AccountId: 011433970860
ContactId: 6644e856-7ca2-44ff-946f-4d1dc246b80a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 910400 ms
Total Talk Time (AGENT): 197652 ms
Total Talk Time (CUSTOMER): 167951 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/2025/03/20/6644e856-7ca2-44ff-946f-4d1dc246b80a_20250320T16:00_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Good morning. Yeah, I have a question. Um, I, well, I think that they submitted a claim and I got two notices and I was confused, um, with the outcome. One said that the claim, I don't have them in front of me, but one was something about um.
[CUSTOMER][NEUTRAL] It was an office visit and it wasn't a hospital visit, and then the other one said my insurance was terminated, which it's not, so I don't know.
[CUSTOMER][NEUTRAL] What's going on.
[AGENT][NEUTRAL] Um, OK. And do you have the policy number?
[CUSTOMER][NEUTRAL] Mm, I don't with me. I don't have my new card with me. Let me see if I have my old card.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Cause I think the old one cause they changed it, so.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do I do with them.
[CUSTOMER][NEUTRAL] I don't have it.
[AGENT][NEUTRAL] Mm. OK. Um,
[CUSTOMER][NEUTRAL] Let me see if I can.
[AGENT][NEUTRAL] OK. Let me have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] OK. It's [PII].
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Did I do it? I thought they had the old one. Yes.
[AGENT][NEUTRAL] 5 696
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I I think I left it on the.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] May I have your date of birth?
[CUSTOMER][NEUTRAL] Yeah, I don't have it.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and may I have the mailing address and email address on file for verification?
[CUSTOMER][NEUTRAL] It's uh [PII] and then I believe the email is my work which is [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, let me look at these two claims. Do you mind holding for me?
[CUSTOMER][NEUTRAL] Mm, no.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I went ahead and pulled the claims um that we have recently processed for you or for your dependent. Um, I see that for you we did process one recently, um, [PII], but that one was denied because it was an office visit and we do not cover office visits.
[AGENT][NEUTRAL] But I don't see anything else coming through for this year or recent.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, are you still there, Miss [PII]?
[AGENT][NEUTRAL] Hello, Miss [PII].
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Can you hear me, Miss [PII]?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding, Miss [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm sorry. I'm not sure what happened. I came back, but it was empty. OK. Um, so, um, I have, um, reviewed all the claims that I found on your policy with us and um the only thing I found was the one that we recently processed on [PII], and that one was denied as office visits are not covered by the policy. I don't see any other claims with us.
[CUSTOMER][NEUTRAL] It would have
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] I'm sorry, I can hardly hear you. Can you repeat?
[CUSTOMER][NEUTRAL] I said it would have been for uh the claim would have been for [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Cause the, the office, there was an office visit through Loveless, but that was not the hospital stay. So I don't know if they tried to put that claim through.
[CUSTOMER][NEUTRAL] Or what? I don't know.
[AGENT][NEUTRAL] It doesn't look like we have received that claim as of today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so do I need to contact them again and see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's going on.
[AGENT][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] What do I, what I need to do.
[AGENT][NEUTRAL] OK, um, yeah, yeah, you need to contact them and see, uh, where did they send the claim, um, if they need to send it again. Um, let me give you the policy number and let me give you the address where to send it because we have not received that claim as of today, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So, um, let me know when you're ready and I can give you the policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK. So your policy number is 02.
[AGENT][NEUTRAL] 12.
[AGENT][NEUTRAL] 62
[AGENT][NEUTRAL] 87.
[CUSTOMER][NEUTRAL] OK, 02126287?
[AGENT][NEUTRAL] Yes, that is correct. And the address to submit claims is going to be [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the zip code is [PII].
[AGENT][NEUTRAL] [PII]. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] So, can you repeat it? OK.
[AGENT][NEUTRAL] Sure, yes, it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I will contact them and see what happened because I did get a notice that it, the office visit, but then I also got another notice that it was my, my APL was, had been terminated at the time, which I don't think it was. I don't know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, I don't, I don't, I, I went ahead and looked into all the policies you have with us if you had anything else, but I didn't find anything else. I only have this one and um this one was effective from [PII] and it's still active and there's no other claims on file and there's definitely not one for [PII] or [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. So I'll contact them and we'll go from there. Thank you.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, well, you're welcome and thank you for calling APL. Have a good day, Miss [PII].
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.