AccountId: 011433970860
ContactId: 2167aab8-472f-4d89-9b04-b7db1a12acda
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 347760 ms
Total Talk Time (AGENT): 140785 ms
Total Talk Time (CUSTOMER): 144611 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/2167aab8-472f-4d89-9b04-b7db1a12acda_20250123T19:07_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I am calling uh regarding my mother's um records. We are trying to file a claim for her. She passed on [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh we're trying to file her claim for her for all the hospital bills um can we scan these records and email them to you or do you need originals? How do we send this to you?
[AGENT][NEUTRAL] OK, so our email, uh, we prefer claim information not be sent via email due to um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's not secured and you have personal health information in the claim information, and we want to protect your information. Now, you can actually fax the copies directly to our claims department.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, and what is that number?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] It's 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am, and that comes straight to our claims department.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah we got all that other stuff and can we just send the bills? OK, um, now can you tell me there was something, um, that you guys were waiting for from us, uh, because we had actually already filed a claim for this, but y'all send us something saying you needed something.
[AGENT][POSITIVE] OK. I'll be happy to check that for you. Do you have your mom's policy number?
[CUSTOMER][NEUTRAL] With
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do. It's 00779036.
[AGENT][NEUTRAL] All right, Miss [PII], and what was your mom's name and date of birth?
[CUSTOMER][NEUTRAL] Her name is [PII]. [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Give me just one second and let me check and see what's going on for you and Miss [PII], what is your callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the current mailing address on the policy?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] I'm just getting everything pulled up. Let me take a look for you real quick.
[AGENT][NEUTRAL] Just checking, hang on just a second.
[AGENT][NEUTRAL] And you said that
[AGENT][NEUTRAL] On a claim processed and paid there was additional information requested.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Was it paid?
[CUSTOMER][NEUTRAL] Huh? I, I think it was, I think we submitted it, but I don't know that it's been paid yet.
[AGENT][NEUTRAL] Let me check this claim. There was a claim that was processed and paid on [PII].
[AGENT][NEUTRAL] 20. That's right.
[CUSTOMER][NEUTRAL] Yeah, $900. Yes, we did, we did get that one but I think we submitted one after that.
[AGENT][NEUTRAL] OK. That's the latest claim I have for her.
[CUSTOMER][NEUTRAL] Oh, actually, no, I'm wrong. It, it was that one, but we were told that they needed more to finish processing places and all that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so what they're requesting is the hospital admission and discharge summary.
[AGENT][NEUTRAL] And that was from [PII].
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And then the itemized bill for the ambulance trip on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so what we do have is the explanation of benefits from the insurance that has everything itemized with the billing codes. Would that do or does it we need need to get this from the hospital?
[AGENT][NEUTRAL] Does it have the hospital admission and discharge information?
[CUSTOMER][POSITIVE] I believe it yes it does.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can you can submit that and let them review it.
[AGENT][NEUTRAL] And see if that will suffice and if not they'll just send you know send another letter with the information needed.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. Do we have to fill out all the forms and stuff again, or? Um, do we need for forms we need to fill out or can we just send the information that we have received in the mail from?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Just the information if we have the claim form on file, it's not necessary to do another claim form.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, great. OK, well we'll get this faxed to the claims department then.
[AGENT][POSITIVE] Yes, ma'am. And anything else I can assist you with today?
[CUSTOMER][NEUTRAL] I think that's it for now. Dad, did you have any more questions? That's it, that's it for now.
[AGENT][POSITIVE] All right, well, be sure to call us if we can be of further assistance for you, OK?
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] And thank you for calling APL I hope y'all have a wonderful afternoon.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mm bye bye.