AccountId: 011433970860
ContactId: 1d8096b7-f514-43fb-ad3b-c5cb5a8fa5a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456410 ms
Total Talk Time (AGENT): 196831 ms
Total Talk Time (CUSTOMER): 184261 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/1d8096b7-f514-43fb-ad3b-c5cb5a8fa5a9_20250228T14:48_UTC.wav
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[AGENT][NEUTRAL] This money
[CUSTOMER][POSITIVE] Hey, happy Friday.
[AGENT][POSITIVE] Happy Friday, how are you?
[CUSTOMER][POSITIVE] I'm doing well. How about yourself? It's been so long since I've heard your sweet voice.
[AGENT][NEUTRAL] I know, right?
[CUSTOMER][POSITIVE] I've been good.
[AGENT][POSITIVE] Yay!
[CUSTOMER][NEGATIVE] It's hard.
[AGENT][POSITIVE] Yay, I'm so proud of you. I knew you could do it.
[CUSTOMER][NEUTRAL] I know, I know, I know, I know I can do too, but sometimes we need a little help and a little research by somebody that.
[AGENT][POSITIVE] Well, just call me. I'm here for you.
[CUSTOMER][NEUTRAL] Well, I've got a provider and this is gonna need a little research.
[AGENT][NEUTRAL] Oh [PII].
[CUSTOMER][NEUTRAL] I'm so sorry. It's um.
[AGENT][NEUTRAL] Tell them to call us back in June.
[CUSTOMER][POSITIVE] Hi [PII], I love it. Can wait till after my birthday, let's just say August.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Yeah, there you go, that's even better.
[CUSTOMER][POSITIVE] I just adore you. The policy number is 140.
[CUSTOMER][NEUTRAL] 7207 Rosemary Paulina Jurado.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Very good. Come on, so slow.
[CUSTOMER][NEUTRAL] I speak Spanish.
[AGENT][POSITIVE] I know, I heard you speaking very well. OK, I got it.
[CUSTOMER][NEUTRAL] I don't know that very well, but you know.
[AGENT][POSITIVE] Yes, you do.
[CUSTOMER][NEUTRAL] I've got [PII] on the line, B E C [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Call back [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Calling for claim status, I gave him claim status on claim number 353.
[CUSTOMER][NEUTRAL] 358 4.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But then he states that it was that the payment was supposed to have been reissued looks like I I'm not sure sometimes the notes don't.
[CUSTOMER][NEUTRAL] Flow to me, um, claim number 3,495,580 was voided, but then.
[CUSTOMER][NEUTRAL] I don't know if it's supposed to be reissued under this new claim number.
[CUSTOMER][NEUTRAL] Or uh
[CUSTOMER][NEUTRAL] Can you research that and help back a little further?
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I will. Thank you.
[CUSTOMER][NEUTRAL] This one made me feel like [PII] for a moment. What, what, what?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's spinning
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Please don't.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I hear you.
[AGENT][POSITIVE] I got you. I got you.
[CUSTOMER][POSITIVE] All right, I, I appreciate it, [PII]. Let me get back on the line. Hope you have a great weekend.
[AGENT][POSITIVE] You as well. Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank, thank you for your patience. I have [PII] on the line and she is researching that further and will assist you further, and I did explain for the claim status. OK, thank you for calling API. have a good week.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Hi, this is [PII]. How are you today?
[CUSTOMER][POSITIVE] I'm doing good. What about you?
[AGENT][POSITIVE] I am great, thanks for asking and I'll be happy to assist you with the claim status. It looks like data service 8-17-2023.
[AGENT][NEUTRAL] For gastrohealth, so.
[AGENT][NEUTRAL] It's processed under 3,495,580.
[AGENT][NEUTRAL] And then it looks like it's reprocessed.
[AGENT][NEUTRAL] And let me go back up here.
[AGENT][NEUTRAL] Looks like it's reprocessed. I wanna make sure it's the same one.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] I do apologize. Our system is very slow.
[CUSTOMER][NEUTRAL] You talk again I missed her.
[AGENT][NEUTRAL] OK. So it looks like it processed originally.
[AGENT][NEGATIVE] Then it was voided out and reprocessed and denied as the outpatient maps met.
[CUSTOMER][NEUTRAL] This
[AGENT][NEUTRAL] So was the check not received?
[AGENT][NEUTRAL] Back
[CUSTOMER][NEUTRAL] So, so, yeah, yes, I'm there.
[AGENT][NEUTRAL] Was the check not received under claim number 3,495,580?
[CUSTOMER][NEUTRAL] On that day, um, it was not received, so we, uh, requested rep to uh issue check track.
[AGENT][NEGATIVE] OK, so you issued a check tracer, which means you never received it.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so what I'll do is I'll write this up, send this over for them to review.
[AGENT][NEUTRAL] And did they verify the correct address? Let me make sure we do have the correct address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm just waiting on the system. I'm sorry.
[AGENT][NEUTRAL] So I have Gastro Health LLC [PII] in [PII].
[CUSTOMER][NEUTRAL] Yes. It's [PII] and the last uh zip code is [PII].
[AGENT][NEUTRAL] OK, so what I'll do is I'll write this up and I'll send it over and once I get the information back to me, can I give you a call back at [PII]?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So I'll write this up and send it over.
[CUSTOMER][NEUTRAL] And um has uh
[CUSTOMER][NEGATIVE] Yeah, as the previous rep said, uh, it was received on [PII] and denied on the same day.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] As maximum benefits for the calendar year has been met.
[AGENT][POSITIVE] Correct. So I'll send this over to see why it was processed the way it was processed and give you a call back.
[AGENT][NEGATIVE] Because they're gonna have to review to see why it was voided and why it was denied when it was reprocessed.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK. I can stay in line. Can you, uh, do it now?
[AGENT][NEUTRAL] Well, I have to send it over to that department and once that department does the research on it, I'm not sure how long it will take.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's why I said I can call you back.
[CUSTOMER][NEUTRAL] OK, OK. Until then,
[CUSTOMER][NEUTRAL] OK. And until then, can you please provide me the call reference number?
[AGENT][NEUTRAL] Yes, it will be my name which is [PII] Last initial is [PII] along with today's date.
[AGENT][NEUTRAL] And as soon as I get this.
[CUSTOMER][NEUTRAL] It's uh yeah.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Yeah. Uh I would like to verify, I would like to verify your name. It's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So I sent that over. As soon as I get it back, I will definitely give you a call back today and let you know the status on this claim.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][POSITIVE] Alright. But thank you for calling American Public Life. Have a great day.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][NEUTRAL] Bye-bye.