AccountId: 011433970860
ContactId: 241a687b-8f40-4851-acbd-c5f3a6a24ac9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 266269 ms
Total Talk Time (AGENT): 146464 ms
Total Talk Time (CUSTOMER): 82821 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/241a687b-8f40-4851-acbd-c5f3a6a24ac9_20250210T22:01_UTC.wav
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[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Hi [PII], good afternoon. How are you today?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEGATIVE] I'm good thanks so I'm confused. I called you all earlier to check on the claim because I was on the road and I finally got a chance to log in, but now that claim is missing off of my portal.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Oh, OK, yeah, that is odd. Let's take a look, just make sure that's all good. um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], last name [PII].
[AGENT][POSITIVE] OK, and then [PII], can I get a good call back number from you really quick in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] 258-675-2
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][POSITIVE] Thank you. Thank you.
[AGENT][NEUTRAL] Alright, I'm just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. The last thing I need is the email address that we've got on file for you. uh, looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] Alright appreciate you verifying all of that so let's see I have a couple of claims here. I do see one looks like it just finished processing today um I'm not quite sure when you checked on it earlier, uh, was it processing still?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well there were 2 claims in there because y'all needed some information from me and I sent that on another claim and now that one's missing so is it all going back on the first one?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I'm showing that I, I am showing two separate pieces of claim information, um, and this is just the latest one. OK, let's see.
[CUSTOMER][NEUTRAL] Oh, see, I don't see you.
[CUSTOMER][NEUTRAL] I see one of one that's it.
[CUSTOMER][NEUTRAL] So can you tell me about the claim that process today please that way that's probably the one I need to know about.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, let me go ahead and check. I'm gonna check both just for good measure. Give me just a moment.
[AGENT][NEUTRAL] OK, so for the original claim, um, we're just missing the diagnosis codes and that is the information that you sent with this other claim, is that correct?
[CUSTOMER][POSITIVE] Correct, yes ma'am.
[AGENT][NEUTRAL] Gotcha. OK, OK. If you don't mind.
[CUSTOMER][POSITIVE] True story. That's what I was told to do.
[AGENT][NEUTRAL] Yes, yes, that is exactly what it's saying um, [PII], if you don't mind, I'm gonna put you on a brief hold and reach out to our claims specialist. I'll get right back with you OK?
[CUSTOMER][POSITIVE] Yes ma'am appreciate you.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] over on the care team. How are you today?
[CUSTOMER][POSITIVE] I'm good how are you today?
[AGENT][NEUTRAL] Doing all right, thank you. I've got an insured on the line, uh, calling regarding a claim that he filed for his meddling. Um, looks like he had filed before and it stated we were missing the diagnosis code. He said he sent that to us.
[AGENT][NEUTRAL] I do see that it completed processing today um and it just says EOB don't miscellaneous correspondence from insured and or provider um that is showing is denied and he is saying that that was the diagnosis codes so wondering if you could take a look and just make sure that's all good to go.
[CUSTOMER][NEUTRAL] OK, what's that policy number?
[AGENT][NEUTRAL] It is 258-6752.
[CUSTOMER][NEUTRAL] OK, I have that as 258-6752.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, [PII]. OK, this is for him. Alright, give me one second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, he's just got the two claims too so.
[CUSTOMER][NEUTRAL] OK, alright, so he's calling in regards to both claims or just one claim?
[AGENT][NEUTRAL] Well, the, the last claim that we received was supposed to be that missing information, um, so the first claim was stating that we were missing the diagnosis codes. He said that was what was sent. um I've just never seen this message before and I don't know if that's just because it's was just processed today or what's going on?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK alright thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, I'm ready for him thank you.
[AGENT][POSITIVE] Do you wanna, oh OK all right thank you bye bye.
[CUSTOMER][NEUTRAL] OK