AccountId: 011433970860
ContactId: bdc81724-db04-498a-884d-a8c189fbdc69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 163139 ms
Total Talk Time (AGENT): 71128 ms
Total Talk Time (CUSTOMER): 57417 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/bdc81724-db04-498a-884d-a8c189fbdc69_20250117T15:49_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APO this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing good. I don't think I need to transfer. I just don't understand this claim. Can you look at something with me?
[AGENT][NEUTRAL] Yeah, what's the policy number?
[CUSTOMER][NEUTRAL] It is 219-214-3, it's for part two.
[AGENT][NEUTRAL] OK, give me just a second here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All these names.
[CUSTOMER][NEUTRAL] So those two claims for 2024.
[CUSTOMER][NEUTRAL] Uh, I read the reason, so it's saying that the benefits were exhausted for the year, but she, I don't see any claims for 2024 that was paid out.
[AGENT][NEUTRAL] Um, 8171, uh, give me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK. Um.
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] So was I, am I looking at this right or no?
[AGENT][NEUTRAL] Yeah, you're looking at it right? Let me pull both these claims up. Hold on, let me make sure they're both entered on the claim form is 2024 and it's just not entered in the system is 2024, not 2023.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3, OK.
[AGENT][NEUTRAL] Give me just a second.
[AGENT][MIXED] If my systems would work for me, it would be great.
[CUSTOMER][NEUTRAL] Oh, it's OK. So I'm looking at the 879.
[CUSTOMER][NEUTRAL] To see what the claim what was sent in.
[AGENT][NEUTRAL] OK, this is the 883 and it's 2024, so what I would do is I know you'll have to send her a request now, right?
[CUSTOMER][NEUTRAL] I don't know. I'm.
[CUSTOMER][NEUTRAL] Uh, I'm sorry.
[AGENT][NEUTRAL] I would just send her request.
[CUSTOMER][NEUTRAL] I think so, but I'll figure it out. But yeah, it's a hub and then what?
[AGENT][NEUTRAL] Yes, I would just send her request asking for those two claims to be reviewed because the remark code shows that those claims have been, um, the benefits have been exhausted for the calendar year and those were the first claims that they sent in for the wellness claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I will do that.
[AGENT][NEUTRAL] So that's what I would do because it doesn't look they've been exhausted.
[CUSTOMER][NEUTRAL] OK. I just, I was like, well, maybe I don't get it. OK. Well, I was just making sure.
[AGENT][NEUTRAL] No, you're looking at it right.
[AGENT][POSITIVE] No, you did good.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Alright, bye bye.