AccountId: 011433970860
ContactId: 70bf9bd1-33c2-491f-b8f2-a28689835ac5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 267809 ms
Total Talk Time (AGENT): 72857 ms
Total Talk Time (CUSTOMER): 193691 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/70bf9bd1-33c2-491f-b8f2-a28689835ac5_20250130T20:48_UTC.wav
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[AGENT][NEUTRAL] This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing good. How are you?
[CUSTOMER][POSITIVE] Hey, I'm doing so wonderful. Thank you so much for asking. Hey, I've got a broker on the line and I am trying to help him as effectively as possible, and I was hoping you could um help me out with the policy. I'm looking at 2441981.
[AGENT][NEUTRAL] Hold on just a second.
[AGENT][NEUTRAL] Meddling
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] And he wants to know about uh like injections or infusions being covered on the policy. I guess this insured had um some.
[CUSTOMER][NEGATIVE] Some medical procedures done at an outpatient facility, and I've seen a lot of denials stating we don't cover injections or infusions, but I don't know like quick enough off the top of my head, each individual policy and neither word comes up when I search them in on-base like as a hot word.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I'm not sure about infusion, but if it's done in an outpatient injection should be covered.
[CUSTOMER][NEUTRAL] OK, so injections could be covered but infusions are not?
[AGENT][NEUTRAL] Um, but if it, hold on, let me.
[AGENT][NEUTRAL] I'm not sure about infusion. Let's see.
[CUSTOMER][NEUTRAL] No worries, I was hoping it would be like in the limitations or exclusions and I could just like find the word, but when I searched them I couldn't.
[AGENT][NEUTRAL] Yeah, it should be covered if it's done in an outpatient facility or if it's done in a doctor's office on this policy, injection should be covered. Is it a specific kind of injection he's talking about?
[CUSTOMER][NEUTRAL] I think it was for cancer treatment. Would you like to talk to him? I'm not exactly sure.
[AGENT][NEGATIVE] Yeah, I'll talk to him because they do have a cancer writer as well.
[CUSTOMER][NEUTRAL] Perfect. So what I'll do his name is [PII]. I did verify him with broker resources, um, on to be approved to talk about this policy, and I will introduce you and you said your name was, and I'm so sorry I should have written it down, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Oh my gosh, I got it right. OK. OK, thanks. I'll introduce you when we join.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you. Um, he's calling on part two, by the way. Uh, thanks.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Hi Mr. [PII], are you still there with me? Yes [PII] uh. Hey, thank you so much for your patience so I actually have Miss [PII] on the line and she does um she works to process claims so she's going to be I think a little better equipped to help answer your questions on if. Yeah I'm sorry about that. I thought I did um maybe went to the journal voicemail box, but I thought I did call claims first but it's fine. Hey [PII]. No worries there's Miss [PII] for you my friend. Thanks.
[AGENT][NEUTRAL] Hello, how are you?
[CUSTOMER][NEUTRAL] There how are you?
[AGENT][NEUTRAL] I'm fine. How are you?
[CUSTOMER][POSITIVE] Yeah, better, but, you know, all good, can't complain, better than most. Hey, um, did you, do you have all the information that Ali gave you, or do you want me to start from scratch?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir. I was just wondering about the injections. Is it for cancer? What type of injection or what kind of facility?
[CUSTOMER][NEUTRAL] Uh yeah, sure, hold on.
[CUSTOMER][NEUTRAL] Well, it's an outpatient facility, um, but hold on, so I just looked them up they got 4800 employees, so, um, but it was injections and it was actually an infusion and chemotherapy.
[AGENT][NEUTRAL] OK, now he does have the cancer writer.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Alright, I wasn't too sure if it was the Medin 9. I'm, I'm calling on behalf of my, uh, friend [PII], who's the broker. I'm the GA for him through, uh, you know, through APL. So alright, that's fine.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'll, I'll, and I'll say the same thing you guys tell me all the time, you know, these claims are indicative of the, you know what I'm saying, of the forms filed in the diagnosis codes enough, but I'll tell him to tell the insured to send it in, OK?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, just tell him this anytime he has any questions, just send it in for a review.
[CUSTOMER][NEUTRAL] Yeah, just tell him that
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Yeah, I got you. All right, thanks, Ms. [PII].
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Alright, take care.
[CUSTOMER][NEUTRAL] No, no, I appreciate the insight. I just didn't know, uh, what, uh, meddling plan it was if it was a select or what, so as long as they have the cancer writer, that's fine, OK.
[AGENT][NEUTRAL] Yes, sir, they do. Mhm.
[CUSTOMER][POSITIVE] Thank you ma'am.
[AGENT][POSITIVE] Thank you, Mr. [PII] for calling APL. You have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you you too ma'am thank you.