AccountId: 011433970860
ContactId: a3c11092-1c62-4802-bfb0-3e77b2420586
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 275299 ms
Total Talk Time (AGENT): 99798 ms
Total Talk Time (CUSTOMER): 104969 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/a3c11092-1c62-4802-bfb0-3e77b2420586_20250623T15:14_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII]. Um, I have the account holder. I wanted to double check on my effective date because my policy should have started on [PII]. When I check online, it says effective [PII].
[AGENT][NEUTRAL] OK, are you the insured?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have your policy number?
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] It is 263.
[CUSTOMER][NEUTRAL] 9902.
[AGENT][NEUTRAL] Thank you. Hold on one moment, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And how did you pronounce your last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] For [PII], correct.
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And you were wanting to know about a claim or your effective date.
[CUSTOMER][NEGATIVE] Uh, no.
[CUSTOMER][NEUTRAL] The effective date, yes, because I have an appointment this Thursday, but I'm a little worried about the effective date.
[AGENT][NEUTRAL] OK, I can help you with that. Uh, the effective date, yes, is [PII] and paid to [PII], but it is showing active.
[CUSTOMER][NEUTRAL] It's showing active but it's showing that.
[CUSTOMER][NEUTRAL] Is there something wrong with it?
[AGENT][NEUTRAL] Not that I know of, no, ma'am.
[CUSTOMER][NEUTRAL] So if they were to call to get benefits, it, they wouldn't say that my policy terms.
[AGENT][POSITIVE] Right, they would get benefits because this the status is active. Yes, ma'am.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty, um.
[CUSTOMER][NEUTRAL] But shouldn't it have a different date?
[CUSTOMER][NEUTRAL] Like the end date?
[AGENT][NEGATIVE] It doesn't. It just says paid to 61.
[AGENT][NEUTRAL] Can I verify your uh address and email address, please?
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And my email address is [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII]. Yes, ma'am. It's showing active, so if they do call, they will get benefits.
[CUSTOMER][NEUTRAL] Got it. OK, I just wanna make sure. I don't want them to have any issues.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK. Sounds good. All right. Thank you so much for your help.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes, um, for outpatients, what is the
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] The amount
[AGENT][NEUTRAL] Outpatient we'll pay up to $6500.
[AGENT][NEUTRAL] And any benefits given over the phone is not a guarantee of payment.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK, and if they don't submit, I have to submit the claim I just call or do that online?
[AGENT][NEUTRAL] Yes, ma'am. You can do it online. We will need an itemized bill that has procedure codes.
[AGENT][NEUTRAL] Diagnosis code and charges.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we would also need your explanation of benefits from your primary insurance because this policy coordinates with the primary.
[CUSTOMER][POSITIVE] Perfect. OK. No, that's all. Thank you so much for your help.
[AGENT][POSITIVE] Thank you, Ms. [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you