AccountId: 011433970860
ContactId: 19cb266a-5a33-4aec-b4ea-ecfde6f92fce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 697260 ms
Total Talk Time (AGENT): 191876 ms
Total Talk Time (CUSTOMER): 249514 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/19cb266a-5a33-4aec-b4ea-ecfde6f92fce_20250624T16:23_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I have a question about a claim.
[CUSTOMER][NEUTRAL] It says it needs more information.
[AGENT][NEUTRAL] OK, I can help you look at that claim. Um, do you have a good policy number I can look up?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh yeah, GCP.
[CUSTOMER][NEUTRAL] 24
[AGENT][NEUTRAL] Uh, I think that might be like the, the plan name. Um, I can look it up by your last name though. What's your last name?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. It's [PII]
[CUSTOMER][NEUTRAL] Oh, I've got policy number. I'm sorry.
[AGENT][NEUTRAL] OK, what's that?
[CUSTOMER][NEUTRAL] Um, OK, it's 024.
[CUSTOMER][NEUTRAL] 30356
[AGENT][NEUTRAL] OK, thank you. OK, give me one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, Ms. [PII], can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then can you verify your address and email address? Excuse me.
[CUSTOMER][NEUTRAL] OK, [PII]. Email is [PII].
[AGENT][NEUTRAL] And then lastly, do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and then what uh claim are we looking at for you?
[CUSTOMER][NEUTRAL] OK, this claim number says 34.
[CUSTOMER][NEUTRAL] 84
[CUSTOMER][NEUTRAL] 580
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][POSITIVE] I've already been on the phone and got some questions answered, but I found more.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me pull it up real quick.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and then how can I help you with this?
[CUSTOMER][NEUTRAL] OK, it says it needs.
[CUSTOMER][NEUTRAL] Uh, provide the itemized billing from the provider's office, but which date is it wanting?
[AGENT][NEUTRAL] Uh, for that claim, it looks like it's for 528 24 [PII].
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't even think I don't even remember filing with those with you yet.
[CUSTOMER][NEUTRAL] So I'm just not sure what I've sent in and what I haven't.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Look up what we originally received.
[AGENT][NEUTRAL] It looks like we got the Blue Cross Blue Shield um explanation of benefits.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] And was that date did I say [PII] or did you come up with another date?
[AGENT][NEUTRAL] Um, you, uh, the claim number you gave me the 3,484,580.
[AGENT][NEUTRAL] Um, that's for [PII] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and I'm not even sure if I can even get to those.
[AGENT][NEUTRAL] That one we got the explanation of benefits um but we didn't get anything else so we we needed a like an itemization of the services because the EOB the shows um it just shows the charges it doesn't really break down what services were rendered or.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's just see what I do with that one for a second here.
[CUSTOMER][NEUTRAL] I'm gonna print that one out just so I can have it for my records.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And then if I happen to find something else, well, that'd be great too.
[CUSTOMER][NEUTRAL] All right, let me go back.
[CUSTOMER][NEUTRAL] What's weird is I'm going through all these claims.
[CUSTOMER][NEUTRAL] And some of them are like out of.
[CUSTOMER][NEUTRAL] Date
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Out of order in your dates.
[CUSTOMER][NEUTRAL] In my, my mind. Yeah.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I've got this kind of figured out.
[CUSTOMER][NEUTRAL] There's I've got 3 things that are pending.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] And I'm not even sure there what I've uploaded because it doesn't let me look.
[AGENT][NEUTRAL] Um, it's, uh, it looks like, let's see.
[CUSTOMER][NEUTRAL] I just have confirmation not even confirmation numbers just this undefined, undefined.
[AGENT][NEUTRAL] Yeah, we show um recently some uploaded.
[AGENT][NEUTRAL] It's like last week for
[AGENT][NEUTRAL] OK this is for.
[AGENT][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the, the three chemo dates that I had that I know that I have sent stuff in for was [PII], [PII], and [PII].
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, um, let's see, let me see.
[CUSTOMER][NEGATIVE] Now the, the new system has not been easy for me to adjust to.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we're finding that, uh, yeah, um.
[CUSTOMER][NEUTRAL] And find things.
[AGENT][NEUTRAL] I'm trying to see which.
[AGENT][NEUTRAL] OK, just making sure verifying everything that we've received. Let's see we've got.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So yeah, the [PII], [PII], [PII], or I'm sorry, [PII], [PII] and [PII], we got those, and then let me see.
[AGENT][NEUTRAL] Got another submission. Let me double check what that is.
[AGENT][NEUTRAL] Looks like that was sent today um let me check what that.
[CUSTOMER][NEUTRAL] Yeah, I, I just uploaded one that said it was needed for 326.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I see the EOBs 326 and then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Maybe I finally got that one up to date.
[AGENT][NEUTRAL] OK, that one just has the EOBs. Do you have the
[AGENT][NEUTRAL] Like the itemization from Methodist.
[AGENT][NEUTRAL] Hospital.
[AGENT][NEUTRAL] Like where it shows
[CUSTOMER][NEUTRAL] OK, uh, on the remarks on the back it says provide copies of your explanation of benefits from your primary insurance.
[CUSTOMER][NEUTRAL] I've already submitted.
[CUSTOMER][NEUTRAL] All of the itemized statements.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, I do see that. OK.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Very good.
[AGENT][NEUTRAL] OK, so yes those are currently in processing so.
[CUSTOMER][NEUTRAL] OK. Well, in that case, uh, all I need are all of the papers for my last 3 chemos.
[CUSTOMER][NEUTRAL] And then I can submit all of that.
[CUSTOMER][NEUTRAL] All right, I do have one question though.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, one of the last things we looked at was for 2024.
[CUSTOMER][NEUTRAL] And if I go back and find that um.
[CUSTOMER][NEUTRAL] Stuff that I'm needing the itemized billing.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Which policy number do I put it under?
[AGENT][NEUTRAL] That one is going to go under, let me get that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That one will go under 243-0356.
[CUSTOMER][NEUTRAL] 243-035-6
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That will be.
[CUSTOMER][NEUTRAL] It says claimant name.
[CUSTOMER][NEUTRAL] And 243-035. OK, I found it. I know what to do now if I can find those papers.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Is there anything else I can help with today miss?
[CUSTOMER][POSITIVE] I appreciate your help.
[CUSTOMER][POSITIVE] No, that's it for today. Thank you.
[AGENT][POSITIVE] OK, well thank you for calling APL. I hope you have a good rest of the day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye-bye.