AccountId: 011433970860
ContactId: 34bf5a98-9a18-4277-bcb4-db185950bfeb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 458369 ms
Total Talk Time (AGENT): 222816 ms
Total Talk Time (CUSTOMER): 172919 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/34bf5a98-9a18-4277-bcb4-db185950bfeb_20241230T15:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling to see if y'all received uh my medical history, your information on the claim that I submitted.
[AGENT][NEUTRAL] OK, so you submitted some information to APO and you're wanting to see if that has been received, is that correct?
[CUSTOMER][POSITIVE] Yes ma'am, that is correct.
[AGENT][POSITIVE] OK. Yes, ma'am. I can help you with that. Oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I think it already
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I already received the claim. I just need additional information.
[AGENT][NEUTRAL] OK, and who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you. And Miss [PII], what's a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your policy number?
[CUSTOMER][NEUTRAL] I don't have a policy number. You can look it up by my social.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] 436271866
[AGENT][NEUTRAL] 1866.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And which policy are you calling about?
[CUSTOMER][NEUTRAL] It's an accident.
[AGENT][NEUTRAL] OK, and Miss [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. I will need to verify several things with you first for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number we have for you is the same as the one that you provided for me, so that is your best number, is that correct? OK, and lastly.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] Uh-huh. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you and lastly your email address?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. So I do see that on the [PII] there was some additional information received, Miss [PII], but that is still in line for review. It has not it has not been reviewed yet, so I can't answer the question as far as if that's exactly what we needed, but it is in line. We did receive it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you did receive it. OK, that's what I wanted to know. OK, and also I wanna ask you, um, do y'all have, I try to sign on, but every time I signed on to the website it says something went wrong, so I don't know what's going on with the website because I was trying to look it up myself.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][NEUTRAL] Are you on a computer or are you on your phone?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] No, I was on my laptop. I have at home. I have a personal laptop, but it, I couldn't do anything, so I didn't know what for sure what was going on. I'll try again today when I get home and see if I can get on and then let y'all know because I think y'all may have send me a schedule benefit for like if someone has cancer or or what y'all pay out. What do y'all pay out for a fracture of the ankle?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The benefits, so I need to talk to another department for that.
[AGENT][NEUTRAL] No, ma'am. I can look at your policy information, but give me just a second. I'll
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I was gonna try to see if.
[CUSTOMER][NEUTRAL] I guess if I was able to get into it, I would have been able to see it. Like I said, I've been experiencing problems, but I will try again this, this evening.
[AGENT][NEUTRAL] Yeah, I don't
[AGENT][NEUTRAL] And what would you, what username were you using?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] OK, so that's not the username that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's not
[AGENT][NEUTRAL] No, ma'am. Your username, according to your profile is [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Lowercase [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, so I was using my middle name is [PII]. I thought it was [PII] OK, that maybe what's name to get into it. OK, so it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct. And the [PII] is the only thing that is [PII].
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] That's [PII]. OK, OK, OK, that's fine.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and you wanted to know what the benefit amount is in this policy, is that correct?
[CUSTOMER][NEUTRAL] Uh-huh. Yes.
[AGENT][NEUTRAL] OK, and any benefit information as I stated before would be a verification of benefits and not a guarantee of payment. So give me a moment to get that policy information pulled up. You're welcome.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, for an open reduction on a, on, and again, this information is in your policy certificate because you do have, you know, there's different benefits set amounts for initial treatment like for the emergency room, so on and so forth, X-rays, diagnostic. Now, for fractures, did you have surgery?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh, no. I had to wear a boot though and, and physical therapy. But, yeah, both.
[AGENT][NEUTRAL] OK. So let's see. This, OK, so under fractures, it's broken out into open reduction and closed reduction. And for the foot excluding toes, ankle, heel, and kneecap, it shows the open reduction benefit amount of $900 and a closed of $450.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK, and like I said I can get in to look at it today and stuff because I think I may have once I get in I'll be able to look at that information.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, you should be able to, yes ma'am, because it's probably it was probably your username if you were trying to use the other.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that's, that would have been that would have been the reason, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Right, right. Right. Yes, I'll look, I'll look when I get home and stuff. Thank you so much.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, and then if you have any other questions, please give us a call back we'd be more than happy to help you.
[CUSTOMER][POSITIVE] Sure will thanks bye bye.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you again for calling APL. I hope you have a great day and a very um happy New Year, Miss [PII].
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Happy holidays to you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.