AccountId: 011433970860
ContactId: 5005a633-255f-4ea3-bace-b315ea490e1c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197160 ms
Total Talk Time (AGENT): 88665 ms
Total Talk Time (CUSTOMER): 98267 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/5005a633-255f-4ea3-bace-b315ea490e1c_20250116T16:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning, [PII]. This is [PII] in customer service.
[AGENT][POSITIVE] Good morning.
[CUSTOMER][NEUTRAL] Uh, I have Ms. [PII], uh, policy 21.
[CUSTOMER][NEUTRAL] 71067.
[AGENT][NEUTRAL] That was 21.
[CUSTOMER][NEUTRAL] 71
[AGENT][NEUTRAL] 71067.
[CUSTOMER][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] All right. She's reaching out to us because um she was recently paid a claim um apparently with the lowest uh plan, but I see here in our sys.
[CUSTOMER][NEUTRAL] That she has the highest plan, um, I think she only received like $100.
[AGENT][NEUTRAL] We don't handle these claims. This is, this is, um, web TPA.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so that will go direct.
[AGENT][NEGATIVE] Should have to be transferred to web TPA.
[CUSTOMER][NEUTRAL] Well, she already did, and they, and they sent her to us so that we correct that claim paid to her.
[CUSTOMER][NEUTRAL] Uh, so I'm not sure.
[AGENT][NEUTRAL] Yeah, any claims processed by web TPA will be handled by them. We don't process their claims.
[AGENT][NEUTRAL] We don't have access to the claims system for web TPA claims. I can't see any of that on my end. What comes up on my end is a a a warning sign that um claims are handled by web TPA.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did she, what type of claim did she say the only thing that I see, she, her her hospital indemnity is through web TPA. She has a disability, a group term life policy, and a dental policy.
[CUSTOMER][NEUTRAL] Um, the one, I have here, it's only the, uh, where to be, the accident, no.
[AGENT][NEUTRAL] She gave you a claim number?
[CUSTOMER][NEUTRAL] Well, we were first revi um reviewing her plan because she was paid as lowest plan, so she thought she was enrolled with the lowest with us. Um, but looking into her policy, I see that she has the highest. So that's when I, uh, we kind of deduct that it was a claim that went wrong there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah, it sounds like that must be under her, her um hospital indemnity, but those claims are processed through web TPA so we can't see those that claim information on our end.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We tra we transfer them to web TPA.
[CUSTOMER][POSITIVE] All right, I got it.
[AGENT][NEUTRAL] Do you want me to give her the, do you wanna give her the number because when you give it to me. I'm just gonna transfer over to web TPA.
[CUSTOMER][NEUTRAL] Yes, um, can you provide it to me, please?
[AGENT][NEUTRAL] Yeah, the number is 18669759458.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, just make.
[AGENT][NEGATIVE] You keep cutting out.
[CUSTOMER][NEUTRAL] 86
[CUSTOMER][NEUTRAL] OK, can you hear me?
[AGENT][NEUTRAL] Yeah I can hear you now.
[CUSTOMER][NEUTRAL] OK, 866.
[CUSTOMER][NEUTRAL] 9759458.
[AGENT][NEUTRAL] 975.
[AGENT][NEUTRAL] 9458, yes, yeah, we transfer them to one of their representatives over there and they handle it.
[CUSTOMER][POSITIVE] All right, I got it.
[CUSTOMER][POSITIVE] All right, I got it. Thank you.
[AGENT][POSITIVE] OK. You're welcome.