AccountId: 011433970860
ContactId: 0ef07761-afcc-40bf-bff9-d20b3bdd36d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205529 ms
Total Talk Time (AGENT): 85459 ms
Total Talk Time (CUSTOMER): 65053 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/0ef07761-afcc-40bf-bff9-d20b3bdd36d5_20250522T19:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I received a letter in the mail, um, from y'all saying that the explanation of benefits received does not match the amounts supplied to the deductible or copay. Please submit a more detailed explanation of benefits. Does that need to come from the place where I had my, um, scan done?
[AGENT][NEUTRAL] Um, yes, ma'am. I can assist you with claim status. Um, first, could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] And my number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, could I get your policy number, please?
[CUSTOMER][NEUTRAL] Yes, it's 02541657.
[AGENT][NEUTRAL] Please verify your name again, your first and last name and your date of birth.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Alright [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Now, please verify your email address and your mailing address.
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] OK, thank you. And on the um explanation of benefits that you received from us, does it give you a claim number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. What's that number?
[CUSTOMER][NEUTRAL] 3593
[CUSTOMER][NEUTRAL] OK 3593575.
[AGENT][NEUTRAL] OK, one moment. I'm pulling up the image to take a look at it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Thanks for your patience. Yes, ma'am, since um the provider.
[AGENT][NEUTRAL] Um, of the medical service, um, file this claim. They also received the same letter in the mail, the same explanation of benefits, so they'll know to resubmit the claim with the requested documentation because the um EOB that we received from them, from Cigna.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, it's showing the services that was provided, but it doesn't show what went towards the copay, the co-insurance, or the deductible, which are the portions that we cover as your secondary insurance. So they will need to send us a copy, updated copy of explanation of benefits.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] So I don't need to do anything.
[AGENT][NEUTRAL] No, ma'am. You'll just need to wait for them to resubmit the um documentation that we're requesting.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] That'll do it. Thank you.
[AGENT][POSITIVE] OK. I thank you again, [PII] for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you.