AccountId: 011433970860
ContactId: b8c544bc-8610-4c00-b139-4c5bf7206dab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 280730 ms
Total Talk Time (AGENT): 125050 ms
Total Talk Time (CUSTOMER): 101596 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/b8c544bc-8610-4c00-b139-4c5bf7206dab_20250121T17:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. Um, my name is [PII]. Um, I did a surgery, um, last year in June.
[CUSTOMER][NEUTRAL] And the doctor sent me a bill for $88.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, insurance.
[CUSTOMER][NEGATIVE] That I have paid $290 something dollars and I paid $30 and the rest, I gave them the APL card but then they're gonna tell me that when they apply the APL um insurance, they said you guys said you're not supposed to pay. I, I don't understand.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, we will take a look at that claim, [PII] um see what's going on with that first, uh, if you don't mind, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, policy number is 137.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2874
[AGENT][NEUTRAL] All right, one moment please.
[AGENT][NEUTRAL] Alright, just gonna verify some information really quick, [PII]. Can I get your date of birth please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address that we've got on file for you. uh, looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEGATIVE] Uh, that's not the one that we've got for you.
[CUSTOMER][NEUTRAL] It's, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, that's not what I've got either.
[CUSTOMER][NEUTRAL] I don't have it in my email address.
[AGENT][NEUTRAL] Hm, OK, that's all right. You were able to verify everything else. All right, let's take a look here. Bear with me just a moment.
[AGENT][NEUTRAL] So the email I've got for you is uh [PII].
[CUSTOMER][NEUTRAL] Yeah, that's, that's my wife.
[AGENT][NEUTRAL] OK, OK, do you want me to change that?
[CUSTOMER][NEUTRAL] That's her, that, yeah.
[CUSTOMER][NEUTRAL] Mm, no, that's what's there.
[AGENT][POSITIVE] OK, OK. Sure, no worries. All right.
[AGENT][NEUTRAL] And OK, so let's take a look at this claim, Roger, do you, uh, know the date of service? What was the date that you had this, uh, procedure?
[CUSTOMER][NEUTRAL] OK, the service was.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And I will also let you know um just so that you are aware, the policy number that you gave me uh was a bit of an older one it terminated in [PII] I can give you your active policy number if you'd like that for your records.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK it is 01.
[AGENT][NEUTRAL] 91
[AGENT][NEUTRAL] 28
[AGENT][NEUTRAL] 79.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and this procedure was for you, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] At um Gastro Health Services.
[AGENT][NEUTRAL] That's your health. OK, thank you. Give me just a moment.
[AGENT][NEUTRAL] OK, so the claim we received, we did receive the claim, uh, from Gastro Health for the state of service was for an office visit and office visits are not covered under your policy.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] All right then. I guess I'll pay that $88.
[AGENT][NEUTRAL] Treatment received in office could be covered. It's just that the visits themselves are not.
[CUSTOMER][NEUTRAL] So the charge is $288 388 dollars for office visit.
[AGENT][NEUTRAL] That's what we have here, yes.
[CUSTOMER][POSITIVE] OK. All right. Thank you.
[AGENT][NEUTRAL] Yeah, did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, that's, that's it.
[AGENT][POSITIVE] All right well thanks for giving us a call [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Yeah