AccountId: 011433970860
ContactId: c7e3a453-baaf-44fe-a6ec-8c610588d2e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 470649 ms
Total Talk Time (AGENT): 216426 ms
Total Talk Time (CUSTOMER): 185155 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/c7e3a453-baaf-44fe-a6ec-8c610588d2e3_20250122T13:52_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I have a claim in for or I had a claim in for a double mastectomy, um, and that was paid out, uh, [PII], however.
[CUSTOMER][NEGATIVE] I did not receive anything for the um implanted.
[CUSTOMER][NEUTRAL] For the for the.
[AGENT][NEUTRAL] For the prosthesis.
[CUSTOMER][NEUTRAL] For the prosthesis and I'm wondering why.
[AGENT][POSITIVE] No, you can take a look at that, and it would be my pleasure to assist you. Do you happen to have your policy number available?
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, well, um.
[CUSTOMER][NEUTRAL] Policy.
[AGENT][NEUTRAL] If not, I can look it up by your social.
[CUSTOMER][NEUTRAL] Um, OK, so let me give you my social, it's [PII].
[AGENT][NEUTRAL] And what is your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, Miss [PII]. And do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And I have the claim number that I'm talking about.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK. Is that the one ending in 5230?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] All right. And what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And then finally, do you mind just verifying your email while I've got you on the line?
[CUSTOMER][NEUTRAL] Um, it's either our.
[AGENT][NEUTRAL] It looks like your basement.
[CUSTOMER][NEUTRAL] Oh, OK, alright, yeah, our [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] I appreciate that verification. So let me just take a look.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Just checking to see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I do apologize, Ms. [PII]. It has taken my computer a minute to get that pulled up.
[CUSTOMER][NEGATIVE] That's OK, you know, the whole world is really cold right now. I wouldn't wanna work either.
[AGENT][NEUTRAL] It is.
[AGENT][NEUTRAL] But alas, we must.
[CUSTOMER][NEUTRAL] I know got bills to pay, right?
[AGENT][POSITIVE] That's right. My mama always used to say, a girl's gotta do what a girl's gotta do.
[CUSTOMER][NEUTRAL] That's right, and my grandmother used to tell me, don't you put yourself in a position that you have to rely on any damn man, [PII], you get up there and and do it yourself.
[AGENT][NEUTRAL] To make it.
[AGENT][POSITIVE] Oh my gosh, I love that.
[AGENT][POSITIVE] Oh, our moms are awesome, aren't they? Or that yours may still be, but mine was.
[CUSTOMER][NEUTRAL] Oh, I know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I love it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm gonna, that's just gonna brighten my day all day long. Thank you for that.
[CUSTOMER][POSITIVE] Oh, I'm glad I'm so glad we all need that.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] It's finally coming up. I want to see where that is listed on the claim and see what.
[CUSTOMER][NEUTRAL] So when I look at the when I download the claim I don't see anything on there about the prosthesis.
[AGENT][NEUTRAL] That's what um.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That's what I didn't either. That's why I was like, let me see, and it looks like they, this is a large document.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah, I, I don't understand.
[AGENT][NEUTRAL] Have you got your that information or do you know you you know it was submitted with this?
[CUSTOMER][NEUTRAL] Um, the, OK, so the.
[CUSTOMER][POSITIVE] When I submitted all of that information, the prosthesis is right there in it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Tell you what I can do, Miss [PII], and probably the easiest thing, let me send a message to our cancer adjudicators.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And get someone to review the claim document, they can actually give you a call back if you would like, once it's reviewed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That would be perfect because I mean that's $4000.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] You know?
[AGENT][NEUTRAL] Let's get that reviewed
[AGENT][NEUTRAL] I mean, that, that's a, that's a lot.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Yeah, that's what I'm gonna do is I'm just going to put in a request that they review the documents for the prosthesis charges.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And give you a call back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that sounds good I appreciate that.
[AGENT][POSITIVE] Oh, it's my pleasure. Now, you should be getting a call back within 24 hours.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that [PII] is a good number?
[CUSTOMER][NEUTRAL] Yeah, now do you know what it'll come up as on my phone so I can make note of that?
[AGENT][NEUTRAL] I am not sure if the adjudicators are going to come from the [PII] number.
[AGENT][NEUTRAL] Or uh area code [PII] number.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] And is there a better time frame to call you or just as soon as they can get that reviewed?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, just
[CUSTOMER][NEUTRAL] Just as soon as they can get it reviewed we'll be fine.
[AGENT][NEUTRAL] All right, well, I am putting in that request right now.
[AGENT][POSITIVE] And I hope it's warm up there in [PII].
[CUSTOMER][NEUTRAL] It is not, it is not -13.
[AGENT][NEGATIVE] It's not here. I'm not.
[AGENT][NEUTRAL] 00 bless you. I'm so sorry. I'm all the way in [PII] and we're like at [PII] this morning. So that's, that's really cold for us.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Now, do you have snow? Do you have snow?
[AGENT][NEUTRAL] You know what, I was just outside the snow area and it, I mean, they got hot down south.
[CUSTOMER][NEGATIVE] I, I, I could not believe when I saw snow in [PII] and [PII] and [PII], like, what the hell?
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEGATIVE] Uh, something must have happened. Hell must have frozen over because.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] So, I mean, that's just, I, I, in my lifetime, and I'm pretty old. I've never seen that.
[CUSTOMER][NEUTRAL] You know
[CUSTOMER][NEUTRAL] Yeah, that's, that's just crazy, crazy.
[CUSTOMER][NEUTRAL] I mean at least we can are equipped for this snow up here but y'all are just in a state of emergency.
[AGENT][NEUTRAL] Oh, yeah, exactly. And I mean, we don't know how to drive in that.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] Mm mm, no, no.
[AGENT][NEUTRAL] Um, it's just, but you know, we'll just take whatever the good Lord sends us, I reckon.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] That's right, that's all we can do. That's all we can do.
[AGENT][NEUTRAL] And I had just put that request in, so I've completed that request.
[CUSTOMER][POSITIVE] Alrighty you have a.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] And it has been such a pleasure to assist you this morning, Mr. [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, not right now, honey, thank you.
[AGENT][POSITIVE] And thank you for calling APL. You stay warm today and have a great day.
[CUSTOMER][POSITIVE] You too, you too.
[AGENT][POSITIVE] Thank you. Take care.
[CUSTOMER][NEUTRAL] OK alright bye bye.
[AGENT][NEUTRAL] Bye-bye.