AccountId: 011433970860
ContactId: a4793256-fd13-4791-afd6-3fc37fbdee30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 462420 ms
Total Talk Time (AGENT): 271665 ms
Total Talk Time (CUSTOMER): 69043 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/a4793256-fd13-4791-afd6-3fc37fbdee30_20250617T20:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, this is [PII]. I was returning your call. Uh, it's for [PII].
[AGENT][NEUTRAL] Sure, uh, just give me one moment, Ms. [PII]. Do you happen to have your, uh, uh, policy number handy, or you need me to look it up?
[CUSTOMER][NEUTRAL] Uh, I have to get it. Hold on.
[AGENT][NEUTRAL] I can look it up. Just give me one moment.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I'll have you verify some information for me if you don't mind. Go ahead and verify your date of birth, please.
[CUSTOMER][NEUTRAL] Uh, mine is [PII].
[AGENT][NEUTRAL] And what about [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what's your mailing address please, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the last piece of verification, your email address please.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] It looks like it could be a work email.
[CUSTOMER][NEUTRAL] My work [PII]
[AGENT][NEUTRAL] OK, thank you. Would you like um if you don't mind, we're gonna go ahead and update that to your um personal email address you wanna go ahead and provide me a personal email?
[CUSTOMER][NEUTRAL] Uh, my personal is uh [PII]
[CUSTOMER][POSITIVE] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me just repeat that back. [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK, I'm gonna go ahead and update that, OK, and let's see.
[AGENT][NEUTRAL] And this was in regards to um and I believe it was um it's been a uh a while since I called you so my apologies. So um yeah, I left.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You know, I keep forgetting, looking at my voicemails.
[AGENT][NEUTRAL] Yeah. And OK, so what we received was actually um what we considered a non-appeal um it looks like you were, let me just pull that information up cause it looks like you were inquiring about um the surgery. Is that right?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, just give me one moment please.
[AGENT][NEUTRAL] I'm gonna pull up that.
[AGENT][NEUTRAL] Information we received last.
[AGENT][NEUTRAL] OK, my system is not cooperating, so I apologize for the delay just one moment, we're gonna go a different way.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like we received um a letter and you were basically inquiring why there was no coverage for the overnight stay from [PII], and this was in [PII], is that right?
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] We what we received was the discharge instructions that let us know that what the admission date was and then also provided us with some additional information. It looks like for uh for the surgery. So, I show that um we actually paid uh paid for the admission from 103 to 106 and it was paid on a previous claim.
[AGENT][NEUTRAL] Um, and I can provide you that claim detail if you'd like, and that was at University Medical Center, so it looks like we had a, um, initial claim for some outpatient services, uh, that were processed on the same claim for uh [PII] and then also we received um the hospitalization for the 103 to 106.
[AGENT][NEUTRAL] So we paid that benefit and it looks like part of it was paid to the hospital and then we paid the additional money that was um due we pay that to you directly. Did you receive that payment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I probably did. I need to go back on my records, so I just
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] I can provide you the check information.
[CUSTOMER][NEUTRAL] Wanted to follow up on everything.
[AGENT][NEUTRAL] Yeah, I can provide you the check information if you'd like. I can also see if that check cleared just let me take a look at that real quick and I can tell you that information as well. So it does look, it does look like the check, um, again that issue date was uh [PII]. We had a check go to you for the amount of 64631.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it showed it was cash and it gives us the uh status date saying that it cleared the bank on [PII]. And I can provide you that check number if you want to reference it with your bank.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] The check number was 17.
[AGENT][NEUTRAL] 48
[AGENT][NEUTRAL] 537.
[AGENT][NEUTRAL] And again that check amount was $646.31.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] And then, just so you're aware, Ms. [PII], your policy doesn't cover the surgery uh itself. It has benefits available for hospital admission and confinement. So it's just strictly those inpatient benefits. So there's no additional benefits such as, you know, for surgery or um any, any additional benefits. Again, it's just for hospitalization.
[CUSTOMER][POSITIVE] OK, alrighty.
[AGENT][NEUTRAL] Did you have, did you have any other questions?
[CUSTOMER][POSITIVE] No, I'm good.
[AGENT][NEUTRAL] OK, and I went ahead and updated your email address.
[CUSTOMER][NEUTRAL] Yes, that's it. I'm just going over.
[AGENT][NEUTRAL] Yeah, I went ahead and updated that email address for you just so you're aware, right?
[CUSTOMER][NEUTRAL] Uh-huh. That's OK.
[CUSTOMER][POSITIVE] All right. Well, thank you for your time.
[AGENT][POSITIVE] You're welcome, Ms. Sounds well. I hope you have a great rest of your day and thank you for calling APL.
[CUSTOMER][NEUTRAL] It
[AGENT][POSITIVE] Thank you bye bye.