AccountId: 011433970860
ContactId: 4d71bdb9-4f20-43f7-b654-e4569a412583
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358390 ms
Total Talk Time (AGENT): 131226 ms
Total Talk Time (CUSTOMER): 92497 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/4d71bdb9-4f20-43f7-b654-e4569a412583_20250513T17:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII]. Uh, I got, I had a question. I got blood work done on February of this year, and I was wondering if the, the blood work was covered through my insurance. I have sent the claims and everything. Uh, I haven't heard back from my insurance.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Oh absolutely I can check your claim status for you [PII]. Can you please give me your call back number sir just in case the call is dropped.
[CUSTOMER][NEUTRAL] OK, uh, yes, it'll be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy, uh, it would be 02584974.
[AGENT][NEUTRAL] OK, let me pull that up.
[AGENT][NEUTRAL] OK, [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yes, uh, [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So my address is [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And what else did you ask?
[AGENT][NEUTRAL] The email address and the phone number on file, please.
[CUSTOMER][NEUTRAL] OK, email, I believe my email on file is [PII].
[AGENT][NEUTRAL] No, it's another one [PII] though.
[CUSTOMER][NEUTRAL] And the phone number is the same [PII].
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] Yes, there you go.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] There you go.
[AGENT][NEUTRAL] Yes, sir, that
[AGENT][POSITIVE] Alright, thank you for verifying your policy for me.
[AGENT][NEUTRAL] And do you know when you sent in the claim?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't remember exactly which date, but I had gotten the blood work done on the [PII], so probably a week after.
[AGENT][NEUTRAL] OK. Let me see.
[AGENT][NEUTRAL] What was the name of the facility you went to and what was the date of service?
[CUSTOMER][NEUTRAL] It was Quest Diagnostics and the date of service was on the [PII].
[AGENT][NEUTRAL] 214 of 25.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right. Let me look.
[AGENT][NEUTRAL] I can find this.
[AGENT][NEUTRAL] OK, and do you know um what the amount was on your bill?
[CUSTOMER][NEUTRAL] Yeah, so the total amount.
[CUSTOMER][NEUTRAL] Was $2,519.
[AGENT][NEUTRAL] OK, let me see if I can find that claim real quick.
[AGENT][NEUTRAL] Just give me just a second while I look it up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the claim, um.
[AGENT][NEUTRAL] It's a remark on it that this policy does not provide a wellness expense benefit so that it was a wellness claim that was sent in but it doesn't provide wellness benefits on your policy.
[CUSTOMER][NEGATIVE] So none, none of it was.
[CUSTOMER][NEUTRAL] Pay for it?
[AGENT][POSITIVE] Correct.
[AGENT][NEGATIVE] It's not covered on your policy.
[CUSTOMER][NEUTRAL] Is there anything that could be done to cover it, or am I just out of luck on this one?
[AGENT][NEUTRAL] Uh, under your policy certificate, you don't have any wellness benefits, so the policy, you know, does not support the wellness claim. Now if you wanted to get with your employer and see if they have a policy that will support wellness claims, you can check with them and see, you know, if there's something that you can get where you can get wellness benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, as of right now, there's just nothing I can do about it.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Because it's non-covered under the plan you have now.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] OK. Well, thank you. Thank you very much for the help.
[AGENT][POSITIVE] You're, well, you're very welcome, [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, that's pretty much it.
[AGENT][POSITIVE] OK, well, I hope you have a blessed day and thank you for calling APL, sir.
[CUSTOMER][POSITIVE] Of course, you too. Thank you, bye-bye.
[AGENT][NEUTRAL] Bye-bye, sir.