AccountId: 011433970860
ContactId: 2e2bea32-870a-49de-9dc0-a1e172e60a0a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 424309 ms
Total Talk Time (AGENT): 156266 ms
Total Talk Time (CUSTOMER): 184800 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/2e2bea32-870a-49de-9dc0-a1e172e60a0a_20250107T17:46_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] in the care team. I've got, uh, Mr. [PII] on the phone. His policy number is 242-715-5.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He is calling.
[CUSTOMER][NEUTRAL] Claim number 354-448-0.
[CUSTOMER][NEUTRAL] I read him the remarks on the claim and he needs further assistance.
[AGENT][POSITIVE] OK. All right. Uh, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You're welcome. Call me a brief hold while I transfer him over. Thank you.
[AGENT][NEUTRAL] Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah this is me.
[AGENT][NEUTRAL] Hi, this is [PII] in the claims department. Um, I understand you needed um some clarification on your claim that was processed on [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] One moment please while I review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the remark code states that um they're needing the claim form, the critical illness claim form completed by yourself and your physician. I am pulling up what you submitted.
[CUSTOMER][NEUTRAL] Yeah, cause, uh, on, on my, I see that, but it says something about.
[CUSTOMER][NEGATIVE] They received it, but they couldn't see it. They said send a lighter copy or something. Is that what it's saying?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] It's like, uh, we received, uh, let's see, please kind of this position.
[CUSTOMER][NEUTRAL] They include treatment received to further.
[AGENT][NEUTRAL] It says the physician portion of the claim form was not legible. Please submit a lighter copy. So, it's, it's um.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It's all dark out. Everything is dark, like I'm not sure if it was highlighted.
[AGENT][NEGATIVE] If portions of what you have was highlighted because everything that was filled out is dark. It's, it's, it's not, we, we can't see it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I don't understand cause I had the, I had the uh the doctor's office, uh,
[CUSTOMER][NEUTRAL] Send it to the maybe is that, is that the fax machine maybe?
[CUSTOMER][NEUTRAL] I sent it to uh I sent it to 8.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] It, it seems like some stuff been highlighted. I'm not sure, um, because we can see the questions that's asked, but what was filled out is dark. So I'm not, I'm not too sure, um.
[AGENT][NEUTRAL] You can ask them to re-fax it.
[AGENT][NEGATIVE] And let them know, you know, that it came out. What they filled out came out too dark.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] So now I'm, I'm at the, uh, I'm at the hospital where I had the uh.
[CUSTOMER][NEUTRAL] Where I had the, uh, stent put in and, uh, this is where I had them, uh, faxed from the last time on the first claim. But on this, on, on the last claim, I had my, my position to do it at, at my doctor's office, so I don't know what could have happened.
[AGENT][NEUTRAL] Um, are you able to ask him to resend it? I mean, who has the copy?
[CUSTOMER][NEUTRAL] Uh, the, I mean, the doctor's office must have it because I, I left, I left it with them and she sent it on out and I just, I didn't, it was, it was a fax machine, so I just.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I kept the, uh, I got another package though, from, uh, that I got through my email and just had it printed off again when I came to this hospital today. I said, I might as well take this with me just in case, but this is not my position. This is just where I had the surgery at, but the itemized stuff that you, that you said that you needed, I know I can get that here because I did that before.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so, um, that, what they sent over, we, we would need that.
[CUSTOMER][NEUTRAL] What they sent over.
[AGENT][NEUTRAL] Yeah, and so what can happen is either you can have them refax it to see if it comes back into where we can see it, or you can get those copies from them and you can upload it to your portal yourself.
[CUSTOMER][NEUTRAL] Uh right.
[CUSTOMER][NEUTRAL] Uh, you said I could upload it?
[AGENT][NEUTRAL] Yeah, um, if you will go on to [PII], use it if you haven't registered already, use the email address that um we have for you, create an online account and then you're able to upload those documents to your portal.
[CUSTOMER][NEUTRAL] OK, that, that's what that means. file claims using the online service center for faster payments, claim status updates, alright.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, I'll do that. I, I, I, I'll send it in one more time, see.
[CUSTOMER][NEUTRAL] If we can make it work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, Mr. [PII], is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] That's it. That's it. I was just at the hospital. I didn't want to go and get the, get it, send the stuff off and didn't need. So, so do I still need to get an itemized thing saying what days I was in the hospital from [PII] or whatever that was.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So I need to get that at this hospital that's not gonna be in my physician's office, right?
[AGENT][NEUTRAL] Um, the itemized billing for your hospital stay will be at the hospital where you stay, so you will get that from the billing department.
[CUSTOMER][NEUTRAL] So, so do I have them email that to you now?
[AGENT][NEUTRAL] You can have them fax that over as well.
[CUSTOMER][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I'm gonna uh
[AGENT][NEUTRAL] But I mean you, but I will also ask them to send, give you a copy as well that way you can upload it to the online service center if there's an issue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's what I'll do. Thank you.
[AGENT][POSITIVE] You're so welcome. Thank you so much for calling APL. You have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye.