AccountId: 011433970860
ContactId: aeec5260-9b03-4c71-aa68-9c36d16f6843
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 561599 ms
Total Talk Time (AGENT): 264846 ms
Total Talk Time (CUSTOMER): 148863 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/aeec5260-9b03-4c71-aa68-9c36d16f6843_20250310T20:26_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], how you doing?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good, thank you for asking [PII]. I'm trying to process a claim for a policy that's terminated and the the data services while the policy was active, but it's not allowing me to it's not allowing me to process the claim.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Who is this?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, I thought I recognized your voice, but it come in through like a [PII] number like an insure call.
[CUSTOMER][NEGATIVE] Because, so I don't have the direct number to customer service, [PII]. So I call my cell phone and then I put myself on hold and then contact customer service.
[AGENT][NEUTRAL] Oh, OK, I see.
[AGENT][NEUTRAL] Oh, I see
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh my. OK. All right, so let me, [PII], I'm sorry, let me go in and take a look. What's your policy number, dear?
[CUSTOMER][NEUTRAL] It's 209-9852.
[AGENT][NEUTRAL] 852. Let me write that down in case I lose my screen too.
[CUSTOMER][NEUTRAL] It's 209-9852.
[AGENT][NEUTRAL] 852. OK.
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] Mhm. And the date of service is [PII].
[AGENT][NEUTRAL] OK, she's paid up to 31.
[CUSTOMER][NEUTRAL] Of 25, but it won't let me process my claim for um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. I mean, it's, I had to reactivate it real quick.
[CUSTOMER][NEUTRAL] Please, if you don't mind, so I can process the claim and then I'll let you know when I'm done.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm. Yeah. So which benefit are you trying to do?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Outpatient?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK. Well, you know what, I love.
[CUSTOMER][NEUTRAL] Well, actually I have all the information in there. Mhm.
[AGENT][NEUTRAL] You know what, there was nothing been chosen.
[CUSTOMER][NEUTRAL] Mm, I got outpatient.
[AGENT][NEUTRAL] Uh, yeah, but it ain't no out.
[CUSTOMER][NEGATIVE] It just won't let me
[AGENT][NEGATIVE] Yeah I know, you know why? Because there's no benefit, no benefit amount out beside the benefits.
[CUSTOMER][NEGATIVE] Oh, see, I didn't even pay attention to that. I just went through with the processing.
[AGENT][NEUTRAL] At all. That's what it is.
[AGENT][NEUTRAL] I know that's what it is. Let me fix it though. Hold on, give me just a second. You're welcome. I have to go pull another policy number up and look.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And see what the benefits are.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't know. That was weird because it
[AGENT][NEGATIVE] It took them away.
[AGENT][NEUTRAL] For some reason.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How have you been, [PII]?
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] I've been busy girl. Busy.
[AGENT][NEUTRAL] What about you?
[CUSTOMER][NEUTRAL] Same, same.
[AGENT][NEUTRAL] Girl.
[AGENT][NEUTRAL] Yes, busy, busy as a bee.
[AGENT][POSITIVE] I've been doing good.
[CUSTOMER][POSITIVE] That's good.
[AGENT][POSITIVE] Oh it, it does have the benefits on here.
[AGENT][NEUTRAL] They just way, it's a, it's different. It's a HI I mean it's an IPPY benefit.
[AGENT][NEUTRAL] I've never seen one of those.
[CUSTOMER][NEUTRAL] Let me see if I can.
[AGENT][NEUTRAL] No, it's you said outpatient?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me take that term out. Mhm. Oh, an ER visit. OK, hold on. Let me go find the ER. This is so weird.
[CUSTOMER][NEUTRAL] That for ER visit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hold on. Never fear. I'm gonna fix it though.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] Let me make sure.
[AGENT][NEUTRAL] It's going.
[AGENT][NEUTRAL] ER OK.
[AGENT][NEUTRAL] It that.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Fix that.
[AGENT][NEUTRAL] It's a lot.
[AGENT][NEGATIVE] I'm just gonna fix all of them.
[AGENT][NEUTRAL] That way it won't mess anything up maybe OK now see if it'll let you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You're saying no plan your dates found for this group.
[CUSTOMER][NEUTRAL] But I see here.
[AGENT][NEUTRAL] Hm. Well, they're activated.
[CUSTOMER][NEUTRAL] Let me go back out.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm. Yeah, do that. Because.
[AGENT][NEUTRAL] Nothing else has been done to the policy?
[AGENT][NEGATIVE] Like no changes to anything.
[AGENT][NEUTRAL] Just
[AGENT][NEUTRAL] help.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It should do it because there ain't been no um other like you know removing the dependent sometimes that'll mess things up if you have a dependent you go back and remove it and change it to individual back and forth and ain't never had nothing like that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm putting it back in again.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm. It still give me year plan dates. No plan year date found for this group.
[AGENT][NEUTRAL] OK, wait a minute now. What date are you doing one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] It should because there's no, there's been no reinstatements.
[AGENT][NEUTRAL] No lapse in coverage.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I just find it.
[CUSTOMER][NEUTRAL] I'm my opinion didn't let San to look at it and see what's going on with it.
[AGENT][NEUTRAL] Yeah, cause it, it's not um.
[AGENT][NEUTRAL] Usually, if, if there's something wrong or off, um.
[AGENT][NEUTRAL] And I don't know if y'all have ever processed a claim for an IPPY.
[AGENT][NEUTRAL] Usually it's IPCY calendar year. This is a plan year.
[CUSTOMER][NEUTRAL] Mhm. Outpatient plan year. we're supposed to go from.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It, it didn't terminate until [PII] though.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] Right, that's what I'm saying, it went from [PII], never had a reinstatement, never anything.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, there's no other like no other dropped benefits or anything in here.
[CUSTOMER][NEGATIVE] And then they just had something that was processed for [PII]. I don't understand.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's not telling me that the benefit.
[CUSTOMER][NEUTRAL] Plan is maxed out. I see that there's no plan you found, but I'll get [PII] to look at it.
[AGENT][NEUTRAL] I bet you that's what, I wonder if that's what it is and it's telling you, giving you that, that kind of message or it's not telling you the right message or something.
[CUSTOMER][NEUTRAL] Because they normally would say benefits maxed out.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] Yeah, it'll tell us. But thank you for assisting me, [PII].
[AGENT][NEUTRAL] But girl, I wish I could assist you and help you out, but I don't know I could do.
[CUSTOMER][NEUTRAL] You tried.
[CUSTOMER][NEUTRAL] You try.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Well, it was nice chatting with you.
[AGENT][POSITIVE] You too, [PII]. You have a good afternoon or good evening.
[CUSTOMER][POSITIVE] You do the same. Thank you. Goodbye.
[AGENT][POSITIVE] All right, honey. You're welcome. Bye bye.