AccountId: 011433970860
ContactId: 27460b40-c06d-4557-a659-ba9e4776526d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299019 ms
Total Talk Time (AGENT): 90416 ms
Total Talk Time (CUSTOMER): 121935 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/27460b40-c06d-4557-a659-ba9e4776526d_20250415T20:56_UTC.wav
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[AGENT][POSITIVE] And thank you for calling APR. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII] with Broker Resources. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good. Um, I have somebody that needs claims help. Can you help with the Medlink?
[AGENT][NEUTRAL] Sure. What's the policy number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I have the is it the same thing as the tracking number or is that different?
[AGENT][NEUTRAL] Um, I'll try it. What, what number are you showing?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 865-111786
[AGENT][NEUTRAL] OK, no, that
[CUSTOMER][NEUTRAL] Of course that's not a policy number, I guess, but I think she tried, I think she's.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, I can get one though. Do you want me, do you wanna hold really fast and I'll get it?
[AGENT][POSITIVE] Oh, no problem. You can just send her over.
[CUSTOMER][POSITIVE] OK, give me just a second, thank you.
[AGENT][POSITIVE] Sure, no problem.
[CUSTOMER][POSITIVE] I have [PII] on the claims team for you. She'll take it from here. Thank you. Have a good day. You too, bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you for calling APL. This is Easy in the claims department. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from the broker's office, and I'm calling on a claim for one of our clients. It's [PII], and the employee's name is [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. Um, do you have the social or the policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, I have her ID number. Her policy number is.
[CUSTOMER][NEUTRAL] 02477075
[CUSTOMER][NEUTRAL] She's turned in the system now. She went on Medicare, but.
[CUSTOMER][NEUTRAL] The date I'm calling about was when she had coverage.
[AGENT][NEUTRAL] OK. Yes, ma'am. And please verify her name and date of birth.
[CUSTOMER][NEUTRAL] [PII], her date of birth is [PII].
[AGENT][NEUTRAL] OK. And what's the date of service and bill charges on the claim or either the claim number?
[CUSTOMER][NEUTRAL] It's [PII], 128793.
[AGENT][NEUTRAL] OK, let's see, one moment.
[CUSTOMER][NEUTRAL] Hello
[AGENT][NEUTRAL] OK, and who's the provider?
[CUSTOMER][NEUTRAL] Uh, it's Quest Diagnostics.
[AGENT][NEUTRAL] OK. Yes, ma'am. I'm showing this claim in our system. I'm showing that it's denying because we need the diagnosis code and we also need the ELB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And the EOB from UHC.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. All right. um, did, did, um, did you guys request this from [PII]?
[AGENT][NEUTRAL] Um, yes, ma'am. She should have received an explanation of benefits with this information on there.
[CUSTOMER][NEUTRAL] OK. Can you tell me when that was mailed out to her?
[AGENT][NEUTRAL] Yes, ma'am. That was mailed out. Let's see.
[AGENT][NEUTRAL] Um, the first time it was mailed out, it was on [PII].
[AGENT][NEUTRAL] And then I'm showing that the claim was resubmitted and we still need that same information and that one was mailed out on [PII].
[CUSTOMER][NEUTRAL] OK, the first time was [PII], and the second time when it was resubmitted was [PII].
[AGENT][NEUTRAL] Yes, ma'am, [PII].
[CUSTOMER][POSITIVE] Got it. OK, perfect. OK, and you need the diagnosis codes and the EOB.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Perfect. OK, great. Alright, and may I get a reference number for my call?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. My name is Evie um it's spelled [PII] and my last initial is [PII] and today's date. Um, is there anything else I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you so much, [PII], and I hope you have a good day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling ATL. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.