AccountId: 011433970860
ContactId: 5ae7b6d4-2935-4634-b31b-a2471dc1b46b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 146229 ms
Total Talk Time (AGENT): 30655 ms
Total Talk Time (CUSTOMER): 93132 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/5ae7b6d4-2935-4634-b31b-a2471dc1b46b_20250403T15:56_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[AGENT][NEUTRAL] I'm fine, thanks. How are you?
[CUSTOMER][POSITIVE] I'm doing good. Um, I have a
[CUSTOMER][NEUTRAL] Insured on the other line that needs to speak with um someone, can you look at this policy with me?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, it's policy number 221-854-1 for part 4.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the, the last 3 claims that we processed for her, uh, really 4.
[CUSTOMER][NEUTRAL] Um, starting [PII] up.
[CUSTOMER][NEGATIVE] So the [PII] and the [PII] were denied um.
[CUSTOMER][NEUTRAL] But then she's asking if the deductible.
[CUSTOMER][NEUTRAL] She wants to talk about the deductible. I told her that the deductible was met, but she wants to know why the other um claim, hold on one second, my line is just flicking. I'm sorry.
[AGENT][NEUTRAL] You're fine.
[CUSTOMER][NEGATIVE] She just wants more clarity about her claims and applied to deductible versus pay because the 4th, the one received on [PII] was paid $4000 but then the one after that was denied and I'm trying to get to.
[CUSTOMER][NEUTRAL] My REMRI and everything's just blinking.
[AGENT][NEUTRAL] OK, give me just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I can see just by looking at it, the emergency room, like there's no deductible for those benefits, so that's why that one was paid.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So let me see.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] I don't need to transfer. It just stopped blinking and I see what the outpatient, it says outpatient benefit for the calendar year met. So that's why that second one, she had already, the 4000 maxed it out when we paid the ER. OK, I just couldn't get to it.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] And I'm like, hold on, OK, um, I can handle it. Thank you though.
[AGENT][NEUTRAL] OK, you sure?
[CUSTOMER][POSITIVE] Yes, I'm good.
[AGENT][NEUTRAL] OK, yeah, well, let me know if you have any other questions.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right thank you [PII].
[AGENT][POSITIVE] OK thanks.
[AGENT][POSITIVE] You're welcome bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.