AccountId: 011433970860
ContactId: ba3d4c17-1a2f-4db7-810a-09eac898d887
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 314989 ms
Total Talk Time (AGENT): 120705 ms
Total Talk Time (CUSTOMER): 159587 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/ba3d4c17-1a2f-4db7-810a-09eac898d887_20250117T20:08_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. I, I just got a statement, uh, that says we received the claim in your policy and the review of the claim has started, um, I have not had.
[CUSTOMER][NEUTRAL] This insurance sets.
[CUSTOMER][NEUTRAL] It should have ended um because the job I had ended [PII], so I have not had this insurance. I want, I'm gonna say since [PII].
[AGENT][NEUTRAL] Well, I'll be happy to check that for you, sir. On that statement, does it have your reference number or policy number?
[CUSTOMER][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] No, it doesn't. It just, it just has, um, let let me look on the bottom.
[AGENT][NEUTRAL] We received information now there may be a policy number on the bottom corner.
[CUSTOMER][NEUTRAL] Um, no, it's, it's, it's your number, address, and all of that there, um, let me see if I can find maybe something else.
[AGENT][NEUTRAL] Or I can look it up by your social or name, whichever would be best for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, let's let's do it that way.
[AGENT][NEUTRAL] What's the social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, thank you and what is your name please, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII]. Can you verify your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Yep, uh, date of birth [PII], mailing address is [PII].
[AGENT][POSITIVE] Thank you. And a good callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. Let me get this claim pulled up because I see we processed a claim on the [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And probably they just still have your information.
[AGENT][NEUTRAL] Um, this is a claim back on [PII] for Ascension McComb Oakland Hospital.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like they sent in a claim and then before and sent this one.
[AGENT][NEGATIVE] And we denied it as duplicate.
[CUSTOMER][NEUTRAL] Yeah, because I
[CUSTOMER][NEUTRAL] Yeah, because if you're looking, if you can if you can see the date this claim should have been [PII], is that the date you have [PII]?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, alright, yeah, so at the time I still had um APL, yeah, I did.
[AGENT][NEUTRAL] Right. So let me take another look.
[AGENT][POSITIVE] I'm getting to the original claim to see why they're sending it back in. Bear with me just one moment. I'll be happy to check on this for you, Mr. [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this was for an emergency room visit and we paid the maximum benefit for that data service before we received the emergency room charges. So there were no benefits payable.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like they just keep sending it in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To see if we're gonna change our minds.
[CUSTOMER][NEUTRAL] Yeah, because
[CUSTOMER][NEUTRAL] I mean, yeah, because they um.
[CUSTOMER][NEGATIVE] They sit with me, let me go I just go because I get so many of these, but I, I already had an account with this with this hospital in this emergency room, and if I'm not mistaken, the emergency room visit was like $700 something dollars and they put it, they put it on the bill that I already had and that I've been paying for the last 2 years, so I don't know what they're doing, but yeah, yeah.
[AGENT][NEUTRAL] So that that's what it is they just keep sending it in you may get another notification looks like they may just keep sending it in. I don't know.
[CUSTOMER][NEUTRAL] Yeah, I, I, I don't either because like I said, I no longer, I no longer have the insurance. I have a, you know, I have a whole different insurance, but I have not been back to that hospital since I have this new insurance, so I don't know.
[AGENT][NEUTRAL] Yeah, but that's what it is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, but I just wanted to, I just want, you know, I just wanted to, you know, resolve it. I think it, I think it's resolved, um, you know, because again, like I said, I don't have this insurance no more so I didn't, you know.
[CUSTOMER][NEUTRAL] Whatever it could or whatever could or could not go, I just wanna make sure that that you know is not going so yeah this I'm all I'm all set and all clear on this, ma'am.
[AGENT][POSITIVE] Well, it's been such a pleasure to assist you, Mr. [PII], and I thank you for calling APL. I hope you have a wonderful afternoon and a very happy weekend.
[CUSTOMER][POSITIVE] You as well thank you very much. I don't know where you're at, but I'm in, I'm in [PII] and the Lions is in the playoffs, so we, uh, we play the [PII] and all night.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] You're gonna have a really good weekend, aren't you?
[CUSTOMER][POSITIVE] Yes we are.
[AGENT][POSITIVE] Well, you enjoy it
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] OK, alright, thank you ma'am.
[AGENT][POSITIVE] Thank you. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] Alright you as well bye bye.