AccountId: 011433970860
ContactId: e96f19a8-21c1-446e-a551-954a31981501
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 677890 ms
Total Talk Time (AGENT): 175881 ms
Total Talk Time (CUSTOMER): 148640 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/e96f19a8-21c1-446e-a551-954a31981501_20250124T13:21_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I am calling from an insurance agent's office, and I have about 5 claims that I'm just calling to check on the status of.
[AGENT][NEUTRAL] You're calling from, are you, did you say from the agent's office?
[CUSTOMER][NEUTRAL] Yeah, a broker from an agent's office, yes.
[AGENT][NEUTRAL] OK, and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], you know, you can also check your statuses online, um, by creating an account. I can help you do that. I can do the statuses, of course.
[CUSTOMER][NEGATIVE] Um, yeah, I was just calling because they just so the all the just to show site that shows processed like it says processed but it doesn't give me the amount or anything on that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what's the group number?
[CUSTOMER][NEUTRAL] Um, the group number is 25755.
[AGENT][NEUTRAL] And what's a good phone number in case?
[CUSTOMER][NEUTRAL] And there's actually two groups I'll be calling them.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the name of the group, [PII]?
[CUSTOMER][NEUTRAL] Is uh center county government.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And your email address.
[CUSTOMER][NEUTRAL] Um, my email address is [PII] so just my first name and then the letter [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And which, what's the first policy number you want me to check?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it is 229.
[CUSTOMER][NEUTRAL] 1069.
[AGENT][NEUTRAL] 069 and what's the employee's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII] I believe it's pronounced, and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and do you have the data service?
[CUSTOMER][NEUTRAL] Um, yes, there was 2 for this one there was two wellnesses for [PII].
[CUSTOMER][NEUTRAL] One was for [PII] and then one was from [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so [PII] claim processed on the [PII].
[AGENT][NEUTRAL] Um, issuing a payment of $50 and that is going to to [PII].
[AGENT][NEUTRAL] And then you said the other one is for dependent, did you say [PII]?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull that up and I can give you that information.
[AGENT][NEUTRAL] And for [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Processed on [PII] as well, issuing a payment of $50 being made payable to the policyholder.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] And let me document
[CUSTOMER][NEUTRAL] Alrighty, and that's all for that policy number?
[AGENT][NEUTRAL] OK, let me document this one quickly, [PII], and then we can move to the next one.
[CUSTOMER][POSITIVE] Alrighty thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what's the next policy number?
[CUSTOMER][NEUTRAL] Is 229-1221.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] and their date of birth is [PII].
[AGENT][NEUTRAL] And what's the data service in charge?
[CUSTOMER][NEUTRAL] Uh, there were two actually for [PII], and then they were for their dependents [PII] and [PII]. Wellness is for both as well.
[AGENT][NEUTRAL] So, [PII] is not the patient?
[CUSTOMER][NEUTRAL] Oh yeah sorry my bad I thought you had a policy holder name.
[AGENT][POSITIVE] It, it's really good and it's OK.
[CUSTOMER][NEUTRAL] Yeah, it was her dependents [PII] and [PII]. I can give you their date of birth as well if you need.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yes please.
[CUSTOMER][NEUTRAL] Ready for [PII], it is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And then for [PII] it is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the date of service is [PII]?
[CUSTOMER][NEUTRAL] Uh, yeah, yeah, for both.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] So I'm showing for [PII] the claim process [PII] issuing a payment of $50 that is being made payable to.
[AGENT][NEUTRAL] The policy holder, one moment.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] And [PII] processed on the same day, [PII].
[AGENT][NEUTRAL] And issuing a payment of $50 being made payable to the policyholder.
[CUSTOMER][POSITIVE] Alrighty
[CUSTOMER][NEUTRAL] And then the last claim I have is for a different group.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the group number?
[CUSTOMER][NEUTRAL] Is 25612.
[AGENT][NEUTRAL] And the group name?
[CUSTOMER][NEUTRAL] R&B Insurance Services.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Is 222-456-3.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What's the name of the insurance agency, Donovan?
[CUSTOMER][NEUTRAL] Should be RMB Insurance Services as well.
[AGENT][NEUTRAL] And what's the name of the insurance company for the other group number that you gave me?
[CUSTOMER][NEUTRAL] Um, R&B insurance services for that one as well too.
[AGENT][NEUTRAL] Same, OK, OK, OK, I got it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's the, that's the insurance agency I was mentioning I'm at and then this one is for actually one of our agents here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] And so under policy 2224563, what's the, uh, patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII] and then the date of birth is [PII].
[AGENT][NEUTRAL] Thank you and what's the date of service?
[CUSTOMER][NEUTRAL] Um, [PII], it was a wellness as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now this one processed on the [PII] as well, but it's denying saying that office visits are not covered under this policy. This is a critical illness policy, I believe. Give me one second.
[CUSTOMER][POSITIVE] Uh, yeah, I think it is as well.
[AGENT][NEUTRAL] Few more minutes.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this one is not a wellness claim. This is an office visit, um, which isn't covered under this particular policy, and so there was no payment made on this one.
[CUSTOMER][NEUTRAL] Yeah, cause um.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Alrighty, and that's all the claims I had for today.
[AGENT][POSITIVE] Alright, [PII], but if no further questions, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Uh, bye bye.