AccountId: 011433970860
ContactId: 188a1e59-15e2-4998-86a7-29eac94ca4e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 580520 ms
Total Talk Time (AGENT): 217559 ms
Total Talk Time (CUSTOMER): 234385 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/188a1e59-15e2-4998-86a7-29eac94ca4e5_20250331T19:45_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hello, Miss. My name is Mrs. [PII]. The reason that I'm calling is because I've been, um, submitting, uh, some claims. Um, my son passed away and, um, uh, I still, um, every time I submitted some uh uh documents that y'all need, um.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] He returns the letter saying that they still need the same thing. So I, I've tried several times and it's through Texas Children's Hospital. And so I was one.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, what I'm calling for is because they've been, uh, requesting, they need, um, uh, provide, uh, the itemized billing for the surgeries that that he has and then with the procedure code and for the surgeries. And then the pathology report for this surgery, uh, uh, procedure, the pathology reports and then um
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then also the anesthesia benefits uh also are about uh they need the, the um
[CUSTOMER][NEUTRAL] Surgery charges for those days and the and the anesthesia.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] That's what it's asking me for. And so, OK, so, uh, every time I, I, I request those documents to take the children, they send them to me and then I'll send it to you, but
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It keeps receiving the same letter, the same letter that you'll need that information. So I want, um, the reason that I'm calling is to see if there is any way that you, that y'all can request those documents directly to the hospital.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, Ms. [PII]. I'll make sure we get you some help with your claims. Um, I'm sorry you're having such a hard time. Um, can you please give me your policy number?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Uh.
[CUSTOMER][NEUTRAL] If I can find my policy number now.
[AGENT][POSITIVE] Yes, ma'am. Go ahead and take your time.
[CUSTOMER][NEUTRAL] Oh, let me see. Uh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh let me see.
[CUSTOMER][NEUTRAL] Because I do have the, I have the document right now with me, and I just have the claim number. I don't have uh the.
[CUSTOMER][NEUTRAL] Policy number with me just at this moment like right now.
[AGENT][NEUTRAL] That's fine. That's fine. What is the claim number?
[CUSTOMER][NEUTRAL] OK, the one, the, the document that I have right now, it is uh 352-6086.
[AGENT][NEUTRAL] OK, I'll look that up real quick and we'll get your policy number that way.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me look this up now.
[AGENT][NEUTRAL] It's gonna be just a second while I pull up that policy.
[AGENT][POSITIVE] All right, Ms. [PII], you're so very welcome. Can you please verify your date of birth for me?
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number, and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, my address is [PII].
[CUSTOMER][NEUTRAL] 42 and um you said my email address is [PII] and my phone number is [PII].
[AGENT][NEUTRAL] Thank you, and it looks like um I have a different email address at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII]. Mhm. Yeah.
[AGENT][POSITIVE] OK, thank you so much. I appreciate you giving me that information. Um, and what I'm going to do.
[AGENT][NEUTRAL] Since, uh, let's see, let's look at it. Which son was it that was in the hospital?
[CUSTOMER][NEUTRAL] My son, uh, his name is [PII].
[AGENT][NEUTRAL] Yes, [PII]. OK.
[AGENT][NEUTRAL] Let me look this up real quick.
[AGENT][NEUTRAL] All right, and I do see.
[AGENT][NEUTRAL] That it is asking for the information that you had already told me that it was asking for the charges and um.
[AGENT][NEUTRAL] Yes, I do see. OK, so what I'm gonna do is since you're having such a hard time, I'm gonna go ahead and transfer you on over to uh the claims department so that you can talk to them and see if maybe they can request the the the documents for you since you're having such a hard time getting what they're asking for, OK?
[CUSTOMER][NEUTRAL] Yes ma'am. And uh while I'm with you right now, can I have the policy number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, it's 209.
[AGENT][NEUTRAL] 1331.
[CUSTOMER][NEUTRAL] OK. 209-1331.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] OK, and it's gonna be a brief hold. I'm gonna get, yes, my name is [PII]
[CUSTOMER][NEUTRAL] And what was your name again?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] All right, Miss [PII], thank you so much. I appreciate you.
[AGENT][POSITIVE] Well, you're very welcome, Ms. [PII]. I'm gonna transfer you now and try to get you some good help, OK?
[CUSTOMER][POSITIVE] I appreciate that thank you bye bye.
[AGENT][POSITIVE] All right. Well, you have a blessed day and thanks for calling APL. Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] You, you too, bye.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, Ms. [PII], it's [PII] in the care team. I've got um Ms. [PII] on the phone. Her policy number is 2091331.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, she is calling about claim number 3526086.
[CUSTOMER][NEUTRAL] Part 1, part 2, part 3.
[AGENT][NEUTRAL] Uh, part, uh, I just, I know it's [PII], whoever, [PII] is part 4.
[CUSTOMER][NEUTRAL] OK, and the claim number again? I'm sorry?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am. It's 352-608-6.
[AGENT][NEUTRAL] She keeps going back and forth with us on her claim. Uh, she says that.
[AGENT][NEUTRAL] She keeps getting all the information that we need from the, you know, from the doctors from the providers, the EOB and the itemized statement, and then she sends it in and it tells us, tells her that she needs the same thing over again but the provider keeps sending the same documentation so she is wondering if there's a way that we can request the information from the provider for her for the claim, and she's on the other line.
[AGENT][NEUTRAL] Wanting to talk to somebody about that.
[CUSTOMER][NEUTRAL] Give me 1 2nd to look at this one.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 348.
[AGENT][NEUTRAL] And apparently her son passed away.
[AGENT][NEUTRAL] And this is bills that he had when he was in the hospital before he passed away.
[CUSTOMER][NEUTRAL] So next chemotherapy has been this.
[CUSTOMER][NEUTRAL] for a surgery.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Not only I eat that one.
[CUSTOMER][NEUTRAL] OK, so basically all we need is the surgeon's meal.
[CUSTOMER][NEUTRAL] OK, you can send her on over.
[AGENT][POSITIVE] Thank you, Ms. [PII]. You have a blessed day.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][POSITIVE] You as well thank you.