AccountId: 011433970860
ContactId: 0d2fbc0d-97de-4fef-98b7-bc44e0e5e45e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227199 ms
Total Talk Time (AGENT): 74569 ms
Total Talk Time (CUSTOMER): 119396 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/0d2fbc0d-97de-4fef-98b7-bc44e0e5e45e_20250609T13:47_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] A
[CUSTOMER][POSITIVE] Hey, good morning, it's uh [PII], APL agent extraordinaire. Happy Monday. How are you?
[AGENT][POSITIVE] Good how are you?
[CUSTOMER][NEUTRAL] Yeah, not too bad. Um, I'm checking on this, uh, lady if she didn't have any bad luck she'd have no luck at all. So let me give you my best call back number which is [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And do you have the policy number for the member?
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, yeah, yeah, the policy number is 2473033. The lady's name is [PII], and tell me when you're ready for her date of birth.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] So I don't want to get on the phone with her because she'll talk my ear off for at least 1 hour and 10 minutes, and I kid you not, it could be halfway around the world before she finishes her conversation but she just emailed me. She's starting, yeah, you have no idea. There should, should be something good on my tombstone to write after helping this lady for like 20 years, but um.
[CUSTOMER][NEUTRAL] She's, she's just telling me she's gonna finally retire after 24 years at this university, but at the end of her thing she says also all the claims that I put in for APL for review were denied. I don't have any treatment dates, but can you look into your crystal ball to see if she's missing like the only two things anybody ever needs to give you guys, uh, is, you know, the diagnosis codes or the or the EOVs.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I don't know how easy you could make it easier you could make it.
[AGENT][NEUTRAL] OK, so we got, let's see.
[AGENT][NEUTRAL] We have one, we've got 2 claims on file. First one we received.
[AGENT][NEGATIVE] Looks like it covered several dates of service, um, several office visits which aren't covered under her policy.
[CUSTOMER][POSITIVE] It covered several days of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There was an outpatient facility charge too, and
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Needing itemized bills with the diagnosis codes.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][POSITIVE] Naturally OK.
[CUSTOMER][NEUTRAL] Alright, and uh do you know what date of treatment that was for?
[AGENT][NEUTRAL] Um, that was.
[AGENT][NEUTRAL] That one was [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, actually, hold on, let me give you.
[AGENT][NEUTRAL] I'm so sorry, [PII]. I was looking at the wrong, wrong numbers there. Sorry about that.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Alright, [PII]. OK, alright, is there anything else in the wheelhouse or no?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, let's see, so outpatient. OK, one other date of service, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Same there needing diagnosis codes. Let me make sure there's not any other dates of service.
[AGENT][NEUTRAL] Yeah, the other ones that she had submitted, um, again were for office visits and then treatment rendered and.
[CUSTOMER][POSITIVE] OK, got it. Alright, alright, give me more than enough information. Alright, let me write her back. Alright, thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a great day. Thanks. Bye-bye.
[CUSTOMER][POSITIVE] Alright, take care.
[CUSTOMER][NEUTRAL] You too bye bye.