AccountId: 011433970860
ContactId: bbd2f4f8-b5b1-42eb-8f53-21d39a5dbf32
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 634000 ms
Total Talk Time (AGENT): 108846 ms
Total Talk Time (CUSTOMER): 161477 ms
Interruptions: 2
Overall Sentiment: AGENT=1.2, CUSTOMER=-1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/bbd2f4f8-b5b1-42eb-8f53-21d39a5dbf32_20250130T17:35_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? My name is uh [PII]. I have, uh, a plan with you guys. It's a group plan, and I would like to have a copy of the inhospital benefits that they were paid out and outpatient benefits that were paid out from [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So you would like a copy of all the ELBs listed on your policy for from [PII] [PII].
[CUSTOMER][NEUTRAL] That is correct, uh, from inpatient and outpatient, uh, benefits. The reason for this.
[AGENT][NEUTRAL] Are you aware of the online? Go ahead.
[CUSTOMER][NEUTRAL] Uh, no, they, I was advised to call you guys because there's a, there's a problem with my, I, I recently went into uh cancer treatment and there's uh an issue between my primary, uh, insurance and you guys, so I need to show proof of everything that you guys pay and to what uh doctor or facility you guys pay the amount.
[AGENT][NEUTRAL] What is your policy number?
[CUSTOMER][NEUTRAL] The policy number, I, the group number, that's what you mean?
[AGENT][NEUTRAL] No, it should say policy or er number.
[CUSTOMER][NEUTRAL] I have a group number 222.
[AGENT][NEUTRAL] Inpatient, no, it should say, that's not the policy number, sir. It should say inpatient, outpatient cert number or policy number on your card.
[CUSTOMER][NEUTRAL] OK, so which one do you, I have two different numbers. I have an inpatient and outpatient.
[AGENT][NEUTRAL] Either one.
[CUSTOMER][NEUTRAL] OK, 01935548 M as in Mary, L as in Larry, number 7.
[AGENT][NEUTRAL] Thank you. So can I have your full name, mailing address, and your date of birth?
[CUSTOMER][NEUTRAL] [PII]. Mailing address is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And what is the callback number just in case the call is disconnected here, bro?
[CUSTOMER][NEUTRAL] I can give you two numbers, so it's uh [PII] or [PII].
[AGENT][NEUTRAL] Thank you and what is the email address that we have on file for you?
[CUSTOMER][NEUTRAL] I don't know if it's my work email or my personal email. I give you both and you tell me which one of the two is [PII] agent [PII]. That is my personal and my work email is [PII].
[AGENT][NEUTRAL] So we have [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so you call and you said you needed ELBs for each.
[CUSTOMER][NEUTRAL] Yeah, in hospital benefit and outpatient benefit, right? Everything that it was paid out to what provider it was paid, uh, from [PII], so the whole year basically.
[AGENT][NEUTRAL] Hey
[AGENT][NEUTRAL] Mhm. So it looks like there was only 3 claims paid for that year.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] That was in the in the hospital. I can give you the outpatient benefit and uh and see how many claims were paid on that.
[AGENT][NEUTRAL] So outpatient, there's one for [PII] for the amount of $3,048.15.
[AGENT][NEUTRAL] I send it to your email.
[CUSTOMER][POSITIVE] Yeah, if you can send me that via email I would really appreciate it.
[AGENT][NEUTRAL] May I place you on a brief hold?
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][POSITIVE] Thank you. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, thank you for holding. So I wanted to come back to verify if you received those emails that I sent out the ELBs that I sent over to you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I got in 3 emails so far.
[AGENT][NEUTRAL] Alright, so that's, so those are the only ELVs that we have. I think it was 4 in total. It was 1234 in total that we paid for 2024.
[CUSTOMER][NEUTRAL] Got it. And these are the I see outpatient.
[CUSTOMER][NEUTRAL] Do you have any inpatient uh pain?
[AGENT][NEUTRAL] No, the only thing that was paid was the ones that I sent over for you. There's no inpatient pay claims.
[CUSTOMER][NEUTRAL] Understood, understood.
[AGENT][NEUTRAL] From [PII] unless if you have services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, so for that I got in 3 emails. You sent me 4 emails you said?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's 4.
[CUSTOMER][NEUTRAL] OK, yeah, I got in 3 so far.
[AGENT][NEUTRAL] Yeah, I said 123, 4's 4 of them.
[CUSTOMER][NEUTRAL] The only one should be coming.
[CUSTOMER][POSITIVE] Alright perfect thank you so much I really appreciate your help.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] That'll be all for now. Thank you.
[AGENT][POSITIVE] Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank.