I request I put in so I just didn't fully understand if it was paid or wasn't paid so I wanted to go over that with you.
[AGENT][NEUTRAL] OK. Do you have a phone number I can get in case we get disconnected, I can call you back?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] Um, let me see. I have the, uh, yes, it's 02489117.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[AGENT][NEUTRAL] And what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I verify your address and email address, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And thank you, Ms. [PII].
[AGENT][NEUTRAL] And you were needing to ask a question about a claim you filed?
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][POSITIVE] Exactly.
[AGENT][NEUTRAL] OK, I can help you with that. What data service was it for?
[CUSTOMER][NEUTRAL] Uh, like, what was, it was quest diagnosed with. I don't know if that answers the question.
[AGENT][NEUTRAL] Do you know what date you went to the doctor, what date it was?
[CUSTOMER][NEUTRAL] Oh, date of service. Yeah, I didn't understand. I thought you said data.
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] Yeah, that's OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, hold on one second.
[CUSTOMER][NEUTRAL] The date of service, it says from 2, so [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on just a moment. Let me pull that claim up.
[AGENT][NEUTRAL] OK, we did deny that claim, uh, as the major medical didn't pay on it, so we did not pay on it.
[CUSTOMER][NEUTRAL] But that's why I have the secondary.
[CUSTOMER][NEUTRAL] If the first one doesn't, and the second one should.
[AGENT][NEUTRAL] Yeah, if your major medical doesn't pay on it, we do not pay on it. We only pay if they apply something to your deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] So like if they pay partial for it, you'll pay the other partial amount, is that what you mean?
[AGENT][NEUTRAL] If they apply anything to your deductible, co-pay or co-insurance, then that's what we pick up.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I understand, I understand.
[AGENT][NEGATIVE] But if they don't pay on it, we do not.
[CUSTOMER][NEUTRAL] Um, and you guys.
[CUSTOMER][NEUTRAL] I can also like if a, if a company doesn't accept your insurance, like if I go to a dentist um or a doctor, um, and they don't accept the insurance, I can then just call you guys after to, uh, to, um,
[CUSTOMER][NEUTRAL] Uh, pay the difference or no?
[AGENT][NEUTRAL] You don't have to call us, you have to file a claim. We would need itemized bills with procedure codes and diagnosis codes and charges, and then your explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can
[CUSTOMER][NEUTRAL] All right, understood, um.
[AGENT][NEUTRAL] You can mail it or fax it or you can set up an account on your online on our online service center on our online service center you can file claims that way as well.
[AGENT][NEUTRAL] And you would be able to see your claims and what's been done with those claims.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK. And then um
[CUSTOMER][NEGATIVE] Oh this is not OK.
[CUSTOMER][POSITIVE] OK. All right. Thank you.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] You guys also cover dental or no?
[AGENT][NEUTRAL] No, ma'am. This policy only for medical.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome. Thank you, Ms. [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.