AccountId: 011433970860
ContactId: 57a47c69-a79b-4a24-820b-26d4e8b56d40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 676919 ms
Total Talk Time (AGENT): 176089 ms
Total Talk Time (CUSTOMER): 168206 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/57a47c69-a79b-4a24-820b-26d4e8b56d40_20250116T16:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I was calling, I'm trying to reach [PII].
[AGENT][NEUTRAL] [PII], and you said the last name was [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and then if you don't mind, can I grab your first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, [PII] and then um can I tell her what it was regarding? Have you been speaking with her in regards to like a claim or something?
[CUSTOMER][NEGATIVE] Yes, it's, it's concerning um my um policy information um on the plan, it's concerning my plan 3.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, um, if you don't mind, let me reach out to her and see if she's available. Is this [PII] a good callback number if anything happens?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, just one moment, let me place you on a brief hold.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] So she did
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for your patience, [PII]. So [PII]'s in a meeting at this moment. If you wanna give me your policy number, she was saying that maybe somebody in customer service could help.
[CUSTOMER][NEUTRAL] Well, the issue is, when I talked to We TPA after um I spoke with [PII] yesterday, [PII] and [PII] had a conversation with [PII] to verify that I was on the plan 3 policy. So Web TPA is telling me that [PII]
[CUSTOMER][NEUTRAL] Or somebody from APL needs to send them the record showing that I have the high plan so that they can they can adjust my claim.
[CUSTOMER][NEUTRAL] So I can give you the claim information. I'm just trying to get my claim adjusted.
[AGENT][NEUTRAL] OK, what's
[CUSTOMER][NEGATIVE] They underpaid me on that policy and
[CUSTOMER][NEUTRAL] I'm, I'm paying for the for the high plan.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, ma'am. OK, let me take a look. If you wanna give me that claim number, I'm happy to check.
[CUSTOMER][NEUTRAL] The, the claim number, um.
[CUSTOMER][NEUTRAL] OK, my, my policy number.
[CUSTOMER][NEUTRAL] Was 21 I mean I'm sorry 002171067-01.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they're saying they need somebody there to send them.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEGATIVE] The correct plan because they're paying, they, they paid $100 a day for my hospital visit when it should have been $800 a day.
[AGENT][POSITIVE] OK, I got you.
[CUSTOMER][NEUTRAL] For the hospital stay.
[AGENT][NEUTRAL] Yes, ma'am. OK. So just for security, can I get your date of birth please and address?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK [PII], let me get somebody on the line and explain to them what's going on here. Give me just one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII] over in customer care. How are you doing today?
[CUSTOMER][POSITIVE] Doing good. How are you?
[AGENT][POSITIVE] Good. Um, I, I have an insured on the line that needs some help. Hopefully, you could help her out. Can I give you the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh, her policy number is gonna be 021-71067.
[CUSTOMER][NEUTRAL] OK. Give me just a second while I pull it up.
[AGENT][NEUTRAL] And it's
[AGENT][POSITIVE] No worries. It should come up for a [PII].
[CUSTOMER][NEUTRAL] OK, I got it.
[AGENT][NEUTRAL] OK, so when she originally came on the line she asked to speak to [PII] in customer service and I reached out to [PII]. She said she's on the phone, hopefully somebody else in customer service could help um what she explained to me that is that she's saying that she has the wrong plan, that she's supposed to have the high plan and that she spoke to web TPA yesterday.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that web TPA is saying that they need something from APL confirming the plan type I guess um she says that she recently had a claim processed for like a hospital stay and the plan paid like $100 but she was supposed to have the higher plan which was 3 or she said $800 a day or something.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's kind of the information I've gotten.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] Uh, OK, this is gonna be a hard one. I'm not quite familiar with these type of policies, but I guess, OK, she elected this plan.
[AGENT][NEUTRAL] She said
[AGENT][NEUTRAL] Yeah, and she said, yeah, she said she, I guess had been talking to [PII] yesterday, but.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, OK. So they are requesting us to send something with the plan that she currently has.
[CUSTOMER][NEUTRAL] Um, OK. Give me just a second. I'm gonna see if we have any correspondence from her application.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I think we do have something from her.
[CUSTOMER][NEUTRAL] Actually yesterday.
[CUSTOMER][NEUTRAL] Uh, no facts.
[CUSTOMER][NEUTRAL] Um, insurance.
[CUSTOMER][NEUTRAL] OK, it was the claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, you can go ahead and um send her over. I will take care of it.
[AGENT][POSITIVE] All right, thank you so much for your help. I appreciate you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Here she comes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Good morning, Ms. [PII].
[CUSTOMER][POSITIVE] Good morning.
[CUSTOMER][NEUTRAL] Hello, this is [PII]