AccountId: 011433970860
ContactId: e2a8517b-63d9-4fd0-b27e-1672f6d4bb6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 821679 ms
Total Talk Time (AGENT): 284750 ms
Total Talk Time (CUSTOMER): 312915 ms
Interruptions: 6
Overall Sentiment: AGENT=2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/e2a8517b-63d9-4fd0-b27e-1672f6d4bb6d_20250130T20:38_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][POSITIVE] Hi, it's uh [PII], heck of a nice guy.
[CUSTOMER][MIXED] You you your voice started out strong, but you sound really distant.
[AGENT][POSITIVE] I'm so sorry about that, [PII]. Is this any better?
[CUSTOMER][NEUTRAL] Uh, now there you go.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Hey, my best callback number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And this is again who?
[AGENT][NEUTRAL] Oh, my name is [PII]
[CUSTOMER][POSITIVE] Oh hey, hey [PII], uh, first time I've ever spoken to you, it seems, so welcome on board [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] So I'm calling on behalf of my friend because I'm actually his GA um and let me give you a policy number uh he just texted me on the phone just bear with me. This is gonna be fun. Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So when people send me stuff over the phone. Uh, first of all, it's gonna be in group number 26139.
[CUSTOMER][NEUTRAL] which is called Landshore.
[CUSTOMER][NEUTRAL] And I have the policy number and tell me when you're ready.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] 231.
[CUSTOMER][NEUTRAL] Uh, yeah, hold on, 2, no, no, no, 261-39.
[AGENT][NEUTRAL] 54 you said?
[AGENT][POSITIVE] Perfect, let me pull that up.
[AGENT][POSITIVE] There it is. Thank you for your patience and
[CUSTOMER][NEUTRAL] Yeah, it's gonna be the probably the first person, but um it's policy number 244.
[CUSTOMER][NEUTRAL] 1981.
[CUSTOMER][NEUTRAL] The actually the insured is [PII], but it's on behalf of his wife [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I'll tell me when that's pulled up and I'll give you her the spouse's date of birth.
[AGENT][POSITIVE] Yeah, if you could give me her date of birth, that'd be so wonderful.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] Perfect. And I do just need to check um our
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Information here and then you said you are her GA who are you calling on behalf of the broker's office?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, well, I'm calling on behalf of my friend whose name is [PII]. He's the agent and I'm, I'm his general agent.
[CUSTOMER][NEUTRAL] So like the broker's broker.
[AGENT][POSITIVE] OK, perfect. And I just need.
[AGENT][NEUTRAL] If you can help me out, I just need to verify your email address, Mr. [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Verify your email
[CUSTOMER][NEUTRAL] Yeah, it's old school. It's [PII] nobody can spell here in [PII]. So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So sorry, I don't know if it just knows it's like the end of the week and everything wants to go slow, but
[CUSTOMER][NEUTRAL] Just know
[CUSTOMER][NEGATIVE] Oh no, here's my old joke. You ready? They're becoming self aware and they don't wanna work any more than we do.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][POSITIVE] I think that's probably right.
[CUSTOMER][NEUTRAL] So yeah it's probably it, yeah, they're finally learning after being on the search for 50 years, these computers.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] All right. And then if you don't mind, I'm gonna put you on just a quick hold. I do just need to um get your email address verified. Is that OK real quick?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Can you email
[CUSTOMER][POSITIVE] Yeah, yeah, yeah take your time.
[AGENT][NEUTRAL] OK. One second, I'll be right back with you, my friend.
[CUSTOMER][POSITIVE] Yeah it's all good, totally understand.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] with the care team. How are you today?
[CUSTOMER][NEUTRAL] I'm well. How are you?
[AGENT][POSITIVE] I'm doing great. Hey, I have a broker on the line and I was hoping you could help me with verification.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Perfect. Um, he is calling on behalf of [PII].
[AGENT][NEUTRAL] And [PII].
[AGENT][NEUTRAL] Um, I'm particularly looking at group number if that helps 26139.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, his name is [PII]. He says he's his [PII] and his email is [PII].
[AGENT][NEUTRAL] Um, but it just doesn't match any of my domain names, so I want to double check.
[CUSTOMER][NEUTRAL] Um, 261-39. I mean, yeah, [PII] is a broker. Is he asking on behalf of [PII] S something.
[AGENT][NEUTRAL] So he said he's calling on behalf of him and he wants um information on a particular policy, and I just need to know if I'm good to speak to him.
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] What? [PII] knows better.
[AGENT][NEUTRAL] Yeah, he says, he says.
[AGENT][NEUTRAL] GA, I'm not, he told me general accountant maybe.
[CUSTOMER][NEUTRAL] Oh, it'd probably be his general like um mm.
[CUSTOMER][NEUTRAL] I don't think [PII] would like not.
[CUSTOMER][NEUTRAL] Be truthful, but that's weird that is.
[CUSTOMER][NEUTRAL] [PII] and
[CUSTOMER][NEUTRAL] Driver
[AGENT][NEUTRAL] And the particular policy he wants to look at is actually the owner of the employer group.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Contact let me see if.
[CUSTOMER][NEUTRAL] National agency solution.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I don't see that [PII] is tied them, but
[CUSTOMER][NEUTRAL] Group rene[PII], new group set up, broker on boarding.
[CUSTOMER][NEUTRAL] Hold on, I'm gonna put you on hold for just a second. I'll come right back, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, he can have information that he needs, yes.
[AGENT][NEUTRAL] He can.
[AGENT][POSITIVE] OK perfect thank you so much for your help on that today.
[CUSTOMER][POSITIVE] Of course. Uh-huh, yeah. Have a good day.
[AGENT][POSITIVE] You too take care.
[CUSTOMER][POSITIVE] Thanks bye.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hi, Mr. [PII], are you still there with me?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Wonderful, thanks. I was able to get you all verified up and so I really appreciate your patience and how can I help you on this account today?
[CUSTOMER][NEUTRAL] Well, I don't know if it's a Medlink 9 plan she has or not, but on [PII], she had a charge of $760 from.
[CUSTOMER][NEUTRAL] Florida specialties, uh, for an infusion therapy and, uh, my friend [PII], who's the agent broker for this group, wants to know, he did she process or file that yet or is infusion underneath the meddling plan they have, uh, you know, a benefit that she's got.
[AGENT][POSITIVE] OK, perfect. So I'm taking a look at this, um, do you know?
[AGENT][NEUTRAL] Who
[AGENT][NEUTRAL] What the provider would have been for the infusion charge?
[CUSTOMER][NEUTRAL] Yeah, it's Florida Cancer Specialties.
[AGENT][NEUTRAL] OK, so I'm actually not showing any claim on file from them for her.
[CUSTOMER][NEUTRAL] And I can't, OK, alright, alright then she's just asking if it's payable then she didn't know any better then so um I don't know why people just don't get the gap.
[AGENT][NEUTRAL] Um, let me
[AGENT][NEUTRAL] Let me double check as far as if um injections are acceptable on her plan, if it covers it. Um, so I'm, again, I'm so sorry.
[CUSTOMER][NEUTRAL] Yeah um injections.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it was done at an outpatient facility and not at a doctor's office, so.
[AGENT][NEUTRAL] At at an outpatient facility. OK, perfect. Let me, I'm actually just gonna reach out to my claims department real quick and double check on that. Is that OK?
[CUSTOMER][NEUTRAL] Yeah if you can
[CUSTOMER][POSITIVE] OK, alright, yeah, thanks.
[AGENT][POSITIVE] Thank you, my pleasure.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Bring.
[CUSTOMER][NEUTRAL] This is [PII]. May I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII]. How are you doing today?
[CUSTOMER][POSITIVE] I'm doing good. How are you?
[AGENT][POSITIVE] Hey, I'm doing so wonderful. Thank you so much for asking. Hey, I've got a broker on the line and I am trying to help him as effectively as possible, and I was hoping you could um help me out with the policy. I'm looking at 2441981.
[CUSTOMER][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] Meddling.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] And he wants to know about uh like injections or infusions being covered on the policy. I guess this insured had um some
[AGENT][NEUTRAL] Some medical procedures done at an outpatient facility. And I've seen a lot of denials stating we don't cover injections or infusions, but I don't know, like quick enough off the top of my head, each individual policy, and neither word comes up when I search them in on-base like as a hot word.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm not sure about infusion, but if it's done in an outpatient injection should be covered.
[AGENT][NEUTRAL] OK, so injections could be covered by infusions are not?
[CUSTOMER][NEUTRAL] Um, but if it, hold on let me.
[CUSTOMER][NEUTRAL] I'm not sure about infusion. Let's see.
[AGENT][NEUTRAL] No worries. I was hoping it would be like in the limitations or exclusions and I could just like find the word, but when I searched them I couldn't.
[CUSTOMER][NEUTRAL] Yeah, it should be covered and if it's done in an outpatient facility or if it's done in a doctor's office on this policy injection should be covered. Is it a specific kind of injection he's talking about?
[AGENT][NEUTRAL] I think it was for cancer treatment. Would you like to talk to him? I'm not exactly sure.
[CUSTOMER][NEGATIVE] Yeah, I'll talk to him because they do have a cancer writer as well.
[AGENT][NEUTRAL] Perfect. So what I'll do his name is [PII]. I did verify him with brokers resources, um, on to be approved to talk about this policy, and I will introduce you, and you said your name was, and I'm so sorry I should have written it down, [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Oh my gosh, I got it right. OK. OK, thanks. I'll introduce you when we join.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, and he's calling on part two, by the way, uh, thanks.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hi, Mr. [PII], are you still there with me?
[CUSTOMER][NEUTRAL] [PII], uh.
[AGENT][POSITIVE] Hey, thank you so much for your patience. So I actually have Ms. [PII] on the line, and she does um she works to process claims. So she's going to be, I think a little better equipped to help answer your questions on if um this.
[CUSTOMER][NEUTRAL] Yeah, [PII], I'm sorry about that. I thought I did, um, maybe went to the journal voicemail box, but I thought I did call up claims first, but it's fine. Hey [PII].
[AGENT][POSITIVE] Oh, no worries. There's Miss [PII] for you, my friend.
[CUSTOMER][POSITIVE] It's yeah, thanks.
[CUSTOMER][NEUTRAL] You are on there, how are you? I'm fine. How are you?
[CUSTOMER][POSITIVE] Yeah, better