AccountId: 011433970860
ContactId: 325992df-bda9-4e69-b41e-81d6f9b2f16b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361839 ms
Total Talk Time (AGENT): 204564 ms
Total Talk Time (CUSTOMER): 97274 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/325992df-bda9-4e69-b41e-81d6f9b2f16b_20250214T14:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm checking on my claims file.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with your claim. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you for that and your name and the member's policy number?
[CUSTOMER][NEUTRAL] Sure, I don't have my policy number with me, but um it's [PII]
[AGENT][NEUTRAL] OK, and you are the insured. I'm sorry, I thought you were calling from a provider's office. OK.
[CUSTOMER][NEUTRAL] Uh-huh. Yeah, I'm sorry.
[AGENT][NEUTRAL] It's OK and Ms. [PII], um, I can look the policy up with your social if you like.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I just need you to verify your date of, actually, hold on one second, it didn't come up. I thought it was going to.
[AGENT][POSITIVE] Sorry about that, it's kind of taking its time here.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] and sma.
[AGENT][NEUTRAL] And it was [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not sure, let me try with the name.
[AGENT][NEUTRAL] What type of policy is it?
[CUSTOMER][NEUTRAL] It's um.
[CUSTOMER][NEUTRAL] Um, I'm calling about the accident, the accident policy and the wellness claims.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And wellness, OK.
[AGENT][NEUTRAL] Here you go. I don't know why I didn't come up with the social, the socials here, but when I put your name in it came right up. So I'm sorry about that. Hold on one moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK. And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Sure, um.
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII] and the email is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So the first one I pulled up was the accident, um, so the, there's an accident claim and a wellness claim or the wellness claim is on the accident policy. OK.
[CUSTOMER][NEUTRAL] Mhm, there's both.
[AGENT][NEUTRAL] Both, OK.
[AGENT][NEUTRAL] So for accident, it looks like the last um claim we received was back on [PII]. Would there should there be something after this?
[CUSTOMER][NEUTRAL] Mm mm, no, I have, mhm, yeah.
[AGENT][NEUTRAL] OK, let me check for the other ones and see because accident doesn't have anything on it. Well this claim would be on cancer. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Critical illness and there goes the cancer claim our policy.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Yeah, OK, so how were the claims sent?
[CUSTOMER][NEUTRAL] They're in there because I could see them in there.
[AGENT][NEUTRAL] Oh, wait, so maybe this is it because when I go to um
[AGENT][NEUTRAL] The cancer policy is the same date, [PII]. So is this the one you do want?
[CUSTOMER][NEUTRAL] No, let me, no, hold on, let me pull it up. I just did it, um, just.
[AGENT][NEUTRAL] Or if you see a claim number, let me, let me know.
[CUSTOMER][NEUTRAL] Yeah, let me see, hang on.
[CUSTOMER][NEUTRAL] T.
[CUSTOMER][NEUTRAL] Just a second, let me pull it up.
[AGENT][NEUTRAL] Mhm. Take your time. I'm gonna look at the other two policies and try to find it. It might be because I only check accident and cancer. Let me look at the critical illness or the your medical one.
[CUSTOMER][NEUTRAL] No, it's, it's, it's under because I have an accident.
[CUSTOMER][NEUTRAL] Claim as well.
[AGENT][NEUTRAL] Wait a minute, is it for you or your husband?
[CUSTOMER][NEUTRAL] For my husband.
[AGENT][NEUTRAL] OK, now that's why, because I'm looking under you. Hold on one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So let me go back, which one is this? This is cancer. Let me go back to asking. I'm sorry about that. I should have asked if it was for you or your husband. I didn't even.
[AGENT][NEUTRAL] Think about the um spouse on the on the policy. So yes, for the cancer policy, I do see the wellness claim that came in on [PII] for your husband, um that is currently in processing.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then let me check on accident. Hold on one second.
[AGENT][NEUTRAL] Accident as well, um, but he has 3. So there was one that was received on [PII] and then two that were received on [PII], but they're all in processing.
[CUSTOMER][POSITIVE] OK. All right, thank you so much.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] You're welcome. It's usually a
[CUSTOMER][NEUTRAL] How long does it normally take?
[AGENT][NEUTRAL] Uh, a 7 to 10 business day turnaround and I do see that you have direct deposit. So you're going to receive, um, depending on how you set it up, you'll receive a text message that the claim has finished processing and then you can go online to see the decision, but then it will also be, um, it'll be direct deposited to you as well, but once you see that decision on there, you know, it's been sent to your bank.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome, Mrs. [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you.