AccountId: 011433970860
ContactId: 10dd4820-5dc0-43c7-9afa-eccefcc4ae9b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 321160 ms
Total Talk Time (AGENT): 118179 ms
Total Talk Time (CUSTOMER): 91699 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/10dd4820-5dc0-43c7-9afa-eccefcc4ae9b_20250512T21:26_UTC.wav
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[AGENT][POSITIVE] Good afternoon and thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. My name is [PII]. I was calling to, uh, check on a claim that I put in, ma'am.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims Mr. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And may I have the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, policy number is 02.
[CUSTOMER][NEUTRAL] 58.
[CUSTOMER][NEUTRAL] 1933.
[AGENT][NEUTRAL] OK. Thank you. For security, may I have your date of birth, mailing address, and email address on file?
[CUSTOMER][NEUTRAL] It's my birthday is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My address is um [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And my email is [PII].
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] Alright, so let's see.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And this is for the most recent claim?
[CUSTOMER][NEUTRAL] Uh yes ma'am, for the gap insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. It's for the surgery on [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Why is she
[AGENT][NEUTRAL] OK, so yeah, there's several charges here. Let me pull the documents and see what's going on with this claim, OK? One moment.
[CUSTOMER][NEUTRAL] And um.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] We have receipts so can you pay.
[CUSTOMER][POSITIVE] For everything, whatever you need.
[CUSTOMER][NEUTRAL] Look at the
[AGENT][NEUTRAL] OK, so it looks like we're missing the itemized bill with the diagnosis codes.
[CUSTOMER][NEUTRAL] Itemized bill with diagnosed, uh, well, OK, what would that just be like the, the explanation of benefits from the hospital, the big hospital bill?
[AGENT][NEUTRAL] And it's gonna be a, it's gonna be the hospital bill, but it's gonna be an itemized bill which it has the diagnosis and procedure codes. It has to have both of the codes. And either you can ask for a UBO4 form, which is the hospital bill, the one they use normally to send claim to us, or you can just ask for just a fully itemized bill with the diagnosis code.
[CUSTOMER][NEUTRAL] Expiration.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, I believe we do have a fully itemized bill for all that, ma'am. I, I thought we sent it to y'all.
[AGENT][NEUTRAL] Mm, OK, let me look at the paperwork. I see you sent explanation of benefits from the primary insurance. Let me see what other documents we have. One moment.
[AGENT][NEUTRAL] That's.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like um the 37 pages that we received um they're all an explanation of benefits from UnitedHealthcare. So these are not the itemized bills. This is just a copy of the explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] It's it's.
[CUSTOMER][NEUTRAL] I'll send it right away. OK, ma'am, we'll, we'll send it over here in about the next 10 minutes. Is it, is there any, you want me to put attention to anybody in the, the email or anything like that?
[AGENT][NEUTRAL] No, it goes to the claims department and it, it goes back in the line to be processed, so it will take 7 to 10 business days for it to be processed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] All right, thank you very much, ma'am.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, that's it.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good afternoon, Mr. [PII].
[CUSTOMER][POSITIVE] All right. Thank you. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye bye.