AccountId: 011433970860
ContactId: 2197b786-1c49-4c04-a178-9872855a3775
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 320720 ms
Total Talk Time (AGENT): 97739 ms
Total Talk Time (CUSTOMER): 122334 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/2197b786-1c49-4c04-a178-9872855a3775_20250303T21:30_UTC.wav
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[AGENT][NEUTRAL] Calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, I had a
[CUSTOMER][NEUTRAL] Question about a claim.
[CUSTOMER][NEUTRAL] I got the check the the other day.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] But one of the items that I had turned in.
[CUSTOMER][NEUTRAL] Was the MRI done on my wife's shoulder after she had a shoulder separation.
[CUSTOMER][NEUTRAL] And that line item on the.
[CUSTOMER][NEUTRAL] EOB says non-covered service.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I was wondering if because I thought when I had looked at.
[CUSTOMER][NEUTRAL] What all the policy covers that it covered.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] X-rays and, and MRI's and things like that.
[CUSTOMER][NEUTRAL] So I'm wondering if I submitted it wrong or.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Well, I can actually check your claim for you. Uh, may I get your name and your uh policy number, sir?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] Policy number is 1289078.
[AGENT][NEUTRAL] OK, let me pull that policy up real quick.
[AGENT][NEUTRAL] OK, Mr. [PII], can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your address, phone number, and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It's [PII]. The email is [PII].
[AGENT][NEUTRAL] OK, and then one last verification.
[AGENT][NEUTRAL] Can you give me your phone number please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Mr. [PII], if our call gets disconnected, is this a good number to call you back on?
[CUSTOMER][NEUTRAL] Yes, I'm, I'm not on that phone right now. I'm on my landline, but that that that's a cell phone number and that'll be the best.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Thank you so much, sir. I appreciate you verifying your policy for me.
[AGENT][NEUTRAL] Alright, let me look and see.
[AGENT][NEUTRAL] Do you have the claim number, sir?
[CUSTOMER][NEUTRAL] Uh, I've got the check in front of me, so it's gotta be on here.
[CUSTOMER][NEUTRAL] Um, check date, check number claim claim number 3,562,400.
[AGENT][NEUTRAL] OK, let me pull that claim up real quick.
[AGENT][NEUTRAL] Let me just
[AGENT][NEUTRAL] OK, I'm looking at the claim right now.
[AGENT][NEUTRAL] After the payment of the check.
[AGENT][NEUTRAL] The policy maximum for this benefit was met and then it says there's another remark that says that no diagnosis code is provided and please provide a diagnosis code.
[CUSTOMER][NEUTRAL] Uh, ma'am.
[CUSTOMER][NEUTRAL] Ma'am?
[CUSTOMER][NEUTRAL] Can can you hear me?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] You're, you're breaking up and I'm hearing about every other word. I don't know why.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh no, OK, if I can sir.
[CUSTOMER][NEGATIVE] It's it's real garbled. The connection is.
[CUSTOMER][NEUTRAL] Uh, can, could you call me on that other number? Would you mind?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][POSITIVE] Yes sir, I can
[CUSTOMER][NEGATIVE] I, I, you're breaking up.
[AGENT][NEUTRAL] Can you hear me sir?
[CUSTOMER][NEGATIVE] Not very well. You're, it's real garbled and I'm, it's cutting out a lot of it. I don't know what's going on.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm so sorry. I'm so sorry. Tell you what, let me call you right back at this phone number that you gave me. We might have a bad.
[CUSTOMER][POSITIVE] That'd be great.
[CUSTOMER][POSITIVE] I appreciate it.
[AGENT][POSITIVE] OK. All right. You're very welcome, sir.
[CUSTOMER][NEUTRAL] Alright bye.