AccountId: 011433970860
ContactId: 091592d4-80c2-4b54-bf88-c38da73aa90b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 515340 ms
Total Talk Time (AGENT): 122737 ms
Total Talk Time (CUSTOMER): 228690 ms
Interruptions: 4
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/091592d4-80c2-4b54-bf88-c38da73aa90b_20250527T17:56_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with the care team. I have [PII] on the line. She, [PII], she submitted some extra documentation and then she was wanting to know um if she needed anything else. I, it was kind of hard to understand her. I told her that it was being worked on and being processed, um, but then she asked if I could send her to claims instead.
[CUSTOMER][NEUTRAL] Because I can't see who's looking at her claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, sure. What was the policy number?
[CUSTOMER][NEUTRAL] The policy number is 254-585-1.
[CUSTOMER][NEUTRAL] I've verified her and she's speaking on behalf of her husband because she's the one who submitted the claim um she's verified everything.
[CUSTOMER][NEUTRAL] She said I do see that she submitted documents today um towards a claim that she had already been working on. It looks like from what I understand, the claim that she submitted last week, she didn't say she needed any. We asked her for any of this extra information she just provided more documentation.
[CUSTOMER][NEUTRAL] And she was wanting to know if she needed to do anything further.
[AGENT][NEUTRAL] OK, and what claim number was she referring to?
[CUSTOMER][NEUTRAL] Since they haven't been processed yet, there's not a claim number. It's just the first two on there for part 2. They show 0, all the zeros.
[AGENT][NEUTRAL] Oh, so she's checking on the claim status for the new claims?
[CUSTOMER][NEUTRAL] I have the date of service though.
[CUSTOMER][NEUTRAL] Yeah and I yeah and I am showing one for the date of service that she's asking for but I don't know if it's the same one and when I tried to get that information she just wanted to be sent to you instead.
[AGENT][NEUTRAL] OK, I just wanna make sure that I know what she's needing.
[CUSTOMER][NEUTRAL] Because I did see one for that data service.
[AGENT][NEUTRAL] So she just wanted to check with the claim status for the two most recent claims she sent in.
[CUSTOMER][NEUTRAL] Right, she wants to know because she didn't put a claim number on them um she I think she wants to have peace of mind on how they're gonna get because she didn't put a claim number on them.
[AGENT][NEUTRAL] OK, um, and do you have a callback number?
[CUSTOMER][NEUTRAL] If that makes sense, yeah.
[CUSTOMER][NEUTRAL] I do. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Right, are you ready for?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK thank you.
[CUSTOMER][NEUTRAL] [PII], are you still there?
[AGENT][POSITIVE] Thank you for
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I, I have [PII] on the line for you through in claims. Uh, she'll be able to help you with what you're asking for, OK?
[CUSTOMER][POSITIVE] OK, thank you. Hi, [PII], how are you?
[AGENT][POSITIVE] Uh, yes, Ms. [PII]. How are you doing? And yes, my name is [PII], and how can I help you today?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Hi, [PII]. I um sent in some documents last week to process and my husband had a new surgery. Um, and then today I uploaded home health records and I didn't know if that's something that's payable on the screen.
[CUSTOMER][NEUTRAL] What
[AGENT][NEUTRAL] OK, sure I'll take a look at that for you. So you were wanting to know if you have home health care benefits available on your accident policy?
[CUSTOMER][POSITIVE] I'll wait for yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, if I can take a look at that for you, uh, bear with me just a moment please.
[CUSTOMER][NEUTRAL] Yeah, we can on the person.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So what do you say?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, bear with me just a moment. I'm just taking a look in your policy certificate here.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] OK, so this is just verification of benefits, non-guarantee of payment, but I'm looking in your policy here and I don't see a specific benefit for home health care. Um, however, you're free to send us any of the itemized bills or medical records, um, in that in regards to the accident, um, for the accident claim, and we'll be happy to review that for you, um, just in case of any additional benefits that could be payable.
[CUSTOMER][NEUTRAL] Be done with the.
[CUSTOMER][POSITIVE] Yeah, alrighty.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, do you see like any, they have they finished working on the last one?
[AGENT][NEUTRAL] Um, do you know what day that was sent in, that claim or the claim number?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So you in a second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 25, wait, no, no, no, no, I don't see the claim number yet. I just have the policy number.
[AGENT][NEUTRAL] OK. Do you maybe remember when you sent that claim in the, the day?
[CUSTOMER][NEUTRAL] 5:20.
[AGENT][NEUTRAL] Oh, OK. Yes, so I see that there's a claim that 520 and 527 that are still currently being reviewed, um, so once that's been reviewed by the examiner and process, then we should have the results of that claim here soon.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so we don't see anything that they've put like any notes or anything yet?
[AGENT][NEUTRAL] Uh, not yet. It looks like it's still currently under review.
[CUSTOMER][POSITIVE] OK, thank you so much. You have a good, well I sent them more documents on today. I was wondering if you guys can just merge those documents in.
[AGENT][NEUTRAL] Uh, yes, so I do see that we did receive additional information today on the [PII], and what, what, what will happen is they'll review that at the same time as the one from the [PII], so they'll both be reviewed at the same time.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you so much. You have a good day.
[AGENT][NEUTRAL] Uh, sure, Ms. [PII], is anything else I could do to help you today?
[CUSTOMER][NEUTRAL] No, that's it. Thank you. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day.