AccountId: 011433970860
ContactId: c15178b5-8b15-4795-ba92-59df36f9aa77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445220 ms
Total Talk Time (AGENT): 143008 ms
Total Talk Time (CUSTOMER): 133177 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/c15178b5-8b15-4795-ba92-59df36f9aa77_20250404T17:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, sorry. My name is [PII]. Um, I have a policy number if that's helpful for you.
[AGENT][NEUTRAL] Yes, ma'am. I, I can take your policy number, Miss [PII].
[CUSTOMER][NEUTRAL] OK, it's 02599472.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] And Miss [PII], can I get your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] OK. Thank you. I appreciate you giving me that. The phone's been going in and out a little bit with this weather, so if that happens, it'll all come right back, but if we get disconnected, I will definitely call you back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, Ms. [PII], I've got your policy pulled up. I'll need for you to verify it for me. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yep, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number, and email address that we have on the policy?
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] I forgot the other thing. Email address is my full name um [PII]. Um, and there was one other thing.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And your phone number that we have on file.
[CUSTOMER][NEUTRAL] Oh, it's [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy for me. How can I help you today?
[CUSTOMER][NEUTRAL] So, I'm calling because um I've, I've changed to this um health insurance policy in the new year, um, from my, I was getting it through my health or from my um employer and um it was very um not well explained to me like how this works or what
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] I guess is covered because I was under the impression that my therapy sessions will be covered, um, but I got um an explanation of benefits in the mail for a couple, I, I submitted the claims myself because my um therapist is not comfortable with your guys' um process. Um, and it says outpatient treatment due to a sickness is not covered under this policy. Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also my, my therapist who didn't have any part in like the claim submittal, got um a letter from you guys that was asking for, it was asking for supplemental information, but the information it was asking for was on the claim that was submitted, which they were also provided a copy of to her. So I'm not sure, like I don't understand any of that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right. Right. I understand. Um, and I can only see what you see that the outpatient treatment due to a sickness is not covered under this policy. If you have additional information that indicates an accident, please submit for further review. So what I'm going to do is I'm going to, your phone number that you gave me, the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm gonna send in a request for a claims examiner to call you back and give you further information about this so that you can get some answers, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] OK, I'm gonna put you on a quick hold while I get that request sent in to them to give you a call back so I'm gonna get that together and I'll be right back with you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for holding for me, Ms. [PII]. I've got that request sent in and you should be getting a phone call back within 24 hours. Now, our office does close central time tonight at [PII] and then we've got the weekend and we don't work weekends, so we'll open back up again at [PII] on Monday.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK. All right. Is there anything else? It's no problem at all. Is there anything else I can help you with, Miss [PII], before we go?
[CUSTOMER][POSITIVE] All right, thank you very much. I appreciate that.
[CUSTOMER][POSITIVE] I don't believe so. Thank you.
[AGENT][POSITIVE] You're welcome. You have a great weekend and thank you for calling APL.
[CUSTOMER][POSITIVE] Thanks you too bye.
[AGENT][NEUTRAL] Bye-bye.