AccountId: 011433970860
ContactId: a703c4a1-f270-4d13-80cb-3df42e958d2f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 215899 ms
Total Talk Time (AGENT): 105179 ms
Total Talk Time (CUSTOMER): 65240 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/a703c4a1-f270-4d13-80cb-3df42e958d2f_20250307T16:16_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 received um a bill from a recent doctor visit and based off what I'm seeing, it shows that insurance covered none of my visits, so I just wanna figure out what happened and if I can get some of it covered.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sure, let's uh check to see if we received that claim and what's going on with that um what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Pretty sure
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and then can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have your policy number?
[CUSTOMER][NEUTRAL] Um, yeah, is it?
[CUSTOMER][NEUTRAL] It's 025.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 17379
[AGENT][POSITIVE] OK, thank you one moment please.
[AGENT][NEUTRAL] All right, [PII] I'm just gonna verify some information really quick. Uh, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then, uh, can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. The last thing I need is the email address we've got on file for you. Uh, looks like it is a Yahoo account.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] I've got [PII]. Is that not right?
[CUSTOMER][NEUTRAL] No, it should be [PII].
[AGENT][NEUTRAL] OK, OK, let me get that changed. That's why we do this.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] OK, so that was [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, OK, so we were just missing the [PII], got it, OK.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] So is this just the one claim, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you happen to have that date of service or uh the name of the provider's office?
[CUSTOMER][NEUTRAL] The provider's office is Louisiana Dermatology Associates.
[AGENT][NEUTRAL] OK, so I will say I've only got one claim on file for you and it is for them, uh, for the date of service of [PII]. Does that sound right to you?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Take a look here. OK, so we were unable to pay a benefit on this claim as per your policy office visits are not covered.
[CUSTOMER][NEUTRAL] So an office visit is $264.
[AGENT][NEUTRAL] Um, that's, I don't know if that's how much they charge. Um, that's going to be their ballpark. We were just unable to pay a benefit just the office visits are not covered. So per your policy, if you receive treatment in office, that could be covered, but if it was something just like, you know, a consultation or something like that, this policy would be unable to pay a benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Interesting. OK, so I need to call them.
[CUSTOMER][POSITIVE] Um, OK, well I appreciate your help. I will give them a call.
[AGENT][NEUTRAL] Yeah, of course. Did you have any other questions for me?
[CUSTOMER][POSITIVE] That's it. I appreciate it.
[AGENT][POSITIVE] Alright, you're very welcome. I hope you have a great rest of your day. Thanks for giving us a call.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thanks bye bye.