AccountId: 011433970860
ContactId: 969c5f70-ee64-46e0-9297-380794fe826c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297540 ms
Total Talk Time (AGENT): 131829 ms
Total Talk Time (CUSTOMER): 115996 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/969c5f70-ee64-46e0-9297-380794fe826c_20250331T18:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I was just on the phone with [PII] actually and got disconnected.
[AGENT][POSITIVE] Oh, I'm so sorry. Um, let me see. Did you want me to see if she's available or I can help?
[CUSTOMER][NEUTRAL] It doesn't matter. Either or, whichever works.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. What were you looking for today?
[CUSTOMER][NEUTRAL] So I am just calling um in regards to an explanation of benefits I received. I am the um insured. Um it just says this premium is being paid through COR, which it is, um, just to contact the folks.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's look at the claim. Do you, what's the claim number that you have?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have um I have quite a few of them here. Let me see if they're, oh no, they're all different. OK, I have a handful. Um, it's 358-0043 is one of the claims.
[AGENT][NEUTRAL] OK, let me just pull this one and we'll kinda.
[AGENT][NEUTRAL] Look
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] All right. And then for security, I will need to verify please your first and last name and date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Sure. It's [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII] and then if you could verify the address and email address we should have.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII], and then email is the other one.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Email should be [PII].
[AGENT][NEUTRAL] OK, yeah, that's what we've got on here alright.
[AGENT][NEUTRAL] So let's see.
[AGENT][NEUTRAL] OK, so I see a few in here. Let me
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] They may be
[AGENT][NEUTRAL] Submitting a lot of these because it's that I'm seeing it says claim was previously denied.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As policy was lapsed, but you were continuing it through COBRA, so it looks like um it says with continuous coverage, it says policy was reinstated see new mail number for a corrected claim, so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That sounds about right. It had just ended, but I had put COR in, and you know, COR has back, back dates. So I think it just kind of the unfortunately, the hospital visit fell in between.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Right. And it looks like, yeah, and it looks like they're just now um kind of resubmitting some of these, yeah, um.
[CUSTOMER][NEUTRAL] Before it was backdated, I think that was the case.
[CUSTOMER][NEUTRAL] Resubmitting, OK.
[CUSTOMER][NEUTRAL] OK, that's
[CUSTOMER][NEUTRAL] And that's what I figured, but I just wanted to call and double check.
[AGENT][NEUTRAL] Yeah, so I, it doesn't look like it's anything that you need to do on your side. It looks like you said it was just a timing thing where the party's talking to one another, you know, we showed it was lapsed, but you were really continuing it on, so I would just give these a little bit more time to process and then see if anything else is needed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and now for my COBR, will I also get another explanation of benefits once those claims go to COA? Will I get the same thing?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm, yep, absolutely. That's always sent out to you. Yeah, anytime one is processed, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] Great, so I'll just keep an eye out for one of those in the mail.
[AGENT][POSITIVE] Yeah, absolutely. That's what I would do for sure.
[CUSTOMER][NEUTRAL] OK, OK, awesome. I just wanted to double check that they are being submitted to COBRA, um, and that that was the case. It was just the kind of the last there.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] No worries. Did you have any other questions or concerns?
[CUSTOMER][POSITIVE] No, that was it. Thank you for your help.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thanks you too. Bye.
[AGENT][NEUTRAL] Bye bye.