AccountId: 011433970860
ContactId: 67b2d0ac-97ad-4c3a-9a1a-1636fbfdfbd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423579 ms
Total Talk Time (AGENT): 181345 ms
Total Talk Time (CUSTOMER): 219758 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/67b2d0ac-97ad-4c3a-9a1a-1636fbfdfbd6_20250418T19:54_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good afternoon. How are you?
[AGENT][POSITIVE] I'm doing well how are you doing today, ma'am?
[CUSTOMER][POSITIVE] I'm excellent, thank you. Um, I have two questions, um, and I can give you my social to verify my account because I don't have my, um, account number.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, um, 1st may I get your name and your callback number just in case our call is disconnected.
[CUSTOMER][NEUTRAL] Yeah, uh, my name is [PII]. My phone number [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is your social so I can pull up your policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me look up your policy real quick, Ms. [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] All right, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number, and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII], uh [PII].
[AGENT][NEUTRAL] OK, and then the phone number that you just verified for me to call back on, is that your cell?
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] OK, thank you. And you said you had some questions about your policy. How can I help you?
[CUSTOMER][NEGATIVE] So first question is I submitted a claim uh I think 2 or 3 days ago, um, it says it was processed and I wanted to know um why it wasn't paid.
[AGENT][NEUTRAL] OK, let me look up that claim real quick. I do see there was one submitted on [PII], and that's the most recent. OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so on the claim, it was denied because durable medical equipment is not covered under your plan.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, OK. OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That, that's understood. Yeah. Um, my other question is, um, my, my policy ends, um, at the end of, uh, this month, I believe.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um, because my insurance, my insurance ends as well, and, um, I had surgery, um, in March, and some of my claims are still being processed. So my question is, am I still able to submit claims, uh, even after my policy ends for any claims from like March?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, you'll be able to submit claims at any time as long as your policy was active on the date of service. So if you had had claims in March, it looks like uh you said it ends this month.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, so, so my, my insurance, um, with my company, um, it, it ends this month and I'm on my husband's insurance, um, moving forward, so I, I wanted to keep my, my gap policy, but, um, when I called a few uh weeks ago, um, the lady explained to me that it's a policy through my job, so I can't, I won't be able to pay for it independently.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Right, that's correct.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, and you guys don't have any, any, any independent policies like um like where I could pay for a policy out of my pocket, correct?
[AGENT][NEUTRAL] That's right, we only do policies through groups through work.
[AGENT][NEUTRAL] Employers
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] We don't, yeah.
[CUSTOMER][NEUTRAL] OK, yeah, I'm, I'm not.
[CUSTOMER][POSITIVE] Keeping the, yeah, because my the insurance that my company has is the exact same insurance that my husband's job has, um, and my husband's job covers it 100% so.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Mhm. Yes, yes, so that's a good deal for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, uh, but I had a, I had surgery, uh, you know, in March, and I just wanted to make sure that, you know, when the bill comes, you know, I will at least be able to submit the claim so I can pay off those bills.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Right. I understand. Now, looking at your policy,
[AGENT][NEUTRAL] It is still active and the pay to date is [PII].
[AGENT][NEUTRAL] So if, so, so, um,
[CUSTOMER][NEUTRAL] I don't know what that means.
[AGENT][NEUTRAL] The pay to date is the date that it's active till. So right now it's saying [PII]. So I don't know if another payment is going to come in.
[AGENT][NEUTRAL] And get you to [PII].
[CUSTOMER][NEUTRAL] Yeah, I pay on my I pay on my check. Yeah.
[AGENT][NEUTRAL] OK. All right. All right. So that may,
[CUSTOMER][NEUTRAL] Yeah, because it should, because my, my, my insurance is still my, my insurance with my job is active until [PII] of this year.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK, good. OK, yes, so, um, yeah, if it's active until [PII], then you should be able to file for March.
[CUSTOMER][NEUTRAL] Yeah, mhm.
[CUSTOMER][NEUTRAL] OK, perfect. So but I haven't gotten any of the bills yet, so um if I if I get it in, in let's say June, I would still be able to submit those.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes ma'am you can you can still submit them.
[CUSTOMER][NEUTRAL] And then will, will I still have access to the online portal even if my policy is not active, or do I need to call to do the claim?
[AGENT][NEUTRAL] No, um, if your policy lapses is no longer active, then you will not have access to the portal, but you can fax in your claim or mail in your claim.
[CUSTOMER][POSITIVE] OK. OK, sounds good.
[AGENT][NEUTRAL] Do you have those numbers?
[CUSTOMER][NEUTRAL] Uh, I, yeah, I think everything is on the, the claim form, yeah.
[AGENT][POSITIVE] OK. Yes, ma'am. You're right.
[CUSTOMER][POSITIVE] Mhm. OK, well thank you so much, ma'am and you have a great weekend.
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] You have a wonderful weekend too. We appreciate you very much for calling APL.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yes ma'am thank you have a good day.
[AGENT][NEUTRAL] You too. Bye-bye.