AccountId: 011433970860
ContactId: c8d102cb-8f48-4100-9acf-5a18b4a8a4f6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382440 ms
Total Talk Time (AGENT): 167288 ms
Total Talk Time (CUSTOMER): 118526 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/c8d102cb-8f48-4100-9acf-5a18b4a8a4f6_20250110T20:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm just calling to check the status of my claim, please.
[AGENT][NEUTRAL] OK, yeah, I can check on a claim for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] Hold on let me pull up the claim number for you. I have it in my phone. It's um 02552188.
[AGENT][NEUTRAL] OK, I'm sorry, you said 0250188?
[CUSTOMER][NEUTRAL] 02552188
[AGENT][NEUTRAL] OK, and what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can I give you a call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, I'm sorry, the the number that you gave me before [PII], was that a policy number or a claim number?
[CUSTOMER][NEUTRAL] The claim number is 02552188.
[AGENT][NEUTRAL] OK, um, I'm not getting a claim for you for that claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's very old that I do pop up.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] Hold on 1 2nd.
[AGENT][POSITIVE] No worries. Do you have your policy number?
[CUSTOMER][NEUTRAL] No, I don't have that either because the employer never provided it to me. 02552102552188.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Yeah that's what I put in.
[CUSTOMER][NEUTRAL] That's what I've been using.
[CUSTOMER][POSITIVE] Yeah, I mean that's what I've been using and that's what was in the text message and that's what I've been using. I'd be more than happy to give you my social so you can pull it up because they just put that claim in on last Friday.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, please, thank you.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, the [PII] that was your policy number, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry about that confusion. All right, um, let me just verify some information really quick. Um, let's see, what was your date of birth please, [PII]?
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address that we've got on file for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright appreciate you verifying all that information. OK, so we just got the one claim on file for you, OK.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Alright looks like it just finished processing um so we did pay a benefit of $2900. Give me just a moment, let me get some further information for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, looks like there was just the one benefit we could not make a payment on I think it was for room and board, um, I could get more further clarification.
[CUSTOMER][NEGATIVE] OK, and that's, yeah, that's why I don't, yeah, yeah, I don't, yeah, I don't understand why cause I was in there. I was admitted. I went in, I was in emergency, then I was admitted to the ICU.
[AGENT][NEUTRAL] OK yeah let me get it pulled up real quick.
[CUSTOMER][NEUTRAL] And there was a charge on one of the bills for ICU.
[AGENT][NEUTRAL] Mhm. Well, we did pay that.
[CUSTOMER][NEUTRAL] I sent 3, I think I sent 3 bills.
[AGENT][NEUTRAL] Right, yes, so we paid the ICU, um, and then there was a hospital admission and hospital confinement, and they are two separate benefits, but from what the states for your policy we can't pay one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, instead of the other if that makes sense, or uh, give me just a moment, let me actually read what that says verbatim for you.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Hospital confinement benefit is not payable on any day and hospital admission benefit is paid. The application of benefits is not allowed under the policy, yeah.
[CUSTOMER][NEUTRAL] Right, OK, OK, I see.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so I see since I went home on the 2nd day.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, that's OK.
[CUSTOMER][NEUTRAL] I went
[CUSTOMER][NEUTRAL] Yeah, cause like they admitted me on one day. I did it on [PII].
[AGENT][NEUTRAL] Yeah, it says if a cover charge, mhm.
[CUSTOMER][NEUTRAL] OK, that's fine. I just wanna make sure, OK.
[AGENT][NEUTRAL] Yeah, if the cover charges payable under more than one benefit, um, only one, which would be the highest would be the one that we pay.
[CUSTOMER][NEUTRAL] OK, so y'all pay the paying the 2900. If I would have stayed another day, then I probably would have got the, the con a day for confinement.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, all right, you know, you gotta give and take, OK, and they're gonna direct deposit that, I see.
[AGENT][NEUTRAL] OK. And you did send uh
[AGENT][NEUTRAL] That's what I was just about to ask if you had direct deposit set up, um, OK, yeah, so it looks like it just finished processing yesterday, so I would keep an eye on your account, uh, depending on the bank, maybe 2 to 3 business days, but it really does depend on the bank, so you should be getting that soon.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great well I appreciate your help. Thank you so much.
[AGENT][POSITIVE] Absolutely. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] Alright, yes ma'am, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.