AccountId: 011433970860
ContactId: c84c3510-97e1-4717-ba98-a39ec6456dd0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 179270 ms
Total Talk Time (AGENT): 63643 ms
Total Talk Time (CUSTOMER): 109450 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/c84c3510-97e1-4717-ba98-a39ec6456dd0_20250131T23:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Oh hi, um, I'm calling about um a claim, um, that was, um, [PII]. Uh, I mean this is, this is going on all these months now, um.
[CUSTOMER][NEUTRAL] At the time he was covered for his, he was covered under the insurance. We did, we didn't we on [PII], that was the day of the uh procedure, he was covered with insurance, OK, we didn't cancel it I believe until the next payment was due, which would have been May.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, and we've been going on like this back and forth for months, and I got a copy, he got a copy of the, um, you know, the, uh, payments and, and the procedures, and um we mailed it in and now you're coming back and saying on [PII], he was not covered.
[AGENT][NEUTRAL] OK, ma'am. Can I please get your name and your callback number so I can help with the claim?
[CUSTOMER][NEUTRAL] I have the claim number if you wanna look uh look it up.
[AGENT][NEUTRAL] I'll need to verify the policy first. Um, can I get your name and your callback number, please?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the policy number?
[CUSTOMER][NEUTRAL] The policy number is 0241799997.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, I see the policy is for [PII]. Is he there where I can speak to him?
[CUSTOMER][NEUTRAL] Yeah, no, not right, yeah, not right now, um, but, um, I just, you know, I was the one that paid his insurance at the time, so that's why I was calling because I ended up having to pay.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Right, I understand. I understand.
[CUSTOMER][NEUTRAL] Yeah, I ended up having to pay, um, you know, because you didn't pay the, uh, doctor, so I had to pay the extra $75 because of our understanding was that we paid $50 co-pay.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, I do understand what you're saying, Ms. [PII], but in order for me to be able to discuss anything about the policy, um, it's for his protection under HIPAA law. Yes, I have to get his permission first.
[CUSTOMER][NEUTRAL] Mhm, you have to speak with him.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Oh OK, all right, all right, well, uh, you're not there tomorrow, are you?
[AGENT][NEUTRAL] Yes, ma'am. OK.
[AGENT][NEUTRAL] No, ma'am, we'll be back open again on Monday morning at [PII]. Yes, ma'am.
[CUSTOMER][NEUTRAL] Monday.
[CUSTOMER][POSITIVE] OK. All right. OK. I'll, I'll have him call you on Monday then. All right, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, Ms. [PII], you have a blessed weekend and thanks for calling APL.
[CUSTOMER][POSITIVE] OK thank you bye bye.
[AGENT][NEUTRAL] Bye bye.