AccountId: 011433970860
ContactId: 2bf9937b-89e0-4038-9274-a1da7e167ce1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270260 ms
Total Talk Time (AGENT): 89284 ms
Total Talk Time (CUSTOMER): 108469 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/2bf9937b-89e0-4038-9274-a1da7e167ce1_20250530T17:00_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for Yale. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Uh yes, I called this morning about a claim that was denied because it needed additional information and I sent that additional information in and I just got a text saying that um that information had been received and then I immediately got another one saying that it had been processed but I don't see anything different.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and it won't let me open the, the paperwork on it to show the reason or whatever.
[AGENT][NEUTRAL] OK, what is your name and the policy number, please?
[CUSTOMER][NEUTRAL] It's [PII] and the policy number.
[CUSTOMER][NEUTRAL] Trying to get out.
[CUSTOMER][NEUTRAL] Is 2010635.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and verify your date of birth and mailing address please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the mailing address is [PII].
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And a good callback number [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well.
[AGENT][NEUTRAL] I show claims have been received today for you and your husband.
[AGENT][NEGATIVE] So they haven't been processed well today for your husband.
[AGENT][NEUTRAL] But I do show the claims for yourself received on the [PII], but they hadn't been processed yet.
[CUSTOMER][NEUTRAL] Right, this is when I send in on the [PII].
[CUSTOMER][NEUTRAL] For a hospital admission.
[CUSTOMER][NEUTRAL] And it was processed but they needed additional information and I sent that and then I just got a text saying that it is complete again a second time.
[AGENT][NEUTRAL] OK, does it have a claim number?
[CUSTOMER][NEUTRAL] It says 3606892 and 3606899.
[CUSTOMER][NEUTRAL] Says your claim is now complete.
[AGENT][NEUTRAL] Yes, ma'am. That was for your husband's claims.
[AGENT][NEUTRAL] And you process on the [PII].
[AGENT][NEUTRAL] Uh, moment.
[AGENT][NEGATIVE] Looks like one was for a wellness visit, which is not covered on the policy.
[AGENT][NEUTRAL] And the other.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] They are needing the diagnosis code or additional information showing the diagnosis codes.
[CUSTOMER][NEUTRAL] And that's what I sent in today and then I just got that um text after doing that saying that it was complete.
[AGENT][NEUTRAL] Well, not for the claim that you submitted, but for the previous claims because those two claim numbers were processed on the [PII] yesterday, so you should be able to view the EOB today, probably later today.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, alright, so it's gotta go so that text is where the old where it was denied because they needed additional information.
[AGENT][NEUTRAL] Correct, yes ma'am, and it looks like you submitted that on the uh today and so that's in line for processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, all right, thank you.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Bye.