AccountId: 011433970860
ContactId: 915d526f-9ae8-4a40-b72b-2dce20341733
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 672969 ms
Total Talk Time (AGENT): 154835 ms
Total Talk Time (CUSTOMER): 126409 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=-2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/915d526f-9ae8-4a40-b72b-2dce20341733_20250321T15:03_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APPL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I was calling in reference to a claim that I see on my account, um, and the dollar amount for the, I guess the service that was provided, um, I just wanted clarity on.
[CUSTOMER][NEUTRAL] Why that dollar amount was selected to go towards the cost of the total bill.
[AGENT][NEUTRAL] OK, uh, sure, I can assist you with claims. May I have your name and a callback number?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, thank you. And may I have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, 259-614-2.
[AGENT][NEUTRAL] All right. And I need to verify the mailing address and your date of birth for security.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you, [PII].
[CUSTOMER][NEUTRAL] Oh.
[AGENT][POSITIVE] And you're right through creative circle, um.
[AGENT][NEUTRAL] OK, I have an email address here. Can you verify that for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so you have one of our limited hospital indemnity plans.
[AGENT][NEUTRAL] Um, and let's see, so this is for [PII].
[CUSTOMER][NEUTRAL] [PII], yes.
[AGENT][NEUTRAL] Sorry, I'm sorry. OK. All right. Um.
[AGENT][NEUTRAL] One month.
[AGENT][NEUTRAL] OK, so the benefit amount um is $75 per visit.
[AGENT][NEUTRAL] Um, see.
[AGENT][NEUTRAL] This is a test. So yeah, it is also $75 per test. So it looks like there is an amount of $43 that the provider asked for 14 months of imaging. So we did send the $43 to them and then the remaining of the $75 was sent to you.
[AGENT][NEUTRAL] And that's the $32.
[CUSTOMER][NEGATIVE] It was sent to me where I haven't received anything.
[AGENT][NEUTRAL] OK, let me see when this process.
[AGENT][NEUTRAL] It was recently processed, so it should be on the way. It was processed on the [PII].
[AGENT][NEUTRAL] So, that was Friday, so more than likely it went out on Monday.
[CUSTOMER][NEGATIVE] Is this supposed to be a check that I receive in the mail?
[AGENT][NEUTRAL] Yeah, it's gonna be a check that you're gonna receive in the mail for $22.
[CUSTOMER][NEUTRAL] OK, um, could you help clarify something? So I'm looking at this on my phone for the different claims that I have, but when I click on the claim number to download the form, it says invalid and it gives me an error message. Is there any way you can email me like a copy of that form so I can review it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, uh, are you talking about the claim, the EOB, the explanation of benefits, or you're talking about the paperwork that it was received from the provider.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so the explanation of benefits.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, one moment.
[AGENT][NEUTRAL] And you say you're getting an error?
[CUSTOMER][NEGATIVE] Yes, it says that it's downloading the document, but then it sends me to another page on the website that says there's been an error.
[AGENT][NEUTRAL] OK, does it have like an error number or a message?
[CUSTOMER][NEUTRAL] I'll have to click on it again and go through the process.
[AGENT][NEUTRAL] OK, so I can report it.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you mind holding for me while I send this email with a copy of the EOB?
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for you, Mr. [PII]. You wanna check and see if you received that email?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK, I just received the email and the attachment. Thank you for sending that over.
[AGENT][NEUTRAL] You're welcome. Do you have any other questions, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um, no, not right now. I'm actually submitting a claim, so, um, I'll just wait to see how that one is processed and if I have any more questions, then I can just call back.
[AGENT][POSITIVE] Yeah, OK, no problem.
[AGENT][POSITIVE] You have a good day, Ms. [PII]. Mhm. OK. Bye.
[CUSTOMER][NEUTRAL] Um, the
[CUSTOMER][NEGATIVE] Oh no, I was just gonna say I had um clicked on the claim number again to download the document and the error message came back up. It just says oops, there has been an error looks like we're experiencing technical difficulties. If you continue to experience issues, please contact customer service.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, uh-huh.
[AGENT][NEUTRAL] OK, so that's fine.
[AGENT][NEUTRAL] This is when you try to get the copy of the EB.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Of you.
[AGENT][POSITIVE] OK, I'll go ahead and report this to make sure that they fix any problems that they need to fix, and thank you so much for that. Is there anything else I'm gonna help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.