AccountId: 011433970860
ContactId: 42374e0f-afe4-495d-b9b5-e8afad8968ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 487059 ms
Total Talk Time (AGENT): 61347 ms
Total Talk Time (CUSTOMER): 86141 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/42374e0f-afe4-495d-b9b5-e8afad8968ea_20250407T12:49_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, I have a claim number.
[CUSTOMER][NEUTRAL] 358-022-1
[AGENT][NEUTRAL] Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] wait what did I say [PII].
[AGENT][NEUTRAL] [PII], and what is your policy number?
[CUSTOMER][NEUTRAL] 01660267.
[AGENT][NEUTRAL] And could you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And you're calling to check the status of a claim [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 0 358-022-1?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] There was a payment of $71.07. How can I assist you today?
[CUSTOMER][NEUTRAL] Oh, the, uh,
[CUSTOMER][NEUTRAL] Um, bill from the lab was, uh, $77.32. There was some kind of differential. I was wondering if there's any information to clarify the differential between the claim for $77.30 on the actual payout of $71.07.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] It looks like you have some prescription.
[AGENT][NEUTRAL] And if it's listed on here as well?
[CUSTOMER][NEUTRAL] I was
[CUSTOMER][NEUTRAL] Yeah, but that was something else that wasn't, and that was denied. I understand that it was, it was, it, I guess it muddied the waters. I didn't realize it sent that to.
[CUSTOMER][NEUTRAL] But the uh lab bill and the uh explanation of benefits was specifically for $77.32.
[AGENT][NEUTRAL] OK, so let me pull up the claim to verify what's going on. May I place you on a brief hold?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding. So I'm looking at the claim at the moment and I do see that there is a shortage. however, I'm gonna have to send this over to the adjuster to review it to verify why there's a shortage because it don't show that your benefits are maxed out. And once it's reviewed if any money is owed, then it will be sent to you.
[CUSTOMER][POSITIVE] OK, we'll settle for such a small amount, but what the heck, let's get it. Let's do what we can. All right, thank you very much. Anything else you need from me?
[AGENT][NEUTRAL] Um, no, that'll be all. Just you called in to with your concerns, so that's all that you needed to do. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] No, we'll just see how it happens in the results. Thank you very much. Have a good day.
[AGENT][POSITIVE] You're welcome thanks for calling AP.