AccountId: 011433970860
ContactId: c25123f7-b8b9-46cb-b14c-8b1a13f5bbb3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371690 ms
Total Talk Time (AGENT): 134189 ms
Total Talk Time (CUSTOMER): 219832 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/c25123f7-b8b9-46cb-b14c-8b1a13f5bbb3_20250626T14:28_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, hi, good morning, um, I just called I I logged in to look at my um my claims. Can I give you, um, what do you need my social or?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Your policy number.
[CUSTOMER][NEUTRAL] 195 or wait I think it's the certificate number 01.
[CUSTOMER][NEUTRAL] 346368, M as in Mary, L as in Larry, number 8.
[AGENT][NEUTRAL] Thank you. Can I have your name, mailing address, and your date of birth?
[CUSTOMER][NEUTRAL] [PII] Little Date of birth is [PII].
[AGENT][NEUTRAL] And what was your date of birth, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The error, what is the email address that we have on file for you and a good call back number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Sure, first name [PII] and my phone number is [PII].
[AGENT][NEUTRAL] So [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And how can I assist you today?
[CUSTOMER][NEUTRAL] So, um, I'm calling because [PII], I think is her name.
[CUSTOMER][NEUTRAL] Send an email to um our office manager saying it appears uh that Ms. [PII] has already reached her outpatient benefits.
[CUSTOMER][NEUTRAL] For [PII], uh, but we were discussing a bill for [PII] lab work that was done.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Um, but I have a question uh.
[CUSTOMER][NEUTRAL] I have a question about a um [PII]. It says that you paid 1,28728.
[AGENT][NEUTRAL] [PII]. There's no, there's no claim on file for the date of service of [PII]. Are you saying that that's the date that we paid it, we made a payment on a claim for [PII].
[CUSTOMER][NEUTRAL] I'm looking
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Right, it says, it says they completed.
[AGENT][NEUTRAL] That's the date we process the claim for [PII]. That is for the [PII] benefits.
[CUSTOMER][NEUTRAL] And that was for, and what, what, but that's for [PII], OK, what uh procedure was that for?
[CUSTOMER][NEUTRAL] Was that for an MRI that I had done, I mean, because it doesn't say, so I don't know.
[AGENT][NEUTRAL] Yes, it looks like the Baptist Outpatient service center.
[CUSTOMER][NEUTRAL] So it was for the MRI, OK, and they were, they were telling me that I, OK, I see, right, 1,0287 now, um.
[CUSTOMER][NEUTRAL] The, I had, I had a question about my, my blood work for Quest.
[CUSTOMER][NEUTRAL] But that was for, it was for this year.
[AGENT][NEUTRAL] It's two completely different years. You submitted a claim because I'm not showing a claim on file.
[CUSTOMER][NEUTRAL] So how
[CUSTOMER][POSITIVE] Right, exactly.
[CUSTOMER][NEUTRAL] Well, no, I don't, I mean, it was for Quest, so they normally submit the claims.
[AGENT][NEUTRAL] So I'm not sure who you spoke with, but did you call someone here in the claims department to verify your benefits? because I don't.
[CUSTOMER][NEUTRAL] So my my benefits are what once I reach what what is it? 2000?
[AGENT][NEUTRAL] So your benefits per calendar year is $2000 and it does not look like you've utilized it for [PII] so I'm not I'm, I'm a little confused so I'm not sure.
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] You're calling about your benefits to verify if they're still available or are you calling because someone told you that your benefits were maxed out or was it for a different.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah, that, yeah, that's, that's what she said, right, they, they said that my benefits were maxed out and I said but we haven't, I haven't used anything for this year, um.
[AGENT][NEUTRAL] Did you speak to someone in the claims department or who is it that?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No, uh, I, I think it was, um, I don't know, it's an email that the manager sent.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so I see that one was $1200 that you paid and then, so I took most of it, and then there was another one for 460 on December, you paid it on [PII].
[AGENT][NEUTRAL] And then there was another one for [PII] as well.
[CUSTOMER][NEUTRAL] But so
[CUSTOMER][NEUTRAL] Right, so all those were for [PII], even though you pay that big one in [PII], correct?
[AGENT][NEUTRAL] Right, that's still the year of [PII]. It doesn't it's not affiliated with your [PII] benefits. It's a completely different year.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, yeah. OK, right, right, I just wanted to confirm because, right, so, so that right there was $2000 now the 460 was for what? Can you, can you see?
[AGENT][NEUTRAL] The 460 was for date of service of [PII].
[AGENT][NEUTRAL] For the diagnostic Center for Women.
[CUSTOMER][NEUTRAL] But it doesn't tell you
[CUSTOMER][NEUTRAL] OK, that was for my um mammogram, for the mammogram or maybe a sonogram. OK, and what was the other 250, 271?
[CUSTOMER][NEUTRAL] The one that was on December, uh, date of service [PII].
[AGENT][NEUTRAL] It is for the vital group holding.
[AGENT][NEUTRAL] I guess there was a procedure done in the doctor's office.
[CUSTOMER][NEUTRAL] Mm, I don't know what that is.
[CUSTOMER][NEUTRAL] OK, but I see that total is the 2000 for [PII]. OK, so that makes sense.
[CUSTOMER][POSITIVE] Uh, OK, but for [PII] it's still 0 because I just had, OK, perfect. I just needed to know that. Thank you so much.
[AGENT][NEUTRAL] Right, you have no claims for [PII]. You're welcome. Is there anything else that I can assist you with? I do apologize that someone gave you the wrong information, but yeah, thanks.
[CUSTOMER][POSITIVE] OK, thank you, take care.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][POSITIVE] That's, that's, that's fine, don't worry. You clarified everything. Thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and you have a great day. Good bye.
[CUSTOMER][POSITIVE] Take care, bye bye.
[CUSTOMER][NEUTRAL] You too.