AccountId: 011433970860
ContactId: 80faa941-cdf5-4135-a9e6-78050b3050e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 374500 ms
Total Talk Time (AGENT): 154528 ms
Total Talk Time (CUSTOMER): 151760 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/80faa941-cdf5-4135-a9e6-78050b3050e8_20250312T16:11_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, I, I have a question uh for you guys if you could help me out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Say if
[CUSTOMER][NEUTRAL] I, well, I'm gonna put myself in somebody else's shoes as well.
[CUSTOMER][NEUTRAL] Say I got let go by my uh my employer, correct?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is my insurance still covering my bills? Do I still have insurance? I would like to know.
[AGENT][NEUTRAL] OK. Are you asking specifically if your policy is still active with us or just giving an example?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, uh, what is your name and policy number, please?
[CUSTOMER][NEUTRAL] No, I'm
[CUSTOMER][NEUTRAL] So my name is [PII] and my policy number is 025.
[CUSTOMER][NEUTRAL] 44472
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK, and Mr. [PII], verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] OK, so my date of birth is [PII].
[CUSTOMER][NEUTRAL] My email address is [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] I'm not sure my mailing address that's on file is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh, show a different address in our system. Um.
[CUSTOMER][NEUTRAL] OK, so is it showing [PII]?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and so you're not longer with your group um.
[AGENT][NEUTRAL] Focus work.
[CUSTOMER][NEUTRAL] Yeah, so
[CUSTOMER][NEGATIVE] Yeah, they, they let me go. I got an injury on the job and they let me go.
[AGENT][NEUTRAL] OK, um, well, we're still showing the policy is active. We hadn't received or I don't show we received any information or if you're no longer being with the group, but if you are wanting to keep your policy or to verify as COR if it's available, you will have to contact Benefits and a card and they can verify that with you.
[CUSTOMER][NEUTRAL] OK. Now, as far as say I, I do have a claim open, how would I know how much of this, uh, my insurance is gonna pay on that claim?
[AGENT][NEUTRAL] Well, we won't know until we actually receive the claim and process it. Um, we can't give a guarantee of payment until a claim has been received and processed, but
[AGENT][NEUTRAL] We wouldn't, if you lost your or your policy was active on that data service, then it could be covered, um.
[AGENT][NEUTRAL] What was the date of service? Like I said, I'm showing your policy is active, like we hadn't received any information that you're no longer with the group.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Correct, but that's the thing too is that
[CUSTOMER][NEUTRAL] Even though I'm still active on your insurance.
[CUSTOMER][NEGATIVE] I got let go from the job, so I wanna be, I wanna get on my wife's insurance. Now if I, I have 30 days to get on her insurance if I cancel this insurance.
[CUSTOMER][NEUTRAL] Are you guys still gonna pay?
[CUSTOMER][NEUTRAL] That bill or pay on that bill.
[AGENT][NEUTRAL] Um, like I said, I can't give exactly yes, it's going to be payable, but as long as you are effective, uh,
[AGENT][NEUTRAL] Or the data service is still when you were effective with us, then it should be fine if it's a covered service, if it's
[AGENT][NEUTRAL] I say, um,
[AGENT][NEUTRAL] If the data services after it shows that you're no longer with the group, then of course it wouldn't be covered.
[AGENT][NEUTRAL] So it just kind of depends on when you're no longer with the group and
[AGENT][NEUTRAL] What the date of service was.
[AGENT][NEUTRAL] Or is.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Can I call somebody to find out how much they're gonna cover?
[CUSTOMER][NEUTRAL] On, um, my insurance or do I have to just wait?
[AGENT][NEUTRAL] We can only pro uh give benefits once claims have been received. We can't say that this is how much it is going to be payable. So, um, once the claim has been received and processed, then we can give a claim decision, but we can't say that yes, we're going to pay so and so amount for service until before a claim has been received. We can't do that.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Like the provider can submit it. Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Are you the person I
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Are you the person, say if I wanna cancel my my policy, can I cancel it with?
[AGENT][NEUTRAL] Uh, you have to contact
[AGENT][NEUTRAL] No, sir, you will have to contact benefits in the card.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Benefits in a card. Do you have?
[AGENT][NEUTRAL] I can give you
[AGENT][POSITIVE] Yes, sir. I can give you their phone number.
[CUSTOMER][NEUTRAL] OK, uh, is it [PII]?
[AGENT][NEUTRAL] Uh, no, sir. I show a different number, [PII].
[CUSTOMER][NEUTRAL] OK, hold on, I'm sorry.
[CUSTOMER][NEUTRAL] Uh, we said [PII].
[AGENT][NEUTRAL] Uh-huh, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, all right, thank you.
[AGENT][POSITIVE] Uh, yes, sir. Uh thanks for calling [PII]. Have a great day.
[CUSTOMER][POSITIVE] You too, thanks.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye.