AccountId: 011433970860
ContactId: 19aa2e3f-d36b-4acd-888a-42d24867bef1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403440 ms
Total Talk Time (AGENT): 198454 ms
Total Talk Time (CUSTOMER): 120403 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/19aa2e3f-d36b-4acd-888a-42d24867bef1_20250103T23:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII]. I'm calling in regards to policy number 02518294.
[AGENT][NEUTRAL] OK, [PII], can you give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, sir, let me pull that policy in real quick.
[AGENT][NEUTRAL] OK, [PII], um, can you verify your date of birth for me, please, sir?
[CUSTOMER][NEUTRAL] Um, [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] Um, [PII].
[CUSTOMER][NEUTRAL] Um, phone number ending with [PII] and then the email I'm not sure if you guys have the [PII] or [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I've got the, the JD uh thank you for verifying all that information for me, [PII]. Um, so what can I help you with today with your policy?
[CUSTOMER][NEUTRAL] OK, so I have two claims numbers, one that was on 1216.
[CUSTOMER][NEUTRAL] The claim number is 3541672.
[AGENT][NEUTRAL] OK, let me look that claim up real quick.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] OK, so on this claim, the claim was denied because the patient is no longer an eligible dependent on the policy.
[CUSTOMER][NEUTRAL] Yeah, that's not true, that's not true. So I have another claim number 354-496-3.
[AGENT][NEUTRAL] 354-496-3. Let me look up that one for you.
[AGENT][NEUTRAL] OK, so on this claim, we're needing the explanation of benefits from the primary insurance carrier.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, that's what, um, that's what I'm confused about and why I'm calling. So on the claim number 1672 there I had, um, uploaded 44, bill on the [PII], the [PII], um, [PII], and [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On this claim that you guys just sent recently ending in 4963, you guys are missing the [PII].
[CUSTOMER][NEUTRAL] But then you guys are asking to um verify from my primary insurance and then the diagnosis that we um what me and my son went there for.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In those days,
[AGENT][NEUTRAL] OK. OK. So what, mhm.
[CUSTOMER][NEUTRAL] Yeah, so
[AGENT][NEUTRAL] All right, [PII]. So what I'm, what I'm going to do, um, I can't actually see the paperwork that you've sent in there's only so much I'm allowed to see, but what I can do is I can transfer you on over to a claims examiner that's the person that actually processes the claims.
[CUSTOMER][NEUTRAL] No, go ahead.
[AGENT][POSITIVE] And let you talk with them as far as if there's anything else that they need from you or um you can explain to them the things that you have sent in and which claim they're for so that they can help you further assist you to get your answers.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Are they um available right now?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes sir, we close at [PII] so I'm gonna go ahead and transfer you on over there so you can go ahead and speak to somebody and get all the answers that you need, OK [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Alright, it's going to be a brief hold while I transfer you on over. Is there anything else that I can help you with as far as looking up your policy, um.
[AGENT][NEUTRAL] The remarks that are on the claims, anything like that that I can help you with before I transfer you?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, OK, I'm gonna put you on a hold. I hope you have a wonderful weekend and we appreciate you calling APL.
[AGENT][POSITIVE] There'll be somebody with you shortly.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're very welcome, [PII].
[CUSTOMER][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Hi APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in the care team. I've got, um, hey, I've got [PII] on the phone, or, or [PII], oh gosh, I don't even know if I'm saying that right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But his um policy number is 251-8294.
[AGENT][NEUTRAL] He's calling about.
[AGENT][NEUTRAL] Two claims um that we have for him. I gave him the remarks that were on the claim, and he said that there's information that we have.
[CUSTOMER][NEUTRAL] For himself or part two?
[AGENT][NEUTRAL] For part two, let me give you the claim numbers.
[CUSTOMER][NEUTRAL] I have it. It's only 2 planes.
[AGENT][NEUTRAL] Right, the one ending in 672 and the one ending in 963.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, he has, he needs further help pass the remarks that I've given him.
[AGENT][POSITIVE] So I'm gonna transfer him on over to you and I hope you have a good weekend.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] You can send them over.
[CUSTOMER][POSITIVE] Thank you and you do the same. Goodbye.
[AGENT][NEUTRAL] OK, bye-bye.