AccountId: 011433970860
ContactId: 2bbbab12-3fa6-47a5-bb6e-5f3c6d2d24de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 189259 ms
Total Talk Time (AGENT): 91062 ms
Total Talk Time (CUSTOMER): 60940 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/2bbbab12-3fa6-47a5-bb6e-5f3c6d2d24de_20250428T21:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], good afternoon. How are you?
[AGENT][POSITIVE] I'm doing well. How are you doing?
[CUSTOMER][NEUTRAL] I'm excellent thank you um I am calling. I submitted a claim and I saw that it was processed, uh, with no payment and I wanted to know um if I missed something uh because um the hospital had sent me the bill.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, I can definitely help you with your claim status. Um, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII]. Uh, phone number [PII].
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] I can give you my social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And I believe I just found it.
[AGENT][NEUTRAL] And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII] [PII] and [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy was received. Um, let me see what this, is this the same thing?
[AGENT][NEUTRAL] Different modifiers. Hold on one second. Oh, different.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we're needing the explanation of benefits from your primary insurance because this policy is 2nd, so we have to know what primary did. So once we receive that, we'll continue processing the claim and then let me see if there's anything else that's needed. Hold on one second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the other one was just that the benefit maximum um had been met for the day. So, once we receive the explanation of benefits from primary insurance, we can go ahead and continue processing and give it your decision.
[CUSTOMER][POSITIVE] OK, I will contact them. Thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much.
[AGENT][POSITIVE] All right, well, again, all the information provided was a verification of benefits, not a guarantee of payment, and thank you so much for calling APL Ms. [PII]. I hope you have a great evening.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye.