AccountId: 011433970860
ContactId: 062f956d-0932-42ac-8765-400fac18d93d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 468040 ms
Total Talk Time (AGENT): 277686 ms
Total Talk Time (CUSTOMER): 213460 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/062f956d-0932-42ac-8765-400fac18d93d_20250307T22:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] Doing all right thank you um I've got a member on the line and it's I'm sorry I'm very confused and she's confused so I don't know if you can help so um seems like she had a claim, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And uh we received a check or we've sent out a check that she never got um and I have the check number and everything the claim number she gave me is completely different, does not have a check number. She said she received a letter from us regarding that. I don't see any letter in Onase, so I don't know if I'm maybe not looking in the right spot or what, but essentially she's just wanting an update on this check, but I don't even see any notes about it.
[AGENT][NEUTRAL] OK, uh, do you know what her policy number is?
[CUSTOMER][NEUTRAL] Yes, yes, it's uh 727-573.
[AGENT][NEUTRAL] OK, and what's the claim number she gave you?
[CUSTOMER][NEUTRAL] The claim number she gave me was 346-615-2.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] Oh, it is the same check number. I'm crazy sorry.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEGATIVE] I'm tired.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Let's see, Miss [PII] 6152.
[AGENT][NEUTRAL] That was processed in June.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And she said that she called and told someone that she didn't get it.
[CUSTOMER][NEGATIVE] Well she said that she got a letter from us a while ago um that we were gonna void reissue the check because she never got it and she said she sent in the forms we asked for which I'm not sure what she's referring to with that but then she said the letter she got today is essentially a second um attempt at reaching her like we didn't get what she sent. That's where I'm really confused so I would have just.
[CUSTOMER][NEUTRAL] Submitted a hub request to uh [PII] to void and reissue the check but I don't know if this was something that had already been worked or is in the middle of something.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Um, I mean, you're right, I don't really see any notes regarding this particular claim or check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] She said in the on the letter she got it gave um [PII]'s information um so but I don't know if it's.
[CUSTOMER][NEUTRAL] I should wait to speak with her because I don't know if she's even in this late.
[AGENT][NEUTRAL] I don't know either and let's see, let's look under for the last correspondence just correspondence in general and on base that I have is from [PII].
[CUSTOMER][NEUTRAL] Um, yeah, I, I was looking at, I saw the correspondence for um claims and regular correspondence, and so I couldn't find anything.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I mean it looks like before this was even processed.
[AGENT][NEUTRAL] There was correspondence in [PII], but again that was prior to this ban process because that was processed in June.
[CUSTOMER][POSITIVE] OK, I think what I might do is I might um just send [PII] an email with this information because I don't wanna make a hub request if there's I don't wanna add to chaos if it's already chaos so I appreciate it. I just didn't know if you could see something I didn't or you'd be like, oh yeah, that's it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I would let her know.
[AGENT][NEUTRAL] No, yeah, I mean it, it hasn't been voided in line, so it's still, it's still showing out there um based off of what I'm seeing because like when you look at it, if it had been voided instead of having a Y out there where it would have a V or it would have a V where the P where the remark code is, so it's not showing as voided um if [PII] has sent anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] It's not an on base as far as I can see.
[CUSTOMER][NEUTRAL] Well, and that's the thing too, I don't see any even any notes regarding this, um.
[AGENT][NEUTRAL] Right, there's not any notes, and I don't know if you've tried searching the hub request for this policy number or anything like that that's OK. I was fixing say other than like trying to filter out what either has been or hadn't been done and just searching in general for her to see if anything's been submitted.
[CUSTOMER][NEGATIVE] Not particularly, no.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] I don't, I mean, it is still outstanding. She's not, uh, you know, you're not wrong about that. She's not wrong about that. It doesn't look like she's ever gotten it and it's better than [PII] old, but.
[CUSTOMER][NEUTRAL] It's more I think I'm more confused on the information she said she sent us in the second attempt that's where I'm a little confused and I have no idea what that's about.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I know, let me see if there's anything going on.
[CUSTOMER][NEUTRAL] But she gave me the right address, so it's not like it was a different address.
[AGENT][NEUTRAL] Right and we just made a payment for something yesterday, so maybe she's talking about that and she doesn't understand but like there's a payment for.
[AGENT][NEUTRAL] Some treatment or yeah, some hormone therapy, it looks like that she's received payment for that was processed yesterday. But other than that, the last payment she got was back in February as far as [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And but as far as correspondence, I don't even like you said, I don't see there was something in October.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] It's not good, but I'm kind of glad that you don't see it either because I thought I was just going crazy.
[AGENT][NEUTRAL] Right. No, no. And like I said, when you look at maybe what has been requested in the past, like there was something for um back in [PII] or [PII] where we had an incomplete.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Like claim form and we needed some additional information then but 73 that was for chemo let me see if we ever went back and paid that.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] We never went back and paid any chemo for that date, so I don't know if that's what she's talking about, but again that was back in [PII], so I don't know if she's questioning not receiving that, but it's so like she's getting everything all turned around because that ain't got nothing to do with that check that she received.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's what it sounds like.
[CUSTOMER][NEUTRAL] So what I'm, I don't know, do you think I should just email [PII] and just touch base with her when we're able to? I feel like if she her name's on there, she must know something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I would email [PII] about that check in regards to the claim number that you have and then I would put.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I would maybe even either email the claims QA team or put in a hub request for claims and see if there is someone that can research.
[CUSTOMER][NEUTRAL] Oh, I can search. I, I can search and uh to see like you said like her policy number see if something had been attempted.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Well I was thinking if yeah well I was thinking too like the information that we requested I said July the date of service was July but we requested information back in October so you could probably put in a hub request to have like some research done on the information requested and everything because she's saying that she submitted information but she's gotten more requests and like you're just not sure because again I don't.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, I it's all just crossing, crossing wires, yeah.
[AGENT][NEUTRAL] Yeah, yeah, I don't know if she's confused or if you and I are just confused or what's going on.
[CUSTOMER][POSITIVE] I had, I think it might be a bit of both, but I really appreciate your help really, um, it does make me feel a lot better just was wanting to see if I was just crazy and not seeing something, so I really appreciate your help, but um, I'll let her know that we'll research it and get back with her and go from there. Alright, thank you so much. Have a good night.
[AGENT][NEUTRAL] It might be.
[AGENT][POSITIVE] Uh, no problem.
[AGENT][NEUTRAL] No. No.
[AGENT][POSITIVE] For sure, for sure.
[AGENT][POSITIVE] You're welcome. You too.
[CUSTOMER][NEUTRAL] Alright, bye.
[AGENT][NEUTRAL] Bye.