AccountId: 011433970860
ContactId: 8a3fd418-7d38-478b-b8aa-9623a16a36fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 580940 ms
Total Talk Time (AGENT): 200949 ms
Total Talk Time (CUSTOMER): 128620 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/8a3fd418-7d38-478b-b8aa-9623a16a36fb_20250123T19:40_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from provide office looking claim status. Can you spell out your name one more time?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] First initial and last name.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Alright, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] and the extension number is [PII].
[AGENT][NEUTRAL] Can you repeat the extension slowly, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today, [PII]?
[CUSTOMER][NEUTRAL] One game.
[AGENT][NEUTRAL] Alright, and may I have the member's policy number?
[CUSTOMER][NEUTRAL] D as in Delta 43716985.
[AGENT][NEUTRAL] And do you have a copy of the member's ID card available?
[CUSTOMER][NEUTRAL] Uh, no, man.
[CUSTOMER][NEUTRAL] ID card is available but not a correct.
[AGENT][NEUTRAL] OK, what is
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] ID card is available but uh it is clear.
[AGENT][NEUTRAL] The ID card is available, but what did you say?
[CUSTOMER][NEGATIVE] Picture is not clear.
[CUSTOMER][NEGATIVE] The picture is not correct.
[AGENT][NEUTRAL] OK, on the card, do you see anywhere that says in hospital or outpatient policy er number?
[CUSTOMER][POSITIVE] Impatient.
[AGENT][NEUTRAL] OK, may I have that policy number, please?
[CUSTOMER][NEUTRAL] D as in Delta 43716985.
[AGENT][NEUTRAL] For the inpatient policy er number it should start with a 01. It might have an ML 7 or 8 at the end.
[CUSTOMER][NEUTRAL] auto policy.
[AGENT][NEUTRAL] May I have the member's first and last name?
[CUSTOMER][NEUTRAL] [PII] [PII]. Date of birth.
[AGENT][NEUTRAL] hold on one second. Just the first and last name. I'm trying to locate the claim, the policy. Can you spell the first name for me, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, may I have the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I'm just waiting for the um policies to populate here. Hold on one moment.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You said [PII], right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, the reason I'm asking is because I don't see a policy with that name. Um, you said you do have the ID card?
[CUSTOMER][NEGATIVE] ID card I have, but no there's no clear picture.
[AGENT][NEUTRAL] OK. Do you have the member's full social?
[CUSTOMER][NEUTRAL] Let me just check.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what's the member's social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Is her first name [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so it's not an [PII] OK, so this is the correct person. Hold on one moment.
[AGENT][NEUTRAL] And this is for their hospital indemnity policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment. I believe I just located the policy. I'm waiting for it to come up now.
[AGENT][NEUTRAL] And can you verify the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim you like me to check on?
[CUSTOMER][NEUTRAL] [PII] $217 even.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. Hold on one moment while I locate the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we actually don't have any claims on file for um [PII]. We have not processed any claims for her.
[CUSTOMER][NEUTRAL] OK, one second, let me just check. I have the claim number as well.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK, may I give you claim number?
[AGENT][POSITIVE] Sure, I'm ready when you are.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim number 2024.
[CUSTOMER][NEUTRAL] 111 92.
[CUSTOMER][NEUTRAL] 002
[AGENT][NEUTRAL] OK, so that might be the major insurance or if they have another insurance provider, but there are no claims here at APL, it's literally blank. There's, we have not processed one claim for her yet.
[CUSTOMER][POSITIVE] Good
[AGENT][NEUTRAL] So was it billed to another um another insurance company?
[CUSTOMER][NEUTRAL] Uh, no idea about any other companies.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][POSITIVE] Yeah, we build the claim, we build the claim for America in public life.
[AGENT][NEUTRAL] Right, but the claim number that you're giving me is not an APL claim number and we don't have any, we've never processed a claim for her, so there's no claims here.
[AGENT][NEUTRAL] So I don't know where that claim number is coming from, but there is no timely filing, so you can file the claim if you like. Um, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Once again.
[AGENT][NEUTRAL] Let me check the effective date.
[AGENT][NEUTRAL] Well, to be honest, the hospital indemnity policy has been terminated since [PII], and there's no other medical policy here. So, uh, you actually can't file the claim with APL because there is no active medical policy.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Banded cotton number this terminal.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] I cannot activate.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEGATIVE] Number is not active.
[AGENT][NEUTRAL] Right, that's the termination date, um, and there's no, there's no active policies with us for medical.
[CUSTOMER][NEUTRAL] APL
[CUSTOMER][NEUTRAL] OK, your reference number?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][POSITIVE] Alright, thank you so much. Have a good day bye bye.
[AGENT][POSITIVE] You're very welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] No ma'am.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] No hold on.