AccountId: 011433970860
ContactId: 2d1bac64-3d40-4496-a461-2c079e73d774
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248520 ms
Total Talk Time (AGENT): 110732 ms
Total Talk Time (CUSTOMER): 114829 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/2d1bac64-3d40-4496-a461-2c079e73d774_20250204T18:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, um, my last name is [PII], I, I have been with you insurance for years. And, uh, um, I went to the hospital, they have uh something because they, you, your APL is my secondary. So my primary already covered some of them. And uh they asked me to pay the left only $22 some dollars, so I told them to claim to you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But right now, they still, they still like tell me to pay, so it, it seems you didn't cover anything. So I just wanted to understand uh why he didn't cover it, yeah. Do you need any, mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Of course, yes, we can definitely take a look at that uh claim and we'll make sure that all of that is accurate um I'm sorry what was your first name please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, what can you say again, what do you, do you want me, my, uh, you want the member ID or my name?
[AGENT][NEUTRAL] What's your name please? Yeah, just so I know who I'm speaking with.
[CUSTOMER][NEUTRAL] Yeah, yeah. My, my first name is [PII] Last name [PII]
[AGENT][POSITIVE] OK, got it and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. And then, yes, if you've got that policy number, please.
[CUSTOMER][NEUTRAL] Yeah, um, I
[CUSTOMER][NEUTRAL] I have my plan number on my card and the member ID group which one.
[AGENT][NEUTRAL] Oh, that's.
[AGENT][POSITIVE] I could take the claim number that's perfectly fine.
[CUSTOMER][NEUTRAL] Uh, no, uh, plan, plan name, actually. I, uh, uh, can I give your member ID?
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yes, uh, I can take that member ID.
[CUSTOMER][NEUTRAL] Or group
[CUSTOMER][NEUTRAL] Yeah, 21.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 77717.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. I'm just gonna verify some information really quick. Um, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] Yes, my date of birth is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright perfect thank you for verifying that information. OK, so give me just a minute let me take a look here.
[AGENT][NEUTRAL] So I do have one claim on file for you. It was for [PII]. Does that sound right to you?
[CUSTOMER][POSITIVE] Yes. Yes, yes. Yes, sir. Yeah.
[AGENT][POSITIVE] OK, perfect. Give me just a moment, let me take a look.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that remaining amount, um, oh goodness I just saw it. 22 $22.87. So that benefit amount that we paid went towards your deductible. So for this plan you also have, you have a deductible of I think it's $100.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, um,
[AGENT][NEUTRAL] Yes, so essentially it would have been covered, but it goes towards that deductible, um, that's resets every calendar year, so just for future so that you are aware, um, that $100 deductible does have to be met first and then we can continue the actual benefit amounts.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see. So I'm gonna pay myself, yeah, OK, just wanted to know.
[AGENT][POSITIVE] Yeah, sorry about the confusion. did you have any other questions for me?
[CUSTOMER][POSITIVE] No, no, that's all for you. Thank you so much.
[AGENT][POSITIVE] OK, of course, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] OK bye bye thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.