AccountId: 011433970860
ContactId: 3d38caa2-0e46-4545-af0d-482104f7c576
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437700 ms
Total Talk Time (AGENT): 157188 ms
Total Talk Time (CUSTOMER): 156582 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/3d38caa2-0e46-4545-af0d-482104f7c576_20250411T16:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi there, um, I was calling because I have a couple of copay. I have you guys as a, um, gap insurance for my employer, and I have a couple copays, um, they're showing, uh, my hospital is billing me for them even though they should be covered by you guys.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, um, I can.
[CUSTOMER][NEGATIVE] And I'm pretty sure they said they were submitted, but I don't know why they weren't approved.
[AGENT][NEUTRAL] OK, I can help you with claim status um can I please get your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 0939.
[AGENT][NEUTRAL] Thank you, Miss [PII]. And then what is your uh your policy number?
[CUSTOMER][NEUTRAL] Uh one moment.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] The inpatient or the in hospital or the outpatient?
[AGENT][NEUTRAL] Either one will help me pull in your policy.
[CUSTOMER][NEUTRAL] Doesn't matter.
[CUSTOMER][NEUTRAL] OK. 025.
[CUSTOMER][NEUTRAL] 06454
[CUSTOMER][NEUTRAL] N as in Matthew. L as in Link.
[CUSTOMER][NEUTRAL] And the number 8.
[AGENT][NEUTRAL] OK, let me pull up your policy real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then I'm also gonna need for you to verify your address, a phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Yeah, uh, [PII], um, it's [PII].
[CUSTOMER][NEUTRAL] And then [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy for me.
[AGENT][NEUTRAL] OK, do you know, um, you said the claims have been submitted, do you know when they were sent in?
[CUSTOMER][NEUTRAL] Oh, you know what? I'm looking at it right now and one of them already got.
[CUSTOMER][NEUTRAL] OK, that's good. Um, the one that's on my balance that you um keeps emailing me about is from [PII] of last.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]. OK, let me see what we've got here.
[AGENT][NEUTRAL] That's the data services.
[CUSTOMER][NEUTRAL] It was a
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It was a visit with my oncologist.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Not the [PII], not the [PII].
[AGENT][NEUTRAL] I'm sorry, what did, what did you say?
[CUSTOMER][NEUTRAL] It was not, not the [PII], just the [PII], [PII].
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Alright, I'm trying to pull it up for us now.
[AGENT][NEUTRAL] OK, looking on the data service of [PII], I don't see that the claim was submitted.
[CUSTOMER][POSITIVE] Uh this is something for you and they still it.
[AGENT][NEUTRAL] There's no claim that has been submitted for that date of.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, so then.
[CUSTOMER][NEGATIVE] I gotta call them and have them do it. I feel like when I called them they said that they had done it though, but you haven't received it?
[AGENT][NEUTRAL] No ma'am, not for [PII]. I do not see a claim on file for that data service.
[CUSTOMER][POSITIVE] Alrighty, well that's all that. Thank you.
[AGENT][NEUTRAL] OK. All right. Well, Ms. [PII], is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Nope, that was the only one, can I let you know though, uh, do you see anything in the system for [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] All right. I'll get back where I need to be.
[AGENT][NEUTRAL] No, there's not one for [PII] either.
[CUSTOMER][POSITIVE] OK. All righty.
[CUSTOMER][POSITIVE] Uh, thank you.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] OK, that's everything.
[AGENT][POSITIVE] OK, well you have a wonderful weekend, Miss [PII]. Yes.
[CUSTOMER][NEUTRAL] Oh hey, what else, actually, uh, what else you guys, wait, sorry, um, do you cover, is it just this plan is good for what? Just the copays, anything else?
[AGENT][NEUTRAL] No, ma'am, it's only good for deductible co-pay and co-insurance, and it's based on the EOB from the primary insurance on what they pay.
[CUSTOMER][NEUTRAL] Ah, OK, so you would pay the um the co-insurance as well.
[AGENT][NEUTRAL] Right, deductible, co-pay, and co-insurance for a covered procedure, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, um, have you received anything?
[AGENT][NEUTRAL] And that's just to verify your benefits.
[CUSTOMER][NEUTRAL] Yeah, um, have you received anything for [PII] of last year? Because I keep getting a bill from [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] And I told them that I had a secondary insurance that would explain why.
[AGENT][NEUTRAL] OK, let me look real quick.
[CUSTOMER][NEUTRAL] If they never actually sent it, that's on them at this point.
[AGENT][NEUTRAL] Right, let me see real quick.
[AGENT][NEUTRAL] I'll check that data service.
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEGATIVE] Yes, there's nothing received for [PII] either.
[AGENT][NEUTRAL] For that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, so there we have it, thank you.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is that all I can help you with before you go?
[CUSTOMER][POSITIVE] Yes, it is. Thank you.
[AGENT][POSITIVE] You're welcome. Have a good weekend and thank you for calling APL ma'am.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.