AccountId: 011433970860
ContactId: 9aa588d5-aa1d-47de-8734-731011d30764
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259399 ms
Total Talk Time (AGENT): 128627 ms
Total Talk Time (CUSTOMER): 117975 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/9aa588d5-aa1d-47de-8734-731011d30764_20250203T21:13_UTC.wav
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[AGENT][NEUTRAL] For calling ATL, this is [PII]. With whom am I speaking and how may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. It's in reference to claim number 3510654.
[AGENT][NEUTRAL] OK, and what's your policy number?
[CUSTOMER][NEUTRAL] Would you like the policy number 00593389?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what's a good call back number for you, Miss [PII], in case we get disconnected?
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][POSITIVE] Thank you for that information and please allow me one moment to get your policy pulled up. I'm gonna have you verify some information and then I'll be able to assist you with any questions you have regarding.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Uh, that policy. Mhm thank you one moment.
[AGENT][NEUTRAL] Thank you for your patience. OK, verify your date of birth, followed by your mail mailing address.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Looks like we have a physical address.
[CUSTOMER][POSITIVE] One, wanna let you either have [PII], they know your great job.
[AGENT][NEUTRAL] That's what we have, that's it. And what is your email address?
[CUSTOMER][NEUTRAL] For either [PII], OK, OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Thank you for verifying that information and allow me one moment to locate that claim number so that I can assist you with that. One moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And that was a claim for yourself, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Or someone else, OK. One moment.
[CUSTOMER][NEUTRAL] No, no, I'm the only one on this policy.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK, so I see the claim and what's your question?
[CUSTOMER][NEUTRAL] OK, um, they denied the claim because of the, um.
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Wellness visit.
[CUSTOMER][NEGATIVE] Well this expense benefit because um I think what they did was put down the wrong date because I'm looking at my um the benefits you all paid, it was [PII]. So I think this is probably a wrong date.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, let me take a look and see what happened.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So you're only allowed one wellness per year. You had already claimed the wellness on [PII], so it was denied. The date was correct, but it was denied because your benefits are exhausted for wellness for the year.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] So do you remember you filed a claim [PII] and we paid $75 for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the next wellness visit will be when I go in for a checkup, correct?
[AGENT][NEUTRAL] You're only
[CUSTOMER][NEUTRAL] Or that's on mammogram.
[AGENT][NEUTRAL] Where you only allow one wellness payment of $75 per year. You've already received that for 2024. You have not received it for 2025, so should you go in and have a mammogram or a chest X-ray, something that's eligible for preventative for 2025, that will be paid for 2025, but you're already exhausted for 2024 as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's fine. Uh, I was just wondering, you know, if I did it right. OK, no problem with that. So, uh, so for [PII] when I go in for the wellness visit, I can go ahead and turn that that one in.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, you did. All right.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] As long as it, it can't just be an office visit. Office visits are not covered. Uh yes, ma'am. It's gotta be, yeah. OK, it's gotta be a mammogram, chest X-ray, something, wellness, OK?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] No, the wellness doesn't.
[CUSTOMER][POSITIVE] OK. All right, yeah, cause I'm sure she'll, she'll have the mammogram done uh when I go in for this next wellness visit. OK dokey. Thank you.
[AGENT][POSITIVE] All right, and yes, you'll be good.
[AGENT][POSITIVE] OK, sounds good. Anything else I can help you with, Ms. [PII]?
[CUSTOMER][POSITIVE] No, ma'am, you did a great job. I appreciate your help.
[AGENT][POSITIVE] Thank you. You have an awesome rest of your day and take care. Thanks for calling APO bye-bye. Uh-huh.
[CUSTOMER][POSITIVE] And, and be safe. Thank you.
[AGENT][POSITIVE] Thank you, ma'am. You as well. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.