AccountId: 011433970860
ContactId: f2a5db24-d3dd-420d-91f4-4c1655552e0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 250509 ms
Total Talk Time (AGENT): 105128 ms
Total Talk Time (CUSTOMER): 63081 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/f2a5db24-d3dd-420d-91f4-4c1655552e0f_20250313T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey, good morning. My name is [PII]. If I provide you a claim number, can you check on that claim for me, please?
[AGENT][POSITIVE] Sure, I can verify claim status for you and I apologize, your name is one more time, you said it kind of fast.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], oh.
[AGENT][NEUTRAL] And what is that er that claim number if you have it or policy number?
[CUSTOMER][NEUTRAL] 357.
[CUSTOMER][NEUTRAL] 5136.
[AGENT][NEUTRAL] OK, thank you, sir. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII]. OK, thank you so much. Give me one quick moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] OK, and Mr. [PII], uh, verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you so much. And you say you're calling to verify that claim. Um, I said it looks like it was processed on [PII] and a check was mailed in the amount of $1000.
[CUSTOMER][NEUTRAL] OK, so the check um.
[CUSTOMER][NEUTRAL] Uh, so the check was mailed to that address, right, the listed address?
[AGENT][NEUTRAL] Uh yes sir, let me, well I say that, let me double check, but I do believe so. Give me one moment.
[AGENT][NEUTRAL] Wait, uh, it was sent to Coor Ridge Orthopedic Center.
[AGENT][NEUTRAL] So it looks like it was paid to the provider. I apologize. So it was processed on the [PII], so the check was mailed out today.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, to the provider.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Well, I think.
[CUSTOMER][NEUTRAL] Because of the surgery.
[CUSTOMER][NEUTRAL] Um, should I file a claim too?
[CUSTOMER][NEUTRAL] Because I had a procedure done.
[AGENT][NEUTRAL] And that was for outpatient surgery or in hospital because it looks like with that payment it matched your outpatient benefit for the year.
[CUSTOMER][NEUTRAL] Yeah, it was uh
[CUSTOMER][NEUTRAL] Outpatient surgery.
[AGENT][NEUTRAL] OK, well, uh, with the payment of this claim, with that $1000 payment, it matched your outpatient benefit for this year.
[CUSTOMER][NEUTRAL] OK, so what does that mean?
[AGENT][NEUTRAL] Uh, that means you don't have any more outpatient benefits for this year because it's a per calendar year, so your outpatient benefits won't start until [PII].
[AGENT][NEUTRAL] You still have inpatient benefits but just not for outpatient.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's for the outpatient. OK, I get it.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] And inpatient as if you are confined in the hospital 18 hours or more.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, appreciate that.
[AGENT][POSITIVE] You're welcome. And is there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, no, no, I was it appreciate you.
[AGENT][POSITIVE] OK, you're welcome, and thank you for calling APL. Have a great day, Mr. [PII].
[CUSTOMER][NEUTRAL] Alright you too bye.
[AGENT][NEUTRAL] Bye.