AccountId: 011433970860
ContactId: cf08c5f4-78a8-4dc0-aafe-b9e71d9535f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 400559 ms
Total Talk Time (AGENT): 194955 ms
Total Talk Time (CUSTOMER): 138804 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/cf08c5f4-78a8-4dc0-aafe-b9e71d9535f5_20250515T21:34_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I would like to submit a claim for wellness benefit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How do I do, how do I go about it?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, all right, so you need instructions to submit a claim. Yeah, I can assist you with that. May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII]. Last name, the phone number is [PII].
[AGENT][NEUTRAL] Thank you, Miss [PII]. Do you have the policy number so I can look at the product you have and go from there?
[CUSTOMER][NEUTRAL] Uh, the policy number will be, hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Where did I find it?
[CUSTOMER][NEUTRAL] OK, I'm on the website where did I find it?
[AGENT][NEUTRAL] OK, it's gonna be under your information. It's gonna be blue. Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh, here, I, I find it I find it. 253-8099.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII]. I just uh I just moved. I don't know if you have my new address, but uh my.
[CUSTOMER][NEUTRAL] Current address is [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] What's the email address on file?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK. And um do you remember what is the old address that you had on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. Let me go ahead and change that address for you, OK, one moment.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 2, you know, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. [PII] is the two words, [PII], it's [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII], yeah, that's what I got. [PII] and then [PII] which is um this
[AGENT][NEUTRAL] [PII] or just one C?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. [PII] and that is in, what's the name of the city?
[CUSTOMER][NEUTRAL] Second
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], [PII] [PII] [PII] [PII].
[CUSTOMER][NEUTRAL] Be a Honda. Like a Honda, like the big.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm. Mhm.
[CUSTOMER][NEUTRAL] But with the [PII] at the end.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it's all separated, Rio and [PII] is separated?
[CUSTOMER][NEUTRAL] Yes, separated, yeah.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK, bear with me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The zip code, can you repeat the zip code again?
[CUSTOMER][NEUTRAL] [PII]. That's the new zip code.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so I went ahead and change that address for you. And you said you're trying to submit a wellness claim, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So, um, for the wellness, um, this policy is one of our secondary supplemental plans for the major medical, and this one doesn't cover wellness. This one is just medical.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Mm mm. No.
[CUSTOMER][NEUTRAL] Oh, OK. Oh, I thought that was cover wellness.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, because I was reading and said this, you should, you can submit a claim for your wellness policy.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] Yeah one is whatever.
[AGENT][NEUTRAL] Mhm. Yeah, I'm sorry, Ms. [PII]. Yeah, that's only for certain policies. It's not for all of them. We do have some products like cancer policies that do offer that wellness benefit and that's why that is they are, but it is not for a secondary policy.
[CUSTOMER][NEUTRAL] OK, and what exactly this policy covers? What exactly if I go to the doctor, what do they, what do I call or the hospital, what should I get?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So this one is a secondary supplemental plan to the major medical, so it's to help your high deductibles, co-payment, and co-insurance from the major medical. Now, this one is for the, um, if you go to an outpatient facility.
[AGENT][NEUTRAL] It covers up to 1000 per cover person per calendar year, and this is not a guarantee of payment, just a verification of coverage. Outpatient facility is an ER visit, urgent care.
[AGENT][NEUTRAL] Um, it does cover surgery.
[AGENT][NEUTRAL] In an outpatient facility or um hospital. It does cover diagnostic testing in an outpatient diagnostic center or hospital. It covers cancer treatment, independent lab.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then it covers for mental disorders in the hospital.
[CUSTOMER][POSITIVE] Mm, I see. OK, OK, so I thought it was covered. OK, thank you so much for your help and your time, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] Cool.
[CUSTOMER][POSITIVE] That'd be all, thank you so much.
[AGENT][POSITIVE] Mm. You're welcome and thank you for calling ATL. Have a good afternoon. Bye-bye.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Bye bye.