AccountId: 011433970860
ContactId: 7ee0362d-a74e-4cbf-b6b6-f749c0a2be34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 606979 ms
Total Talk Time (AGENT): 138977 ms
Total Talk Time (CUSTOMER): 233148 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/7ee0362d-a74e-4cbf-b6b6-f749c0a2be34_20250117T18:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, my name is [PII]. I was calling about a bill that I just got, and they're saying that my insurance didn't pay nothing. So I was trying to see like what's going on.
[AGENT][NEUTRAL] OK, I can assist you with claims, and may I have a callback number just in case we get disconnected, Mr. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the policy number?
[CUSTOMER][NEUTRAL] 02416319.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have your date of birth for security?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] OK, thank you. What is the mailing address and email address on file for verification?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, the email is [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, thank you. And what is the date of service for that claim?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, they were
[CUSTOMER][NEGATIVE] Oh Lord, they didn't give me that. It was last, it was last year.
[CUSTOMER][NEUTRAL] And I did it, uh, I went to
[CUSTOMER][NEGATIVE] American family um got off.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so based on our records, it looks like there was a lapse in coverage, um, so you will have to um get in contact with benefits in a car and see if they have uh different information about the premium because it was denied stating that premium for the date of service was not received.
[AGENT][NEUTRAL] Do you need the numbers to benefits in a card?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. What you say I need to do again?
[AGENT][NEUTRAL] Call benefits in a card and check and see if they're up to date with your premium payment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or do I need to call back to the clinic, I mean to the doctor office and tell him to run the card again.
[AGENT][NEUTRAL] Um, first, you need to contact benefits in a card and you will have to have that date of service because they're probably gonna ask you for the date of service to see if um, if they did pull out premium for that date of service, and if they did, they need to send that information over to us so we can reprocess the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, but they're the ones that handles the premium, so you have to get in contact with them to see what happened to that week, OK? Um, so the phone number to benefits in your card is [PII].
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, do you need me to transfer you? Yes.
[CUSTOMER][NEUTRAL] Can, can you send me the uh mail?
[AGENT][NEUTRAL] Yeah, I can transfer you. Do you need me to transfer the call?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is there anything else I may help you with today before I transfer?
[AGENT][POSITIVE] That's right
[CUSTOMER][NEUTRAL] Uh, do you think, you say they won't have the date of it?
[AGENT][NEUTRAL] More than likely they're gonna ask for what day, what date of service was it like uh what month, what day, what week so they can check um and see if they received any premiums for that week.
[CUSTOMER][NEUTRAL] Do you have it? Do you see it?
[AGENT][NEGATIVE] The last one I got here that we processed and denied was [PII] for American Family Care.
[CUSTOMER][NEUTRAL] [PII] to what?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, so let me go ahead and transfer you over. Is there anything else I'm gonna help you with today before I transfer?
[CUSTOMER][NEUTRAL] OK then.
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK. Well, thank you for calling APL. Have a good afternoon. One moment while I transfer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] Para espanol precios.
[CUSTOMER][NEUTRAL] Your call may be recorded for quality control purposes.
[CUSTOMER][NEUTRAL] Your call may be monitored or recorded for quality assurance purposes.
[CUSTOMER][NEUTRAL] Benefits in the car, this is [PII] speaking. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I was calling about um.
[CUSTOMER][NEUTRAL] I had went to the doctor and they had charged me and they said my insurance then um cover it. So I was trying to see what was going on.
[CUSTOMER][NEUTRAL] And who do you work for, ma'am?
[CUSTOMER][POSITIVE] It made you work for a solution.
[CUSTOMER][NEUTRAL] May I have the last four digits of your social so I can pull up your file.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What was that ma'am?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right. And your first and last name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] We will
[CUSTOMER][NEUTRAL] OK, for security reasons and just to make sure we are in the correct file, can you please verify your complete address and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] Is your zip code [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] We have a telephone number on file [PII] and your email your [PII] name, your last name [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And you said at the beginning of the conversation that uh some
[CUSTOMER][NEUTRAL] Procedure were not covered?
[CUSTOMER][NEUTRAL] Yes ma'am, they, they said that um my insurance didn't pay at all.
[CUSTOMER][NEUTRAL] And what was the type of service?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It was an American, um, you know, what do you, what do you got done on
[CUSTOMER][NEGATIVE] That they didn't pay.
[CUSTOMER][NEUTRAL] Uh, well, I went in for a cold.
[CUSTOMER][NEUTRAL] Whoever it was. It happened [PII].
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] You went to the doctor on [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[CUSTOMER][NEUTRAL] But you were not active.
[CUSTOMER][NEUTRAL] The benefits became effective on the [PII].
[CUSTOMER][NEUTRAL] So my Insta.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, so they just uh took out my account $175 and I'm like for what? cause I got insurance.
[CUSTOMER][NEUTRAL] OK. But I, I guess, I guess that happened when I didn't know if they had.
[CUSTOMER][NEGATIVE] Hurt my insurance I when I had went out for um workman's comp.
[CUSTOMER][NEUTRAL] Yeah, cause the way this insurance works, like if you're not working and we don't receive the premium, your benefits will not be active, and then you call back on
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I mean, I'm sorry, on [PII] to reinstate the benefits.