AccountId: 011433970860
ContactId: 58b118a8-56f4-41da-944e-3e8a55481347
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175979 ms
Total Talk Time (AGENT): 56602 ms
Total Talk Time (CUSTOMER): 46372 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/58b118a8-56f4-41da-944e-3e8a55481347_20250428T18:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, I'm calling for my son because he you know he works business hours, but, um, he received a letter from your company and it says, uh, dear policy uh policy holder, he doesn't know what is, why, why, why he received this. We received a claim on your policy and a review of the claim has started in some cases the additional information must be requested from you or your provider.
[CUSTOMER][NEUTRAL] So we don't know what it's related to.
[AGENT][NEUTRAL] OK, on the letter does it have a claim number?
[CUSTOMER][NEUTRAL] No, I think that claims department number, your phone number, but no claim number.
[AGENT][NEUTRAL] OK. Do you have the policy number? I can pull that up.
[CUSTOMER][NEUTRAL] No, there's no policy number on it.
[AGENT][NEUTRAL] What is
[CUSTOMER][NEUTRAL] It was dated [PII].
[AGENT][NEUTRAL] OK, so I'll need to look up the insured. I can do that by name or social, whichever you would prefer to give me.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]
[AGENT][POSITIVE] Alright. Thank you so much. Give me just one moment, please.
[AGENT][NEUTRAL] What is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Did he recently go see a provider, a doctor?
[CUSTOMER][NEUTRAL] Well yeah, I mean.
[CUSTOMER][NEUTRAL] But at that time he didn't have insurance.
[AGENT][NEUTRAL] Yeah, so it looks like there was a provider physicians East for a date of service of [PII]. If they had this insurance on file, it looks like they just submitted a claim to it. The policy is not active, so therefore it's just denied due to the policy not being active.
[AGENT][NEUTRAL] So it would just be the provider that submitted that information. Um, they must have just still had this on file as the insurance.
[CUSTOMER][POSITIVE] OK. All right, that makes sense. OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.