AccountId: 011433970860
ContactId: 1cdbe8ff-000b-4cba-a8f3-3f687cccd1fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 453660 ms
Total Talk Time (AGENT): 193557 ms
Total Talk Time (CUSTOMER): 133632 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/1cdbe8ff-000b-4cba-a8f3-3f687cccd1fb_20250227T15:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hey [PII]. [PII], it's [PII]. Hey.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm sorry, my phone was on mute. I'm sorry. How are you today?
[AGENT][POSITIVE] I'm good. How about you?
[CUSTOMER][NEUTRAL] I'm good, thank you. I have an insured on the line um with policy number 02525111 Miss [PII] the [PII].
[CUSTOMER][NEUTRAL] And she, she and I just went over the claim that was processed yesterday, claim 356-865-3, and she's gonna be getting the explanation of benefits that we need. However, on the transportation, we did pay her, but she says that she also submitted information for her family member that traveled with her, her daughter.
[CUSTOMER][NEGATIVE] But there was no reference to that.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Get it pulled up here. Let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Real sweet lady too.
[AGENT][NEUTRAL] You said she submitted like receipts for the daughter?
[CUSTOMER][NEUTRAL] She said she submitted for her daughter as well.
[AGENT][NEUTRAL] Hm, let's see, still looking here to see if I see any.
[AGENT][NEUTRAL] I'm not seeing any receipts.
[AGENT][NEUTRAL] I see we got the itemized bill and then like she sent.
[AGENT][NEUTRAL] Let's see what it is.
[AGENT][NEUTRAL] It's a bill.
[AGENT][NEUTRAL] And then she was like she sent sent the the GPS, the Google Map is the rest of it.
[AGENT][NEUTRAL] The directions to the facility. I don't see any receipts in this.
[AGENT][NEUTRAL] Let me see, is there any other policy out here to make sure ain't nothing under something else.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Yeah, I'm not seeing any receipts in this new mail. I don't see anything, um.
[AGENT][NEGATIVE] Yeah, there's no receipts in this information.
[CUSTOMER][NEUTRAL] Because I can see, yeah, we paid for her for the [PII] and [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I don't see anything regarding family receipts or anything in here.
[AGENT][NEUTRAL] All I see is itemized billing and then the directions to the facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So,
[AGENT][NEUTRAL] So if she has it, she can submit it to us. I don't show that we received it.
[CUSTOMER][NEUTRAL] What is
[CUSTOMER][NEUTRAL] OK, so, um,
[CUSTOMER][NEUTRAL] OK. So hypothetically, let me ask you this. If they stayed in the same hotel room, how do you submit for the family member?
[AGENT][NEUTRAL] Well, under this policy, let me glance at the, make sure it has the family lodging.
[CUSTOMER][NEUTRAL] I'm just saying, I mean.
[CUSTOMER][NEUTRAL] She's just been on hold a while.
[AGENT][NEUTRAL] The family lodging benefit. Let's see.
[CUSTOMER][NEUTRAL] It does.
[AGENT][NEUTRAL] So it has to be during the time that they've actually received treatment.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mhm. She says she
[AGENT][NEUTRAL] It all depends on that as well during that time frame.
[CUSTOMER][NEUTRAL] OK, so what do I need to tell her before I end up just having to release her?
[AGENT][NEUTRAL] Yeah, we have, just let her know that we, I don't, we don't, I wouldn't, we didn't receive any um billing related to the um family lodging, so we'll need that, the, the billing for the lodging.
[CUSTOMER][NEUTRAL] So receipts for the lodging?
[AGENT][NEUTRAL] Yeah, it actually had to be the, yeah, receipt and or um the, the statement from that particular facility as well, so it can provide us with the dates and all that information.
[AGENT][NEUTRAL] For wherever they did the lodging at the hotel, the hotel lodging, if for example, if it was there, then we will need the, the billing from the hotel that shows us the dates and that information.
[CUSTOMER][NEUTRAL] OK, but we have that for her. We just don't have that for the daughter.
[AGENT][NEUTRAL] Um, no, I don't. We have the bill where she received treatment, so they pay the transportation benefit based off the treatment she received from the hospital.
[CUSTOMER][NEUTRAL] OK, so,
[AGENT][NEUTRAL] That's how they paid her.
[CUSTOMER][NEUTRAL] OK, and then how do they pay the family member? That's where I'm not understanding. I'm sorry, [PII].
[AGENT][NEUTRAL] So if they can submit the receipts along with if it's a hotel, that billing from the hotel, which provides the dates that they were.
[AGENT][NEUTRAL] Lodging at that hotel, for example.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] The receipts from the hotel.
[CUSTOMER][NEUTRAL] OK. And what else?
[AGENT][NEUTRAL] And that bill from the.
[AGENT][NEUTRAL] From that first hotel.
[AGENT][NEUTRAL] So wherever they receive, where, wherever they have lodging at, we'll need the receipt in.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Just receipts from the where they were lodging.
[AGENT][NEUTRAL] Not, not just the receipt, not like if they paid it and there's a receipt. We wouldn't, so if, for example, is the Holiday Inn, you know how they give you the statement when you check out, it shows the dates and all that information, we will need the actual statement from, if they, for example, went to Holiday Inn, we will need that that provides the dates and that information.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so a detailed, you know, receipt from the hotel showing dates and charts. OK. And what else? Anything else?
[AGENT][POSITIVE] Yes. Mhm, correct.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that's it.
[CUSTOMER][NEUTRAL] Nothing from the facility. When you say when you say facility, I was thinking like the treatment center or whatever, but just the hos OK.
[AGENT][NEUTRAL] No, no, no, no. So we would compare it to the dates that she was receiving treatment. So whatever dates that that's submitted as far as their lodging, it will have to coincide with when she was receiving treatment. Cause if it's outside of her treatment dates, then it wouldn't be, you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, well let me see if I can provide her that information if she has any other questions I'll, I'll just connect her.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] OK, all right, thank you, [PII].
[AGENT][POSITIVE] You're welcome bye.
[CUSTOMER][NEUTRAL] All right, bye-bye.