AccountId: 011433970860
ContactId: 59a631df-9d24-4a6c-80c5-acd969b7fa48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195699 ms
Total Talk Time (AGENT): 72732 ms
Total Talk Time (CUSTOMER): 88668 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/59a631df-9d24-4a6c-80c5-acd969b7fa48_20250321T14:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Good morning [PII], this is [PII] over in customer care. How are you today?
[AGENT][NEUTRAL] I'm good, [PII]. How are you?
[CUSTOMER][NEUTRAL] I'm good thank you for asking um I have a question on a claim. If I give you a claim number, is that maybe something you could look at and try and help me decipher what the denial is for?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, awesome. Do you want the policy number or claim number?
[AGENT][NEUTRAL] Uh, let me get the policy number first.
[CUSTOMER][NEUTRAL] OK, no worries. It's 244-617-6.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then the claim is for [PII] and it's claim number 357.
[CUSTOMER][NEUTRAL] 553 1.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so it says index error see part two, and the insured's calling on a wellness claim that was submitted one for her and then one for the husband. I see the husband's one was paid.
[CUSTOMER][NEUTRAL] But I'm not sure what the error was on [PII] and they just wanna know if they need to submit anything else.
[AGENT][NEUTRAL] OK, yeah, let me take a look at what was submitted.
[CUSTOMER][NEUTRAL] And then I was scrolling through that.
[CUSTOMER][NEUTRAL] Based off their policy, it seemed like they both should be able to get a wellness for the year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so [PII] and then [PII].
[AGENT][NEUTRAL] Was mentioned as the patient wellness PSA OK.
[AGENT][NEUTRAL] OK. Also [PII].
[CUSTOMER][NEUTRAL] It looks like they may have submitted both for [PII], huh? I may have just.
[AGENT][NEUTRAL] Yeah, because all of these documents have his name at the top, and we don't, as of right now like I'm on page 11 and I don't see her name on and the form that they filled out had his name and he signed it so it doesn't look like she actually submitted her wellness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, which is why it says see part two because everything submitted was for him.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, that makes total sense now. It was just clicking. I'm, I haven't had enough coffee. I'm sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, that's OK. Look, I get it. I haven't had all mine yet either, and I hadn't been here for about 25 minutes, so I feel you. But yeah, so.
[CUSTOMER][NEUTRAL] Yeah, yeah, me too, girl. Yeah, OK.
[AGENT][NEUTRAL] So if she's trying to submit for herself we did not get that we only got his.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, OK, perfect sense. Thank you so much. I appreciate you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. You're welcome. No problem at all.
[CUSTOMER][POSITIVE] Have a good day.