AccountId: 011433970860
ContactId: 026f7e7e-cf6f-439e-bae7-3c2544eef14a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 627119 ms
Total Talk Time (AGENT): 180906 ms
Total Talk Time (CUSTOMER): 233354 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/026f7e7e-cf6f-439e-bae7-3c2544eef14a_20250311T14:49_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, and I have a question about a claim that we have. Can I give you the claim number?
[AGENT][NEUTRAL] Sure, go ahead.
[CUSTOMER][NEUTRAL] 35732007
[AGENT][POSITIVE] Thank you. One moment. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah this is [PII] [PII].
[CUSTOMER][NEUTRAL] And I'm with my wife [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One moment, let me pull the explanation of benefits so I can pull the policy.
[CUSTOMER][NEUTRAL] Yeah, the policy is under [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And Mr. [PII], uh, since I got you on the line, may I have your date of birth for security?
[CUSTOMER][NEUTRAL] Alright. Spanish is [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] My [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you. And I need um mailing address and email address for verification, Mr. and Mrs. [PII].
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, Mr. and Mrs. [PII], can you hear me?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mr. [PII] or Miss [PII], can you hear me?
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] I, I cannot hear you. I'm not sure if you got me on mute or but I cannot hear you.
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, I'm gonna try to call back at the number that you provided to me for a call back, um, because I cannot hear you. I'm not sure if you're able to hear me.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Your call has been forwarded to an automated voice messaging system.
[CUSTOMER][NEUTRAL] [PII] is not available.
[CUSTOMER][NEUTRAL] At the tone, please record your message. When you've finished recording you may hang up or press one for more options.
[CUSTOMER][NEUTRAL] We didn't get your message either because you were not speaking or because of a bad connection. To disconnect, press 1. To record your message, press 2.
[CUSTOMER][NEUTRAL] At the end of your message press one.
[CUSTOMER][NEUTRAL] We didn't get your message either because you were not speaking or because of a bad connection. To disconnect, press 1. To record your message, press 2.
[CUSTOMER][NEUTRAL] We didn't get your message either because you were not speaking or because of a bad connection to disconnect at the end of your message, press 1.
[CUSTOMER][NEUTRAL] We didn't get your message either because you were not speaking or because of a bad connection. To disconnect, press 1.
[AGENT][NEUTRAL] Thank you for holding, um, Ms. Can you hear me now?
[CUSTOMER][POSITIVE] Yes ma'am, I'm sorry.
[AGENT][NEUTRAL] OK. I'm not sure what happened. I tried to call but it was not connecting either, so, uh, OK. Um, may I have the mailing address and email address on file? I didn't get that information.
[CUSTOMER][NEUTRAL] Uh, the mailing address is [PII].
[CUSTOMER][NEUTRAL] The email is [PII].
[AGENT][NEUTRAL] OK. Looks like we may have her work email. Do you know which one it is?
[CUSTOMER][NEUTRAL] Uh, her work email is [PII].
[CUSTOMER][NEUTRAL] I believe at
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Are you looking, are you verification of what it is, or I mean you need to know what it is. What I can get her back in here to tell.
[AGENT][NEUTRAL] I, I
[AGENT][NEUTRAL] Yeah, I'm looking at what we have to um to see what um it's just a verification to make sure that we have that correct.
[CUSTOMER][NEUTRAL] OK, got
[CUSTOMER][NEUTRAL] Right, [PII], what's your school email?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hm
[AGENT][POSITIVE] Perfect. OK, thank you. And I'm sorry, how may I assist you today?
[CUSTOMER][NEUTRAL] Yes, we got uh explanation of benefits and it says on the notes that more information is needed and it lists what the information is needed, but when we submitted the we submitted the authorization for APL to uh to get that information.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, so my question is, will APL submit the hospital and for the information they need to finish the claim, or do I have to track it down and.
[CUSTOMER][NEUTRAL] Upload it or send it.
[AGENT][NEUTRAL] OK. Uh, when we ask for additional information is because this information that we cannot request, uh, the authorization that was signed is to get medical records.
[AGENT][NEUTRAL] Um, so that will be the only thing that we can get with that authorization is medical records. If we're asking for itemized bills, um, or anything like that, that needs to come from the insured or the provider of service.
[AGENT][NEUTRAL] Um, in this case, it looks like um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah, we need the itemized bill. So yeah, that's something that you need to send us.
[CUSTOMER][NEUTRAL] OK, my next question is I see where I can upload that from or I can see where I can upload files uh from that claim number, is that an option um or does it need to be faxed in?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can upload the documents. It's not gonna go to the same claim number because that claim is already processed and work.
[AGENT][NEUTRAL] So, um, it's gonna be as a new claim and we'll go ahead and put it all together once we receive the information, but you can just upload it to the system.
[AGENT][NEUTRAL] That's a new claim.
[CUSTOMER][NEUTRAL] So I, OK, so now my question is you're saying they closed that claim out I do I have to resubmit everything all over again?
[AGENT][NEUTRAL] No, uh uh, you only need to submit what we're requesting right now. Everything else we have it, we can go through it if we need to, we just need that additional information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Now let me um I because I wanna make sure it seems like the option to upload though is tied to that one claim.
[CUSTOMER][NEUTRAL] Yeah, let me look right quick if you don't mind, uh, upload documents files, OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alright, so I can uh I can just do it right here coverage time.
[CUSTOMER][NEUTRAL] Claiming info alright, so I don't have to tie it back to the that claim they'll know because they can look back at the information I have already submitted, is that correct?
[AGENT][POSITIVE] Correct, correct.
[CUSTOMER][NEUTRAL] OK, and is there, is there a time frame because we're leaving to go on vacation now I mean I can do this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can do it when you come back. Um, there's no um time frame and you just submit the claim or submit the information that we're requesting, and we'll go ahead and go through it. That doesn't change our decision.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, thank you, um, OK, well.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] All right. You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] OK. Bye-bye.
[CUSTOMER][POSITIVE] Uh, no, ma'am, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][POSITIVE] Thank you, bye.