AccountId: 011433970860
ContactId: 2f109980-bdb3-497f-a9c3-daf15e64d442
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 438130 ms
Total Talk Time (AGENT): 206227 ms
Total Talk Time (CUSTOMER): 110743 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/2f109980-bdb3-497f-a9c3-daf15e64d442_20250305T20:51_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, my name is [PII], and uh I wanted to call and get a claim status because um.
[CUSTOMER][NEUTRAL] I got a um what you call it? I got a text message today saying.
[CUSTOMER][NEUTRAL] Your claim and or additional information has been received.
[CUSTOMER][NEUTRAL] And, um, I actually found it like and I actually found it like last, uh, April last year in April.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, Mr. [PII], so you're wanting to check claim status on a claim for yourself that you've received notification about, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, sir, I can help you with that. And Mr. [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 7343.
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] Oh, my policy number, um.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Is it the same as a claim number or certificate number or is it different?
[AGENT][NEUTRAL] Uh, it would not be the same as the claim number, policy certificate number.
[AGENT][NEUTRAL] Start with a 0 or it may just be a number, but it's not the claim number.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh, you said it start with a 0. I have one here that's
[CUSTOMER][NEUTRAL] 016.
[CUSTOMER][NEUTRAL] 27,230.
[AGENT][NEUTRAL] OK, thank you. So give me a moment please, Mr. [PII], to get your information pulled up.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Mm, OK, so maybe I misheard you. 01627230.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. What is your so that's pulling up another policy holder.
[CUSTOMER][NEUTRAL] Um, I have here, let me see.
[AGENT][NEUTRAL] That does not pull out, that's not your information.
[CUSTOMER][NEUTRAL] OK, I see one, well, it starts with one, but um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 153.
[CUSTOMER][NEUTRAL] 9661.
[AGENT][NEUTRAL] OK, thank you. Let me try that one, just one moment.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so that's the number that I needed. So give me just a moment, Mr. [PII], to get all of your information pulled up, please.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, Mr. [PII]. So first off, I will need to verify several things with you for security purposes and also any information that I do provide would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then also your home mailing address, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that we have on file for you is the same as the one you gave me. So that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you and lastly your email address please, Mr. [PII].
[CUSTOMER][NEUTRAL] [PII], the letter [PII]
[AGENT][POSITIVE] Oh, OK. Thank you very much for verifying everything with me. OK, so just a moment.
[AGENT][NEUTRAL] OK, so yes, sir. I see that we have received a claim for you that it has not yet been reviewed, but it is, we did receive a claim um that is in line for review. It was just received on the [PII].
[AGENT][NEUTRAL] Of [PII]. And if you'll give me a moment, I can pull the claim up.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Sometimes we will receive claims, Mr. [PII], for services, you know, in the past, we do not have a timely filing limit for our claims. So this looks like this has been filed by a provider, but give me just a moment to load the documents so I can tell you who it was received from.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But because you're, you are set up on the online service center.
[AGENT][NEUTRAL] When we receive a claim like that, you will receive that because you did opt in for the text notification alerts and then you should also receive another one as well once it has been reviewed.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's still loading the information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh right.
[CUSTOMER][NEUTRAL] Well, since we're waiting, I was wondering, uh, on the [PII], I mean, I didn't send anything in. I mean I sent everything in, you know, last year around April and May.
[AGENT][NEUTRAL] So yes, so this was received from a provider.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Then this was for a data service actually it was for January.
[AGENT][NEUTRAL] 13 of this year.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Jackson Heart Clinic is the billing provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you have an appointment in January?
[CUSTOMER][POSITIVE] Oh, that, yeah, yeah, yeah, at the heart, yeah, yeah.
[AGENT][NEUTRAL] Yes, sir. So that said that we have received a claim from them. So that's what that is.
[AGENT][NEUTRAL] But again, it hasn't been reviewed. We just received it.
[CUSTOMER][NEUTRAL] Oh, OK, OK, I was wondering what it was for.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, so, so, so do I need to do anything or no?
[AGENT][NEUTRAL] No, sir, you don't. That was just notifying you, letting you know that we have received a claim for you and it's in processing.
[CUSTOMER][NEUTRAL] Oh, OK, alright.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, well, I guess that's it. That's that.
[AGENT][NEUTRAL] OK. Well, is there anything else that I could help you with um this afternoon?
[CUSTOMER][POSITIVE] Well, that'll be it. Thank you.
[AGENT][POSITIVE] OK, Mr. [PII], well, you're certainly very welcome and thank you again for calling APO. I hope you have a very nice evening.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] Yes, sir. Thank you very much.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Alright bye.