AccountId: 011433970860
ContactId: 6ec938c5-e828-42a0-a00d-39f78968e297
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 538080 ms
Total Talk Time (AGENT): 199507 ms
Total Talk Time (CUSTOMER): 199281 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/6ec938c5-e828-42a0-a00d-39f78968e297_20250616T18:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I had called, um, I spoke to somebody earlier about my claim.
[CUSTOMER][NEUTRAL] I can give you my um policy number if you like.
[AGENT][NEUTRAL] OK, what's your policy number?
[CUSTOMER][NEUTRAL] It's 1836605.
[AGENT][NEUTRAL] And so, I have 183 and what was the rest?
[CUSTOMER][NEUTRAL] 1836605
[AGENT][POSITIVE] Alright, thank you so much. Give me just a moment to look that up.
[AGENT][NEUTRAL] And can I get you to verify your date of birth for me please?
[CUSTOMER][NEUTRAL] Yes, my date of birth is [PII]. Uh, email address you don't want [PII]. Address [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And you had questions about a claim uh for yourself that you just submitted?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] No, no, it's for my daughter [PII] and the claims adjuster.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think yeah I think she was supposed to like check it and get back with me.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I know she's probably busy and stuff like that the weekend probably got to her so, but I, I was just gonna see like if she notated in the, you know, the files that like it wasn't gonna pay out anything, then y'all can tell me that and that's fine cause
[CUSTOMER][NEUTRAL] I was trying to stay in the house and then she called me back, but I really need to get my younger one out, you know, outside to go play and go to the library and stuff. And we may not have a good signal while we're out and about and I don't want to miss the phone call. So I didn't know if her notes had notated uh what the outcome was or she was still actively working on it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And it's for your most recent claim, correct?
[CUSTOMER][NEUTRAL] It, um, well, there's one for the [PII] and one for the [PII], [PII].
[AGENT][NEUTRAL] Uh, the one for the [PII] is still being processed.
[AGENT][NEUTRAL] Let me see, for the one on the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] I'm sorry, I'm at the
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I got the date wrong, sorry, I'm at the [PII], um.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It looks like the uh that one was denied because the maximum benefit for that data service had been met.
[CUSTOMER][NEUTRAL] Right, so that was initially what she did say, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This is the, this is where it was tricky because information that came from the North Louisiana Orthopedic Clinic, it had surcharge and it was 00 because they did not send the bill or they did not incorporate the bill from the actual hospital where the surgery was done. So, um.
[CUSTOMER][NEUTRAL] When I finally got that one, that's when I called APL a couple of weeks ago, and they, and they told me to go ahead and send that over. So like that, um, I think the one that I did send over with the actual surgery charge.
[CUSTOMER][NEUTRAL] Whereas on APL it says I cannot pay.
[CUSTOMER][NEUTRAL] You know, can't, you know, they can't because there was nothing there for the surge charge it was 00 or something like that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does that make sense to you?
[AGENT][NEUTRAL] Yes, let me see, um.
[CUSTOMER][NEGATIVE] And I think what I well I, I don't know, I kind of fell asleep on the phone. I'm so tired. I've been so tired. Uh, last I, well, last I knew she was on a phone call with somebody else and she was gonna call me back, but um.
[CUSTOMER][NEUTRAL] It's like, but now we're still go outside.
[AGENT][NEUTRAL] Yes, um.
[AGENT][NEUTRAL] Yeah, let me see if I can get someone on the line um the person you were originally speaking with um is out for right now, but let me see if I can get someone else for you real quick, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, she's out now.
[AGENT][NEUTRAL] Well, she's out to lunch. So not, so not long, but let me see if I can get a hold of someone for you, OK?
[CUSTOMER][POSITIVE] Great. OK.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, give me just one moment.
[CUSTOMER][NEUTRAL] I mean when she got to [PII], she may call me back.
[AGENT][NEUTRAL] Did you want to go ahead and wait or did you want me to see if I can transfer you to someone else from claims?
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] I don't know cause I know how these can be tricky. I go to someone else, they may say, nope, squash and done.
[CUSTOMER][NEUTRAL] But if I wait for the original person, I don't know what all actions or, I don't know what movement, you know, I don't know what she has going on.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I can go ahead and see if someone from claims can can at least see what's going on they'll be able to read the notes and see uh what she was doing so let me get someone from claims for you, OK?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] with uh the care team.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Um, I'm calling, uh, it's for policy number 1836605 [PII] in regards to her daughter [PII].
[AGENT][NEUTRAL] It looks like she was speaking with [PII] earlier um about her claim uh looking at the notes.
[AGENT][NEUTRAL] Well, and then there's an [PII] and an [PII]. I don't know who those would be, um.
[AGENT][NEUTRAL] But I have uh seen in the claim, uh, remarks that the claim was denied because the benefit maximum had been met. But then I guess, let me see, called inured to go over the surgery benefits.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And she looked like she was uh expecting a call back from [PII], but [PII]'s not in, and I don't, I can't read those claim remarks and understand quite what she's talking about, but um.
[AGENT][NEUTRAL] Let me see, I was wondering if you could help her with that because the claim is still being processed and I guess they were going over something for the last claim, the one that got denied.
[AGENT][NEUTRAL] Where is it?
[AGENT][NEGATIVE] Like I'm not understanding these.
[AGENT][NEGATIVE] No it's not even letting me see the rest of the messages.
[AGENT][NEUTRAL] Let me just get back to the claim.
[AGENT][NEUTRAL] It's the claim number 3611434. I guess they were trying to reprocess it.
[AGENT][NEGATIVE] And it looks like Misty is out, so I don't know who to contact for that.
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Alright, are you still there?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] I, I will have to send [PII] a um the person that was helping you with your claim. I will send her a message about um seeing when she will be able to call you back um my call dropped for some reason. I wasn't able to get a hold of someone.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, um.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK then.
[AGENT][NEUTRAL] Alright, um, is there anything else I can help you with or is this the number that she can call you back on the [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Alright well I will have her call you back as soon as we get a chance, OK?
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] Alright, thank you so much for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye