AccountId: 011433970860
ContactId: 6f893c0f-f985-43b6-9cfe-6969d35eabcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 613380 ms
Total Talk Time (AGENT): 228227 ms
Total Talk Time (CUSTOMER): 281939 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/6f893c0f-f985-43b6-9cfe-6969d35eabcf_20250203T14:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII]. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good. I have an insured on the phone. Let me give you the policy number.
[CUSTOMER][NEUTRAL] Let me know when you're ready.
[AGENT][POSITIVE] All [PII], go ahead.
[CUSTOMER][NEUTRAL] OK, that number is 197.
[CUSTOMER][NEUTRAL] 3189.
[CUSTOMER][NEUTRAL] And I'm looking at her policy, sir, you know, where it gives the age she's wanting to know I think on whatever documents she received from her employer, it um says that it's a Metin policies and in parenthesis it says up to age [PII] or something like that and she's wanting to know, I know the premiums are based on several things one to include the age.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But that's the extent of me knowing how they determine the premiums for each individual.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, and that is all there is to it on midlink. OK. um.
[AGENT][NEUTRAL] Oh, because this is what's being hail from her check. Is that what she's
[CUSTOMER][NEUTRAL] Yeah, she's saying is, is, is her premium amount based on her age and other factors or is it just her age? Is this like for since she's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she said on the document that she has it says the the Metlink policy in parenthesis it says I think she said under [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, but I can speak to her. Yes, I'm sorry, I'm just pulling up uh.
[CUSTOMER][NEUTRAL] Yeah, I mean, I'm assuming I'm assuming that it's saying if you're under [PII] this is your premium but I'm not educated enough to tell her yes or no that's what that means.
[AGENT][NEUTRAL] OK, right. Got you. OK, yes.
[CUSTOMER][NEUTRAL] All right, and you're speaking with [PII]?
[AGENT][POSITIVE] OK, thank you. Thank you.
[CUSTOMER][NEUTRAL] Here she comes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hi, Miss [PII].
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Miss [PII].
[CUSTOMER][NEUTRAL] I'm here. I'm sorry, did the other person explain to you what was going on?
[AGENT][NEUTRAL] She did, yes, ma'am. Um, now, she did say, did you receive something from us or from your employer about the premium?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, so this is what I want. So forget who I received one from. What I wanna find out is the policy that you have me on there does it has um H.
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] Now, it does have
[CUSTOMER][NEUTRAL] Does it change if you're. Go ahead.
[AGENT][NEUTRAL] It does have two age brackets. It's [PII] to [PII] and then [PII] um on up.
[AGENT][NEUTRAL] Um, so that's the difference, uh, you know.
[CUSTOMER][NEUTRAL] OK, so what?
[CUSTOMER][NEUTRAL] So what are the benefits if you're [PII] and up? Is it the same as if it's not the same as if you're
[AGENT][NEUTRAL] They
[AGENT][NEUTRAL] Yes, they are the same. Yes and they're the exact same.
[CUSTOMER][NEUTRAL] OK, alright, so here, OK, so another issue I have here is, are there any claims there for me because I was in the hospital last month, early last month for a couple of days and
[CUSTOMER][NEUTRAL] As I understand you do cover some of the hospitals.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] Now I really can't see details of the claim, but I do see that we have received a claim on [PII].
[AGENT][NEUTRAL] Now I can definitely let you speak to someone in our claims department to get details of it um but we did receive it.
[CUSTOMER][NEUTRAL] Yeah, but I wasn't out the hospital on the [PII], so I don't know.
[CUSTOMER][NEUTRAL] OK, so I can speak to someone who can go into that with me even though I can't speak.
[AGENT][NEUTRAL] OK, you would like to speak to someone in our claims department?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, yes ma'am. And also just to let you know you can um register your account online with us and you can.
[CUSTOMER][NEUTRAL] Yeah, I try. I know I tried. I tried to last night, but what happened? you haven't sent me a new card, so my policy number that I have is totally different from the one that it is you just gave me.
[AGENT][NEUTRAL] OK. Now, when you set your account,
[CUSTOMER][NEUTRAL] Wait, what's my policy number?
[AGENT][NEUTRAL] Now this one is 1973189.
[AGENT][NEUTRAL] But to register your account online, you do not need that number.
[CUSTOMER][NEUTRAL] 31.
[CUSTOMER][NEUTRAL] Well it was asking me for it and it wouldn't just online.
[AGENT][NEUTRAL] It should, you should just need.
[CUSTOMER][NEUTRAL] It wouldn't. I tried yesterday.
[AGENT][NEUTRAL] Um, you should just need to put in your, um, it does ask for your social and an email and your zip code, um.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] And the part on your number you did ask for all of that. You're correct, but it also asked for the your policy to enter your policy number. It didn't say why it wasn't going through.
[CUSTOMER][NEUTRAL] But it just didn't, but then again it could be because this number was wrong because I have an old one from [PII] so um if I could get to speak to someone from the claim department.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] OK, I sure can, um, I get you to them, um, but just to let you know if you do want to register your account you would choose um an individual with an ACL policy and it does not ask for your policy number, um, it just does ask for some personal information to find you in our system, so you do not need your policy number to set up that account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I will go ahead and get someone for you to go over the claims with you, OK? But can I do anything else for you before I transfer you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, thank you, Miss [PII]. You have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, this is [PII]. I have an insured on the line and she wants to speak to someone about a couple of claims, um, that she says we should have received in January.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy number is 1973189.
[CUSTOMER][POSITIVE] OK, thank you and um her name and
[AGENT][NEUTRAL] Um, [PII], let me see. [PII], and she was transferred me to me from the care team and so they fully verified her.
[CUSTOMER][NEUTRAL] OK. And uh did she um
[CUSTOMER][POSITIVE] OK, uh, yeah, if you'll just send her over, um, [PII], it's [PII], right? If you'll just send her over, uh, yeah, I'd be glad to talk to her.
[AGENT][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK. And um uh it's really hard to hear her, but I tried to explain to her to set up her account on the online service center and she give you her claims and stuff, and she says she tried to, but it wouldn't go any further because it wouldn't accept her policy number and I told her multiple times that she did not need her policy number to set up that account and I don't know that. So anyway, just to let you know, I tried to get her to set it up.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I, I don't know, but it is hard to hear her, just let you know, OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] OK, yeah, thank you. Yeah, no problem.
[AGENT][POSITIVE] OK. But here she comes. Thank you.
[CUSTOMER][POSITIVE] Appreciate it. Thank you.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. I'm in the claims department. I understand that there are, there is a claim that was submitted in January that you have a question about.
[CUSTOMER][NEUTRAL] Yeah, um, yeah, I, well, I was in the hospital, so I wanna see what is it that you're covering and what is it that you're not covering.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] So we received a, a, we received one claim in January.
[CUSTOMER][NEUTRAL] Uh, it's for, um, West Side Hospital for data service, uh, [PII]. Now that's, that's the, the last claim that we received.
[CUSTOMER][NEUTRAL] It's from west side from of the service.
[CUSTOMER][NEUTRAL] Yes, is that the one that you're looking for?
[CUSTOMER][NEUTRAL] No, what is this one again for West side what? OK, we received a claim.
[CUSTOMER][NEUTRAL] You um you we received a claim in January.
[CUSTOMER][NEUTRAL] Last month.
[CUSTOMER][NEUTRAL] For, for West Side Hospital.
[CUSTOMER][NEUTRAL] And that's [PII] with with with the data service. Now if that's not the one that you're looking for, um, what date of service are you looking for uh.
[CUSTOMER][NEUTRAL] OK, OK, well, that booking is extremely late, um.
[CUSTOMER][NEUTRAL] Uh, yeah, the one I was looking for is January of this year, so you probably, I, I don't know if I have to set up a claim with you or not. OK, no we haven't received that yet, um, so that's.