AccountId: 011433970860
ContactId: 1f95f820-9acb-4723-b2bb-c0606dea7445
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 517150 ms
Total Talk Time (AGENT): 216258 ms
Total Talk Time (CUSTOMER): 249157 ms
Interruptions: 6
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/1f95f820-9acb-4723-b2bb-c0606dea7445_20250320T19:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hello, this is [PII] calling.
[CUSTOMER][NEUTRAL] And what I'm calling about is it said uh I got a letter saying you had received a claim on my policy and I wanna know what's going on here.
[CUSTOMER][NEUTRAL] It says in a review of the claim has started, but I wanna know what's going on here. Can you punch in my name? I don't have a claim number or anything on this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you did not receive like a, a policy number or anything like that on that message?
[CUSTOMER][NEUTRAL] I'll say that again now you didn't receive what?
[AGENT][NEUTRAL] A policy number or any reference number or anything like that on the message?
[CUSTOMER][NEUTRAL] No, this is a letter that just came from you guys dated [PII] from the claims department.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, uh, one moment.
[CUSTOMER][NEUTRAL] Do you, do you want spelling of my last name or anything to look it up, try to see if you find anything?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, give me just a second. I'm pulling another system that I can use the personal information. One moment.
[AGENT][NEUTRAL] And let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Go ahead with the spelling of your last name.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And you said the first name is [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm. That's my first name, yes.
[CUSTOMER][NEUTRAL] What does APL, what kind of insurance do you guys have at APL?
[AGENT][NEUTRAL] We have many products including um hospital indemnities, secondary supplemental plans, cancer policy, accident policies, um, dental policies. We have many, but we work with employers.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] So let me check and see.
[AGENT][NEUTRAL] OK, I did find a policy, uh, can you verify your date of birth for me to make sure this is your policy?
[CUSTOMER][NEUTRAL] 32767.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and the mailing address on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Alright, so this is um the policy you got through Business Workers of America BWA.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, say that again now. What is it from?
[AGENT][NEUTRAL] The policy you got.
[CUSTOMER][NEGATIVE] You kept bleeding in and out. I'm sorry but.
[AGENT][NEUTRAL] OK, I'm so sorry. uh, is the policy you got through BWA?
[AGENT][NEUTRAL] Business workers of America.
[CUSTOMER][NEUTRAL] Hm, OK. I don't remember that one, but OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Are you sure I picked up one from Business Workers of America.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Is that your employer?
[AGENT][NEUTRAL] That's who we got as your employer.
[CUSTOMER][NEGATIVE] Business Workers of America? No, I don't have a Business Workers of America.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You don't work for BWA?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Somebody trying to set up some kind of account that I don't know about?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Not sure. You probably need to contact BWA because this is, you got this policy through them, um.
[AGENT][NEUTRAL] Bear with me just a sec.
[CUSTOMER][NEUTRAL] When was that policy purchased?
[AGENT][NEUTRAL] [PII] through your employer.
[CUSTOMER][NEUTRAL] Through BWA
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, I'm trying to think of, now I did brokerage something.
[CUSTOMER][NEUTRAL] I know there's some sort of um, OK, and what was that, a life insurance policy or what is it? What kind of policy is that a health care policy?
[AGENT][NEUTRAL] No, it's it
[AGENT][NEUTRAL] It's a medical, medical policy.
[AGENT][NEUTRAL] And um I see that you went to the doctor on [PII] of this year.
[AGENT][NEUTRAL] To the oncology, hematology.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, they sent us a claim and, yeah, they sent us a claim and we went ahead and sent the benefit of $50 for that visit.
[CUSTOMER][NEUTRAL] That was me.
[CUSTOMER][NEUTRAL] OK. Now I know what you're talking about. OK, got you now. Now you jog my memory. Sorry about all that. I have to go from there because that's a long time ago. And now, yes, I did go to gynecology, yes, I remember them saying something about it, but you have it through BWA or whatever?
[AGENT][NEUTRAL] Yeah, and we just
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it's OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, it's through BWA mhm.
[CUSTOMER][NEUTRAL] Business worker.
[AGENT][NEUTRAL] Yes, Business Workers of America.
[CUSTOMER][NEUTRAL] OK, so there was a thing put through for the $50.
[AGENT][NEUTRAL] Mhm. Yes, we pay $50.
[CUSTOMER][NEUTRAL] And so you guys covered the $50?
[AGENT][POSITIVE] Yes, we do.
[CUSTOMER][NEUTRAL] Uh, so you covered the $50 to payment to whoever billed for that?
[AGENT][NEUTRAL] Yes, for the oncology Hematology Association, I think it is, yeah.
[AGENT][NEUTRAL] For that date of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it's just a document letting you know that we receive a claim we process and we send that payment out.
[CUSTOMER][POSITIVE] OK, that's good then.
[CUSTOMER][NEUTRAL] OK. I know who that's through now. No, yeah, BWA, no, I don't work with them, but they did it through associate. I don't know. It's just strange how they did it, but I know who you're talking about now, through, through like a second party or something. Like if, um, I don't know.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Like you work for your company now APL, but then, um, your boss went and helped to do something or whatever and said, here, we got this APL. It's through APL, but I'm gonna use my uh kind of, I don't know, like a third party thing is what it was. That's what BWA comes in. I was trying to figure that out and then the way you guys sent this it was like a false claim or something. I was like, wait a minute now, I better look into this.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yeah, it's a third party. Correct. Yes, that is correct.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah, I understand your concern.
[CUSTOMER][NEUTRAL] I gotta write notes down on this now what you just said for everything but OK, so it was for a claim you sent $50. I gotta write that down, send $50 to the.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Oncology, hematology.
[CUSTOMER][NEUTRAL] To oncology, oncology, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the date of service of [PII].
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] you said or [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] of [PII].
[CUSTOMER][NEUTRAL] There's, OK.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] And you said that's through BWA.
[AGENT][NEUTRAL] Yes, and that's who um got the policy.
[CUSTOMER][NEUTRAL] Which is called what is it called again? Business?
[AGENT][NEUTRAL] Business workers of America.
[CUSTOMER][NEUTRAL] Business workers association.
[AGENT][NEUTRAL] The Business workers of America.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] America, you know I'm writing this down as you're speaking, don't you? That's why you did that.
[AGENT][NEUTRAL] Yes. Yeah, it's OK. It's fine. Yes.
[CUSTOMER][POSITIVE] You're a good girl. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Got it. Business workers of America.
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] All right. I got it now. I wondered when I'm sorry about bothering you out there in [PII], but
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Yes, no problem. That's, yeah, I understand.
[CUSTOMER][NEUTRAL] I had to make sure that's where they said that the $50 came from because I saw a bill from the oncology and it said paid $50 and I was wondering what the heck, I said I didn't pay nothing. Wait a minute, what's going on? Now I know cause they submitted it through and it went through you guys and you paid them for it. Gotcha. All right, well, I appreciate you guys doing that for me. Um, if I have any other questions about my policy, I'll call you guys up then too.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Sure, no problem. And yeah, here, we're here to assist you in any way we can. Yeah, I, whenever you have any questions, just feel free to call us, OK?
[CUSTOMER][NEUTRAL] Um, just in case I
[CUSTOMER][POSITIVE] OK, well thank you very much I appreciate it you have a good day.
[AGENT][POSITIVE] You're welcome. You as well, Mr. [PII]. Have a good afternoon.
[CUSTOMER][POSITIVE] Alright, alright, you, yeah, it is afternoon. Yeah. I say you have a good afternoon. All right, we'll see you. Thank you. bye.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] All right. You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Hi