AccountId: 011433970860
ContactId: 075b6afd-d563-4182-b10d-1923d93c53d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 222300 ms
Total Talk Time (AGENT): 67410 ms
Total Talk Time (CUSTOMER): 123276 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/075b6afd-d563-4182-b10d-1923d93c53d7_20250102T21:21_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, I'm calling you from an agent's office. We have a member of one of our groups insured with you guys that needs to submit a claim. What's the easiest way to do so? She sent me the uh EOB from the medical carrier.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] OK. Yes, sir. I can assist you with filing a claim. Um, first, I'll need your name and a good callback number just in case we're disconnected.
[CUSTOMER][NEUTRAL] My name is [PII]. My direct number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] Uh, the member or the group, which one do you want?
[AGENT][NEUTRAL] The member's policy number.
[CUSTOMER][NEUTRAL] OK, let's locate that [PII]. I'm looking at her online. Policy number says 2357627.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And please verify her name and date of birth.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh, date of birth is.
[CUSTOMER][POSITIVE] Great, now I gotta look for her date of birth. Give me one sec. I'll get that for you right away.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] Group files break up, break up the animal.
[CUSTOMER][NEUTRAL] Group implementation.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] There it is.
[CUSTOMER][NEUTRAL] Hold on, it's loading.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 9 1295.
[AGENT][NEUTRAL] OK, thank you. And yes, sir, in order to file a claim, um, you can file it online. You can fax us the information or you can send the information through mail. Which way do you prefer?
[CUSTOMER][NEUTRAL] Uh, online, how do I do it? Is it like uploading?
[AGENT][NEUTRAL] Yeah, you would upload it, but um actually she would need to set the policy up online.
[CUSTOMER][POSITIVE] Oh sure, perfect.
[CUSTOMER][NEUTRAL] Oh, so, yeah, she's uh a little lazy, hence why I'm calling you. So I guess I can fax you the whole thing. I have the, the claimant statement thing already filled out. It's like a three-page thing from APL.
[AGENT][POSITIVE] OK. Yes, sir. We'll need that.
[CUSTOMER][NEUTRAL] It's form C as in Charlie 101 and then I have like I said, the EOB from the carrier. What, what else do I have to provide to fax it in?
[AGENT][NEUTRAL] We would need her diagnosis code and the diagnosis code, you can get that from the provider and write it on the explanation of benefits. And um I can give you the fax number to fax that in to us.
[CUSTOMER][NEUTRAL] Please go ahead.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII] and please attention it to the claims department.
[CUSTOMER][NEUTRAL] Attention claims department got it so make sure that the EOBs.
[CUSTOMER][NEUTRAL] Have not just the procedure codes but the diagnosis codes and make sure the cover page says attention claims department [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][POSITIVE] Awesome you've been super helpful thank you very much for your time.
[AGENT][POSITIVE] OK, no problem. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] That'll do it thank you so much.
[AGENT][POSITIVE] OK, I thank you again, [PII], for calling APL. Have a great rest of your day. Mm bye.
[CUSTOMER][NEUTRAL] You too bye bye.