AccountId: 011433970860
ContactId: c903ad87-89dd-4b00-92a4-dd9a62b4204c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 256220 ms
Total Talk Time (AGENT): 90025 ms
Total Talk Time (CUSTOMER): 75193 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/c903ad87-89dd-4b00-92a4-dd9a62b4204c_20250613T13:58_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I've got insurance, uh, uh, but, uh, I've got a thing from my hospital where I had to go in for MI test and surgery and all. Can you check, see what's going on here? I can give you the claim number.
[AGENT][NEUTRAL] Yeah, what's the claim number that you have?
[CUSTOMER][NEUTRAL] 3606085.
[CUSTOMER][NEGATIVE] No one of them.
[CUSTOMER][NEUTRAL] One day 4 and one of them 85.
[AGENT][NEUTRAL] Right, and then for security, I will need to verify please your name and date of birth.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Thank you. And then what is the address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. OK, let me see here.
[CUSTOMER][NEUTRAL] OK, on the back of this, it's got explanation of benefits. Our records indicate the premium for this service dates was not received. Therefore been, OK, I've had insurance came out of my check the weeks before, and I think I need to find out what's going on.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah, no, I mean the the policy is active, um, it hasn't lapsed or anything like that. Um, it looks like from what I can see on that particular claim,
[AGENT][NEUTRAL] Um, let me pull that back up, sorry, one moment.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah, so it says claim previously denied this policy was lapsed policy was reinstated, and then it says see new mail number for corrected claim. So that's what I was looking for was a corrected claim to see if maybe it had been reprocessed.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Well, they took all this information when I went in.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I had, uh, I didn't have the cards yet, the ID cards, but I had it on my phone, and I took all this information at the time I went in for this and my insurance was in effect for this. So what's the conclusion of this?
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, I do.
[AGENT][POSITIVE] I do show that it was active at the time of service, so you don't need to worry about the fact that that was an error. It was definitely active. It looks like the imaging place resubmitted the claim, um, so you don't need to do anything with the explanation of benefits if you want to check with the provider that it was resubmitted, like I show it looks like that they resubmitted it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll do that OK.
[AGENT][NEUTRAL] All right, [PII], anything else?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] That'd be it thank you.
[AGENT][POSITIVE] You're welcome, bye bye.