AccountId: 011433970860
ContactId: 6f4166d8-3fa1-4e4b-b463-2ab8126e658d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 145669 ms
Total Talk Time (AGENT): 74915 ms
Total Talk Time (CUSTOMER): 50809 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/6f4166d8-3fa1-4e4b-b463-2ab8126e658d_20250515T14:14_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], I just need to go over uh how a claim processed for a member.
[AGENT][POSITIVE] Sure, I can assist you with that. Can I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII], what is the policy number?
[CUSTOMER][NEUTRAL] D as in Delta 40409055
[AGENT][NEUTRAL] This for dental
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] Um, what is the member, do you have the member's social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is that member's name?
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] And his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the claim number that you're calling in regards to?
[CUSTOMER][NEUTRAL] 3591202.
[AGENT][NEUTRAL] 359.
[AGENT][NEUTRAL] 1202.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Please.
[AGENT][NEUTRAL] For data service [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So this policy is a limited hospital indemnity policy and the policy only pays $50 per visit with 5 visits per calendar year and you sent in a bill for $375 however, the benefit amount is the maximum benefit amount allowed is $50.
[CUSTOMER][NEUTRAL] OK, so is the rest patient responsibility?
[AGENT][NEUTRAL] So because this is not a primary insurance policy insurance company here at American Public Life, we can't say that we can only verify that we only made a payment of $50 of the $375 that you're sending in.
[CUSTOMER][NEUTRAL] OK, and the rest is up to our discretion on how it's.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Handled OK alright just need a reference number and then I'll be good to go.
[AGENT][NEUTRAL] We don't provide those [PII], but you can use my name in today's date as a reference.
[CUSTOMER][NEGATIVE] Oh, no.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Alright, and what's the spelling of your first name? Mhm.
[AGENT][NEUTRAL] [PII] and today's date. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] In today's date? No, that'll be it. I appreciate your help. You have a good rest of your day.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and have a great one as well, [PII].
[CUSTOMER][POSITIVE] Thanks, bye bye.
[AGENT][NEUTRAL] Bye bye.