AccountId: 011433970860
ContactId: a63dfcf4-ff16-4d70-ad86-4b663344c432
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 322640 ms
Total Talk Time (AGENT): 231625 ms
Total Talk Time (CUSTOMER): 130860 ms
Interruptions: 8
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/a63dfcf4-ff16-4d70-ad86-4b663344c432_20250211T14:14_UTC.wav
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[AGENT][NEUTRAL] For calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] trying to she said.
[CUSTOMER][NEUTRAL] Yes, ma'am. Maybe you can help me cause the last agent could not. I am calling.
[AGENT][NEUTRAL] Yes, ma'am. I see, before, before you start, give me your name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Ms. [PII], what's your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. Ms. [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me have it.
[CUSTOMER][NEUTRAL] 252-744-1
[AGENT][NEUTRAL] All right. Thank you, Ms. [PII]. And just verify your date of birth for me and your mailing address for verification.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, and what's the email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you for the information. How can I help you today?
[CUSTOMER][NEUTRAL] Yes, I'm calling about a claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That was denied. Can I give you the claim number? Maybe that would be helpful in this situation.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. Hold on one moment. Give me one second to write this down. 527441. What's that claim number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It is 35.
[CUSTOMER][NEUTRAL] 61584
[AGENT][NEUTRAL] All right. Let me look that up for you.
[CUSTOMER][NEUTRAL] Give me 1 2nd. Sit down.
[AGENT][NEUTRAL] US school
[CUSTOMER][NEUTRAL] Get off the stage. Get off the stage and sit in the seat.
[CUSTOMER][POSITIVE] I apologize. Yes, ma'am.
[AGENT][NEUTRAL] You at school, you at school.
[CUSTOMER][NEUTRAL] Yes, ma'am, just walked in, man here back and pray.
[AGENT][NEUTRAL] Yes sir, I got it. And Miss Miss uh [PII], that policy number that that particular claim is on, that's on claim on policy number 242-6704. So I do see that in this uh date of service [PII] for we pay $50 for a mammogram.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] And yeah I guess.
[CUSTOMER][NEUTRAL] OK, and say hey.
[CUSTOMER][NEUTRAL] Oh so so.
[CUSTOMER][NEUTRAL] No, we can look for something.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am. What, what, what, what, what, what you call, what's going on with that one?
[CUSTOMER][NEUTRAL] OK, well, I thought that was the one I had claimed that my husband that was denied.
[AGENT][NEUTRAL] No, this one right here is on you area. This one, so you let me, let me put, let me see on this one. Let me see did you do anything on your husband. Hold on. Let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Yes, one on there for him too.
[AGENT][NEUTRAL] Number 2, it's in the line to be processed. Something just came in our office on uh [PII] in line to be processed, but on [PII] we processed an image of $500 on him for a PET scan and then it's uh it's another claim waiting to be processed came in on [PII]/7 and it's in line. I'm not sure what it is, but it's in line. Yes ma'am.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes, ma'am. OK.
[CUSTOMER][NEGATIVE] OK, I'm just making sure I thought that was the one cause I'm like y'all denied that too fast.
[AGENT][NEUTRAL] Oh no, we, we haven't, no, we, we haven't denied anything on this particular policy which is 0257441 on him. That's the, that's the one they got it on. Yeah. And what is that data, what is that data service for his uh wellness?
[CUSTOMER][NEUTRAL] I was just trying to see.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Well, it's not a wellness, it's a cancer claim.
[AGENT][NEUTRAL] OK, what is that data service? Is it after one?
[CUSTOMER][NEUTRAL] 116 25 and then 130 25.
[AGENT][POSITIVE] Yeah, they're gonna have it on.
[AGENT][NEUTRAL] Let me see, because they gonna have to get it on the right claim then let me look at it out here for you because uh this particular policy stops at 11 of 25. The policy you gave me previous 252-7441, that starts at 125, so they're gonna have to get it on the right policy, but we'll make sure it gets on the right policy. 7441.
[CUSTOMER][NEUTRAL] Yeah, cause the policy is supposed to be on [PII]6, supposedly they told me I could start claiming after the 16.
[AGENT][NEUTRAL] OK, yeah, let, let me see what the data are.
[AGENT][NEUTRAL] Yeah, let me see what that day service is that service data service is and they'll get it on the right one.
[AGENT][NEGATIVE] And they got 20 pages. That's what was submitted 20 pages.
[CUSTOMER][NEUTRAL] Oh, I ain't no telling. I just downloaded and upload it.
[AGENT][NEUTRAL] OK, it came up 20 pages, OK. I'm just trying to look at a data service where we can get this put on the right policy. OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, let's see what's coming up.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, this date of service receive, OK, let's say [PII]nuary 3rd service date. So yeah, I get them to put this on the right policy. They got it on the wrong policy. So long as they nothing in 2004 on it, it's on the correct, it's gonna be put on the correct policy. I'm trying to make sure everything is 2025.
[AGENT][NEUTRAL] After after 11 of 2025.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, OK, well, anyway, uh, we do have it and I'll make sure they get this on the right, uh, policy, so if you call back to check on it, it will be on the first policy you gave me 252-7441.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, ma'am. That's the correct one.
[AGENT][POSITIVE] OK. OK, yes, ma'am. I'll get it on the correct one. All right.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate it.
[AGENT][POSITIVE] You're welcome. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, that's all.
[AGENT][POSITIVE] Alright, have a wonderful day and thank you for calling American Public Life. Bye-bye.
[CUSTOMER][POSITIVE] You do the same. Thank you.