AccountId: 011433970860
ContactId: 2b3a57c8-e622-4d8a-a31d-506185ad38a9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423230 ms
Total Talk Time (AGENT): 180491 ms
Total Talk Time (CUSTOMER): 120476 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/2b3a57c8-e622-4d8a-a31d-506185ad38a9_20250117T16:52_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] in [PII]. I'm a broker. How you doing?
[AGENT][POSITIVE] Hey, I'm doing wonderful, [PII], how about yourself today?
[CUSTOMER][POSITIVE] Doing great, doing great, um, would you mind if I give you, I'm just checking on the claim for one of our customers.
[AGENT][POSITIVE] Yeah, I'd love to help you with that, [PII]. I, um, do you have that policy number I can snag real quick?
[CUSTOMER][NEUTRAL] Yes, policy number is.
[CUSTOMER][NEUTRAL] 244-6222
[AGENT][POSITIVE] Perfect, and hang tight for me.
[AGENT][NEUTRAL] And do you mind if I also take a really quick callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Wonderful. Thank you, [PII]. And your um insured's first and last name and date of birth, please?
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] And date of birth is?
[CUSTOMER][NEUTRAL] Of course it just went off my screen the minute I open this, let's see.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, I appreciate that, and then hang on one second for me.
[AGENT][POSITIVE] Perfect, thanks. I'm so sorry. I just had to like get to the end of my page so I could see the listed agents and I do see you on here, so thank you.
[AGENT][NEUTRAL] Um, and we want to check on a claim, uh, do you know if a particular claim number you want to look at?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, yes, we, we already paid a bee sting on her. She also had a, a fall, um, the claim ends in 663.
[AGENT][NEUTRAL] OK, I just.
[CUSTOMER][NEUTRAL] But I'm not sure that it actually processed so I think something may be wrong with it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me take a look at that here.
[AGENT][NEUTRAL] Alright, I do show it states on it, um.
[AGENT][NEUTRAL] Receipt of your claim is acknowledged, however, in order to provide further consideration of this loss under the policy, we need supporting documentation um to evidence the accident and when it occurred. Supporting documentation may include but not limited to office notes, hospital admission and discharge summaries and or diagnostic testing results. Um, and then it does have another um remark on it that says,
[AGENT][NEUTRAL] Medical records requested.
[AGENT][NEUTRAL] Let me see if it has any additional notes on it that aren't pulling up. One second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And now, I'm not seeing any free written notes in there, but it does look like there was a request for
[AGENT][NEUTRAL] Medical records?
[CUSTOMER][NEUTRAL] Let's see, I'm taking a look here. I'm looking at what was uploaded. OK, I see an itemized bill that shows.
[CUSTOMER][NEUTRAL] X-ray of knee X-ray of lower leg.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Visit level 4. OK, so the itemized bill shows that there was an X-ray of the knee in the lower leg and the charge for the visit, uh.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So you see those, right? So there's our, our proof of our charges. Let's go look at.
[CUSTOMER][NEUTRAL] See what they're trying to say they don't have.
[CUSTOMER][NEUTRAL] I normally don't even upload these unless they're perfect. Let's go take a look.
[CUSTOMER][NEUTRAL] OK, here's an after visit summary report.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Diagnosis, pain on left calf, left knee pain.
[CUSTOMER][NEUTRAL] OK, and it shows right here there was imaging of X-rays. I wonder what they're what they're not liking on here.
[AGENT][NEUTRAL] You know, let me go ahead if you don't mind, let me get you in touch with an examiner, [PII], and see if they have any information that they are explicitly looking for to help you narrow that down. Would you mind if I put you on a quick hold and took, I got somebody on the line?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Sure, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hey, [PII]. This is [PII] with the care team. How are you doing today?
[CUSTOMER][POSITIVE] I'm doing well [PII] thank you how are you?
[AGENT][POSITIVE] Hey, I'm wonderful, thank you for asking. I've got a broker on the line who is calling for a claim status.
[AGENT][NEUTRAL] Um, his name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I have this callback number listed as [PII].
[AGENT][NEUTRAL] He is calling in regards of policy number 2446222.
[AGENT][NEUTRAL] For Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I verified him on the broker page and he was able to verify [PII]'s first last name and date of birth. He's calling particularly for claim number 3552663, and he is curious about what other, I did read the remarks, what other medical records are being asked for and needed.
[CUSTOMER][NEUTRAL] And that's the [PII] you're saying? I'm sorry.
[AGENT][NEUTRAL] Mhm. Yes, it is.
[CUSTOMER][NEUTRAL] OK, and you said you verify them on the broker side and on the patient side, correct?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, you can go ahead and put him through. I'm gonna pull up that.
[CUSTOMER][NEUTRAL] Claim information and see if I can figure out what it is we're needing.
[AGENT][POSITIVE] OK perfect and I'll introduce you Ms. [PII] when we join if that's OK.
[CUSTOMER][NEUTRAL] Certainly.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Hi [PII], are you still there with us?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Hey there. I have Ms. [PII] on the line. She's excellent. She's one of our examiners and she's gonna be taking a look at this claim and seeing if she can help you identify exactly what else is needed, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Hey, my pleasure. Thank you.
[CUSTOMER][POSITIVE] Thank you [PII] have a great day.