AccountId: 011433970860
ContactId: 7cfa3cdf-f796-427b-9c24-e0673ec8c101
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 384429 ms
Total Talk Time (AGENT): 105350 ms
Total Talk Time (CUSTOMER): 127298 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/7cfa3cdf-f796-427b-9c24-e0673ec8c101_20250306T14:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. It's [PII].
[CUSTOMER][NEUTRAL] I have policy number 486.
[CUSTOMER][NEUTRAL] 564.
[CUSTOMER][NEUTRAL] [PII], I was trying to do a hub request and she wanted to talk to somebody. I was going to send it in hub, but she wanted to talk.
[CUSTOMER][NEUTRAL] It's [PII]. I've verified all of her information. She's calling regarding the denied claim 3558801. Now she has in the policy the $10,000 chemo benefit and also a $10,000 rider benefit for chemo.
[AGENT][NEUTRAL] OK, what was that claim number again?
[CUSTOMER][NEUTRAL] 35 that's the paid one. The denied one is 3571696.
[AGENT][NEUTRAL] Mhm. And the policy number you gave me was 486-564?
[CUSTOMER][POSITIVE] That's right.
[AGENT][NEUTRAL] OK, why am I not seeing that claim number? It's oh wait, hold on. OK, there it is. I will scroll down. OK, let me pull it up here.
[CUSTOMER][NEUTRAL] [PII] for part one.
[AGENT][NEUTRAL] I was like why am I not seeing that claim number?
[AGENT][NEUTRAL] Let me pull it up here. Let's see what we got.
[CUSTOMER][NEUTRAL] I was thinking, hm, did I give it wrong?
[AGENT][NEUTRAL] Listen, I feel like it's a Monday today already.
[CUSTOMER][NEUTRAL] Me too. I'm like, no, let's don't do that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so it looks like she met her max chemo.
[CUSTOMER][NEUTRAL] So she's got 2 chemos.
[CUSTOMER][NEUTRAL] Well, that's what it says.
[AGENT][NEUTRAL] And radiation, let me see what we paid it last.
[CUSTOMER][NEUTRAL] But we have not paid that um the writer or.
[AGENT][NEUTRAL] So this was for February and we last paid on.
[CUSTOMER][NEUTRAL] Is it a per calendar year benefit on this plan though?
[AGENT][NEUTRAL] I have to pull up the policy. Let me take a look.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Says per calendar year.
[CUSTOMER][NEUTRAL] Benefits begin after the above radiation chemo benefit of 10,000 has been paid.
[AGENT][NEUTRAL] Looks like we paid January most recently.
[CUSTOMER][NEUTRAL] Mhm, yeah, she's talking about her 2025 chemo benefits.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Looks like we paid it out.
[AGENT][NEUTRAL] We paid the one, the additional chemo was paid on 120.
[AGENT][NEUTRAL] Let me see what all we paid on that one.
[AGENT][NEUTRAL] Under the additional writer.
[AGENT][NEUTRAL] So we only pay $7,904.37 on the additional rider.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, you can send it to me.
[CUSTOMER][NEUTRAL] Alright and her callback number is the number in this in her in line.
[AGENT][POSITIVE] OK, thanks.
[CUSTOMER][POSITIVE] Alright, let me get Ms. [PII] on the line, and I hope you have a wonderful day. Girl, I hope this day and tomorrow goes quick so we can have our weekend.
[AGENT][NEUTRAL] You too.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hang on just a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] [PII], I do have [PII] on the line and she's reviewing reviewing that information and will assist you further, OK? I was explaining to her what the situation was, so you didn't have to do that. OK, thank you so much. It's been such a pleasure, Ms. [PII]. Thank you for calling APL and have a wonderful day. Thank you.
[AGENT][NEUTRAL] Hi, Miss, Miss [PII]. This is [PII]. And you have some questions in regards to your February chemo that you received?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Let me check.
[CUSTOMER][NEUTRAL] I, I only received the 7904 from the [PII] rider.
[AGENT][NEUTRAL] OK, let me take a look.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I take a look at this a little further. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thanks for holding, Ms. [PII]. OK, so I do show you do have the additional chemo writer. I do not show that you've met your max yet. I will submit a request to get this claim reprocessed. Is there anything else that I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, if you can just take care of that.
[AGENT][POSITIVE] OK, well thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome bye.