AccountId: 011433970860
ContactId: ee388e1b-ff66-45d7-b24f-b79d8c395409
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 450279 ms
Total Talk Time (AGENT): 140371 ms
Total Talk Time (CUSTOMER): 247370 ms
Interruptions: 4
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/ee388e1b-ff66-45d7-b24f-b79d8c395409_20250515T16:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and I'm calling uh regarding the bills that I just received um from um medical uh for anesthesia called Envision.
[CUSTOMER][NEUTRAL] I had a colon done on [PII], and they sent me a bill for um $809.40 for anesthesia. So I'm trying to figure out that American um did they cover any of this, um, bills on
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] American public life insurance, did they cover any of this, this bill?
[AGENT][NEUTRAL] OK, can I get your spell your, get you to spell your name for me?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK [PII], what's your, what's your policy number?
[CUSTOMER][NEUTRAL] Um, I have the group number here. It's um 16944.
[AGENT][NEUTRAL] OK, is there a policy er number on the card?
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] A policy certificate number on the card? That would be your policy number?
[CUSTOMER][NEUTRAL] Mm, this is for um medical, but I don't see a policy number. I just, I just see insured, uh, which is, uh, with my husband, under my husband.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um coverage employee and spouse, and it's just have a group, group number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't see anything about um
[AGENT][NEUTRAL] You what
[CUSTOMER][NEUTRAL] I don't see anything about a policy.
[AGENT][NEUTRAL] OK, read everything on the card if you could just tell me out loud what it says.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, OK, I just was telling you that the insured uh with with with under my husband [PII], covered employees and spouse, group number 16944 effective date [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And plan
[CUSTOMER][NEUTRAL] Um, group med and then it say inpatient.
[CUSTOMER][NEUTRAL] An outpatient and they just have the numbers.
[AGENT][NEUTRAL] Policyer number I need one of those numbers.
[CUSTOMER][NEUTRAL] But for the hospital or outpatient?
[AGENT][NEUTRAL] The number before the letter M should be the same for both the inpatient and out, so give me the number before the letter M.
[CUSTOMER][NEUTRAL] Um, I just have um 01659143 ML 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that would be the policy number. That's the number that you provide whenever you call us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right. Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And [PII], the claim is for you.
[CUSTOMER][NEUTRAL] Yes, it's for me.
[AGENT][NEUTRAL] OK. What's your date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the date of the service?
[CUSTOMER][NEUTRAL] The service was um [PII].
[CUSTOMER][NEUTRAL] For colon, colonoscopy and um and the bill that they sent me is for anesthesia.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Was it this year?
[CUSTOMER][POSITIVE] Yes, this year I'm sorry.
[AGENT][NEUTRAL] OK. It's OK.
[CUSTOMER][NEUTRAL] Well, see what it say right here.
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Still looking.
[AGENT][NEUTRAL] OK [PII], I don't show that we've received a claim for you, uh, for date of service [PII]. Um, I also show that the policy is no longer active as of [PII].
[CUSTOMER][NEUTRAL] Um, um, this, um, because every month they're taking out money for this, this policy.
[CUSTOMER][NEGATIVE] Um, from the check, and, um, this policy has to be, I don't know, something going on with this right here. I don't understand why cause I called once before and they were saying that this policy is not covered, but every month they're taken out for this, this, um, coverage every month.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I'm paying $70.70 dollars something dollars every month, $79 every month, and you're telling me that this insurance policy is not is not accurate now?
[AGENT][NEUTRAL] Yeah, and I don't show any premiums deducted under this policy either.
[AGENT][NEUTRAL] We've not deducted any premiums.
[CUSTOMER][NEUTRAL] Something is wrong.
[AGENT][NEUTRAL] The policy within your spouse will need to contact his employer. I don't show an active metlink policy under your husband's name, and I do show you as a spouse on the policy, so he'll have to reach out to his employer if you're stating should not be covered or termed.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Yeah, so that means I'm paying for something I'm not, I can't even get any service on.
[AGENT][NEUTRAL] And if it's a, if it's a screening, was it a screening for a screening colonoscopy or are you having it because of a medical concern?
[CUSTOMER][POSITIVE] Yeah, so thank you so much.
[CUSTOMER][NEUTRAL] Yeah, it's like my yearly, like my um um normal um.
[CUSTOMER][NEUTRAL] Um, um, colonoscopy that I have, yes, uh-huh.
[AGENT][NEUTRAL] Screening? OK.
[AGENT][NEUTRAL] Like a screening. OK, so screenings would not be covered if the policy was active. It's has to be a result of an accident or a sickness. That's a screening.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK. OK. Thank you so much, but still.
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] One more thing, the policy number that you gave me, um, it actually termed [PII]. I do show a more recent policy which termed in 2023. Do you want that number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, because I, um, wait, hold on, let me get that number. OK, go ahead, I'm ready.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the policy number is 198.
[CUSTOMER][NEUTRAL] 198
[AGENT][NEUTRAL] 1909.
[CUSTOMER][NEUTRAL] 1909.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, but I still, I still need to go and, and um
[CUSTOMER][NEUTRAL] So the employee and um and make sure an employer to make sure that this is um accurate this um yeah.
[AGENT][NEUTRAL] Your spouse would because he's the employee. Yeah, your, your spouse would have to contact his employer. That is correct.
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[CUSTOMER][POSITIVE] OK. OK. Thank you so much and you have a great day.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] You're welcome, [PII]. If no other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. You too.