AccountId: 011433970860
ContactId: b21c0a0b-4c05-417e-861a-08309bedf0c3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 306459 ms
Total Talk Time (AGENT): 86139 ms
Total Talk Time (CUSTOMER): 138508 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/b21c0a0b-4c05-417e-861a-08309bedf0c3_20250225T16:08_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], good morning. My name is uh [PII]. I'm calling um about a claim.
[AGENT][POSITIVE] OK, I'd be happy to assist with the claim today, Ms. [PII], if I can get a good call back number for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] 01936591.
[AGENT][NEUTRAL] Alright, and if you can please verify your date of birth and the email address on the account.
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] And you said email?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Uh it's, I don't know if it's my job or my, or my personal, but it's [PII].
[AGENT][NEUTRAL] Um, that's not the one that we have.
[CUSTOMER][NEUTRAL] I don't know if that's the newest
[CUSTOMER][NEUTRAL] Or the one with the palace, probably that's, it's my work one. maybe [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's what we have.
[CUSTOMER][NEUTRAL] Yes, that's through work, mhm.
[AGENT][NEUTRAL] OK, and is this regarding yourself or dependent?
[CUSTOMER][NEUTRAL] My dependent, my child.
[AGENT][NEUTRAL] Uh, their name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, and what's the date of service?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, I have here for the [PII].
[CUSTOMER][NEUTRAL] It's for cranial technology.
[AGENT][NEUTRAL] OK, I'm showing that that did not because durable medical equipment is not covered under the policy.
[CUSTOMER][NEGATIVE] It's because it's not covered.
[CUSTOMER][NEUTRAL] And if this is like a medical necessity within that.
[CUSTOMER][NEUTRAL] Wouldn't it be covered if it's like something that's medically necessary?
[AGENT][NEGATIVE] It's, you don't have a benefit for durable medical equipment, so that's why it's not covered.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm showing that on your your gap policy only covers for inpatient.
[CUSTOMER][POSITIVE] I'm pretty draw.
[AGENT][NEUTRAL] An outpatient.
[AGENT][NEUTRAL] It doesn't cover for durable medical equipment. Yeah, that's a different benefit.
[CUSTOMER][NEUTRAL] Oh, that's a different thing.
[CUSTOMER][NEUTRAL] Wow, OK. I see. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Um,
[CUSTOMER][NEUTRAL] Sounds good. Um, I, there's nothing to do about that, I guess.
[CUSTOMER][NEUTRAL] Well, um, OK, and then I have a quick question because I had another, um, I was trying to put in another claim. I know that there's a company that was trying to, to work on that and get a claim as well with the gap.
[CUSTOMER][NEUTRAL] Um, under like the company of pediatrics, ending with an X. I don't know if you can check that for me, please.
[AGENT][NEUTRAL] You said someone else was trying to file a claim?
[CUSTOMER][NEUTRAL] Well, yeah, I was trying to find it because I, I was getting a bill from the hospital, um, from a company. I got a letter from a company called Pediatrics.
[CUSTOMER][NEUTRAL] So I had given them, I had given them my gap.
[AGENT][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] For it to see if it was covered by, you know, their gap.
[AGENT][NEUTRAL] And this is for your dependents still?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, for what data service?
[CUSTOMER][NEUTRAL] I actually would not be able to tell you that. I don't have the letter.
[AGENT][NEUTRAL] I'm only showing we have two claims for her, the one that we just discussed, and then another claim from [PII].
[CUSTOMER][NEUTRAL] I would have to get that.
[AGENT][NEUTRAL] A hospital stay and we paid that, so there are no other claims that we've received.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, there's no other thing. It might have been that long.
[CUSTOMER][NEUTRAL] OK, OK, might have been down. I'll check the letter. I don't have it with me, but I'll check to see if it's the same date.
[CUSTOMER][NEUTRAL] So it was when she was born that same day.
[AGENT][NEUTRAL] Oh, OK, yeah, we received the hospital claim for that and then we paid it we paid what was owed the $538.80 but those are the only two claims we have for her. No one else has filed with us.
[CUSTOMER][POSITIVE] OK. All right, perfect. Thank you so much.
[AGENT][NEUTRAL] OK, was there anything else I could assist with today?
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][POSITIVE] No, that's all. Thank you so much for your help.
[AGENT][POSITIVE] Mm thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You too bye bye.