AccountId: 011433970860
ContactId: 4ebf37ed-4b19-40e1-bd59-cd0750aacfad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 525559 ms
Total Talk Time (AGENT): 121864 ms
Total Talk Time (CUSTOMER): 219916 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/4ebf37ed-4b19-40e1-bd59-cd0750aacfad_20250429T14:39_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I had, uh, I have a plan with you guys and I had surgery and um they uh they're, they're charging me a claim because they never submitted to a secondary insurance uh claim, um, but they gave me a form to send to you guys.
[CUSTOMER][NEUTRAL] Um, to, to have, uh, to claim the, the cost of the fling.
[AGENT][NEUTRAL] Can I have your name and callback number, and the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, uh, my name is [PII].
[CUSTOMER][NEUTRAL] Uh, the policy number, uh, would that be the payer ID?
[AGENT][NEUTRAL] No, it should say cert or policy number.
[CUSTOMER][NEUTRAL] OK, I have a group number. I have a coverage says individual. Oh yeah, I'm sorry, I, uh, hospital or outpatient?
[AGENT][NEUTRAL] It doesn't matter.
[CUSTOMER][NEUTRAL] OK. 025.
[CUSTOMER][NEUTRAL] 80209 M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] Could you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII], and my uh date of birth is [PII].
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Your phone went out. What was your date of birth?
[CUSTOMER][NEUTRAL] Yes, can you hear me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And could you verify the email address that we have on file for you?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII].
[AGENT][NEUTRAL] Do you recall the email address you used when you signed up with the benefit for the benefits?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh yeah.
[AGENT][NEUTRAL] And what is the email address?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Give me one moment while my system closed down.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] I do apologize. May I place you on a brief hold?
[CUSTOMER][POSITIVE] Yeah, don't worry thank you.
[AGENT][POSITIVE] Thank you. I apologize.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding so my system has closed down, so if possible, could you give me your policy number again if you don't mind? I do apologize for the inconvenience.
[CUSTOMER][POSITIVE] Yeah, no, no, don't worry about it.
[CUSTOMER][NEUTRAL] That's 025.
[CUSTOMER][NEUTRAL] 80209
[CUSTOMER][NEUTRAL] M as in Mary. L as in Larry.
[CUSTOMER][NEUTRAL] 8
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And could you give me the email address that you use when you signed up for the policy?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, uh, you see this, this, this, uh, was done through my company, the company I work for, so I don't know if they put my, my company email and we have like 3 emails, but the one I use for my, for everything is my first [PII].
[AGENT][NEUTRAL] Now what is your work email?
[CUSTOMER][NEUTRAL] Uh, give me a second, hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so that's [PII]
[CUSTOMER][NEUTRAL] And the last name [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] With [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, we have another one.
[CUSTOMER][NEUTRAL] OK, let me see, hold on.
[CUSTOMER][NEUTRAL] Uh, it could be the old, um, what about [PII]?
[AGENT][NEUTRAL] Yes, that's correct. So would you like to update this to your, your personal email address so that way you, when you do call us back and us for us to verify your identity, you don't have to puzzle your brain about the email address.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So what's your personal email address?
[CUSTOMER][NEUTRAL] Is my first name [PII].
[CUSTOMER][NEUTRAL] Last name [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So hold on, so it's [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, between first name and last name there's a dot in the middle.
[AGENT][NEUTRAL] OK, between first name and last name, there's a dot in the middle. So what comes after your last name?
[CUSTOMER][NEUTRAL] First name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII]. [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, and would you like for us to have a callback number on file for you?
[CUSTOMER][NEUTRAL] Are you
[CUSTOMER][NEUTRAL] Um, yeah, sure. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, so now you're calling about a claim. Do you recall the date of service?
[CUSTOMER][NEUTRAL] Uh yeah, let me give it to you right now.
[AGENT][POSITIVE] And thank you for your patience.
[CUSTOMER][NEUTRAL] No, no problem. The date of service should be hold on, let me make sure they put the right one because I know the day of service, but you know, the insurance company, these, these people are always, yeah, it's [PII] 1425.
[AGENT][NEUTRAL] OK, for a facility charge?
[CUSTOMER][NEUTRAL] Let.
[CUSTOMER][NEUTRAL] Um, no, it's a, um, it's, it's called chromium clavicular sling. It's a sling that they put after shoulder surgery.
[AGENT][NEUTRAL] Your DME. So you're calling about doable medical equipment.
[AGENT][NEUTRAL] The swing that they put your your arm in.
[CUSTOMER][NEUTRAL] I guess
[CUSTOMER][NEUTRAL] Yeah, yeah, they, they bill me, they billed me.
[AGENT][NEUTRAL] So you want to verify if it's covered?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So you don't have DME coverage on your policy?
[CUSTOMER][NEUTRAL] No? OK.
[AGENT][NEUTRAL] No, those are for the medical supplies, correct?
[CUSTOMER][NEUTRAL] OK, so, so this, OK, so then I have to pay it, OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Thanks for calling APL and have a great day. Goodbye.
[CUSTOMER][NEUTRAL] You too bye bye.