AccountId: 011433970860
ContactId: e4b490d8-fe57-4ee4-bd7d-b09075d99ff0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282899 ms
Total Talk Time (AGENT): 128299 ms
Total Talk Time (CUSTOMER): 80158 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/e4b490d8-fe57-4ee4-bd7d-b09075d99ff0_20250519T21:11_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help?
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] Hi, hold on one minute, OK.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello, yes ma'am. So this is my name is [PII].
[AGENT][NEUTRAL] Hi [PII] how are you?
[CUSTOMER][NEUTRAL] And I have this uh.
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][POSITIVE] I'm doing well thank you. What can we help you with?
[CUSTOMER][NEUTRAL] Uh, I have the claim number. The number is 3599.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 581.
[CUSTOMER][NEGATIVE] Uh, I don't know why this is rejected. Uh, you guys told me to send it to you with the explanation of benefits. I sent it to you, but you guys rejected it. I don't know why, but when I, when I took the insurance.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry? Say that again?
[AGENT][NEUTRAL] No, no, that's fine I was just saying I can definitely take a look and get some clarification regarding that, um, before we go any further, um, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then just gonna verify some information really quick, uh, [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. Uh, last thing I need is the email address that we've got on file for you. It looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] OK, I appreciate you verifying all of that. Alright, let's see, give me just a moment, let me take a look here.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so per the notes that I see for this claim, it is simply saying that this is not a covered loss under the plan so that there is no amount payable for the expense. Now if you'll give me one moment, um, I just kind of see surface level so I can get some clarification regarding that um as to exactly what.
[AGENT][NEUTRAL] Particularly is not going to be covered because as what I'm seeing is just that it's not covered. So if you'll give me one moment, [PII], I'm just gonna put you on a brief hold and reach out to our uh claims specialist. I'll get right back with you, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's not in this.
[AGENT][POSITIVE] Alright thank you one moment please.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[CUSTOMER][POSITIVE] Doing well [PII] thank you how are you?
[AGENT][NEUTRAL] Doing alright thank you. I've got a member on the line who is calling regarding a claim that denied um it is an HI claim and just simply saying it's not a covered loss um she's a little bit um irritated uh just kind of wants further information.
[CUSTOMER][NEUTRAL] Sure, what's the policy number [PII]?
[AGENT][NEUTRAL] That is 02560925.
[CUSTOMER][NEUTRAL] OK, just one moment.
[AGENT][NEUTRAL] Yeah, I've got that claim number as well.
[CUSTOMER][NEUTRAL] And it's that
[CUSTOMER][NEUTRAL] Uh, OK, go ahead with that callback number.
[AGENT][NEUTRAL] Oh yeah, that's uh 443-629.
[AGENT][NEUTRAL] 683 7.
[AGENT][NEUTRAL] And it's that claim number ending in uh yeah [PII] um it's the one ending in 9581.
[CUSTOMER][NEUTRAL] OK and that's for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And everything's been verified?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And it's [PII], is that right?
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK, I can take it from here.
[AGENT][POSITIVE] Alright, I appreciate your help thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] You're welcome have a good day [PII] thank you.
[AGENT][NEUTRAL] You too. Bye.