AccountId: 011433970860
ContactId: ca9c2c29-53a0-4853-aa58-935a49844e74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 188520 ms
Total Talk Time (AGENT): 57099 ms
Total Talk Time (CUSTOMER): 94545 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/ca9c2c29-53a0-4853-aa58-935a49844e74_20250224T21:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, good afternoon, uh, calling in reference to a, uh, claim that was night.
[AGENT][NEUTRAL] OK, I can help you with your claim, sir. Can you please give me your name and your callback number?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] The call number [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And is the claim for yourself?
[CUSTOMER][NEUTRAL] No, it's for my wife [PII].
[AGENT][NEUTRAL] OK, and what is the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is 0251.
[CUSTOMER][NEUTRAL] 0864.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your address and email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Email [PII].
[AGENT][POSITIVE] Thank you and
[AGENT][NEUTRAL] Is Miss [PII] there for me to get verbal consent to discuss her claim with you, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, no, she's not. I, I just wanted to understand the reason for the denial.
[AGENT][NEUTRAL] OK, I understand that, um, but on claims, anybody that is [PII] or over, we have to get consent to discuss the claim because it's personal information.
[AGENT][NEUTRAL] Can you recall
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or so I can talk to her and just get a verbal consent.
[CUSTOMER][NEUTRAL] OK. I
[CUSTOMER][NEUTRAL] I'll, I'll ask you to call in, but I just wanted to understand because if one of the outpatient benefits is physical therapy and that's the claim that we're presenting, so I'm not understanding why it's been denied if the the primary doctor recommended for the physical therapy to be done and that's what she proceeded to do.
[CUSTOMER][NEGATIVE] And now with the bouncing back and forth, back and forth, back and forth of documentation that we provided and it's still denied so it's, it's really.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Concerning
[CUSTOMER][NEUTRAL] I'm gonna ask her to call, but more than likely I'm gonna have to find a way if this is the way this policy is gonna work, it's not gonna work for us, but I'll ask her to call in. Thank you.
[AGENT][NEUTRAL] Yes
[AGENT][POSITIVE] Yes, [PII]. I thank you so much.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][NEUTRAL] I