AccountId: 011433970860
ContactId: 2f4c7cbf-8633-4b7a-be8f-c2e1e7ba026c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 905570 ms
Total Talk Time (AGENT): 298934 ms
Total Talk Time (CUSTOMER): 315609 ms
Interruptions: 4
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/2f4c7cbf-8633-4b7a-be8f-c2e1e7ba026c_20250313T18:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] What did you say your name is [PII]?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, hi, my name is [PII]. I have had an APL, um.
[CUSTOMER][POSITIVE] Policy for years with y'all and I'm just calling to check on some things that I filed on like because I haven't heard anything back in a really long time on them and I wanna make sure they made it there uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So what do you need to look that up? Uh, what it is, I'm a cancer patient and I require blood transfusions. I'm actually transfusion dependent right now and my policy covers blood transfusions and chemotherapy drugs and I have filed on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One chemotherapy drug and um 4 blood transfusions and I haven't heard anything. The, the chemotherapy I sent him was back in January.
[AGENT][NEUTRAL] OK, alright, Ms. [PII], I can help you with your claims and we'll look at them and see if we've received them and um what the status is. Can you please give me your policy number so I can look your policy up?
[CUSTOMER][NEUTRAL] Sure, sure. It's uh.
[CUSTOMER][NEUTRAL] I guess it would be this number 707-115.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am, and then I'm also going to need for you to verify your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Uh, what did you ask for first, phone, phone number, area code, OK, area code [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII] is my cell phone. You may also have my home phone, which is, I'll give you that too if you need it, but um most people just use my cell.
[AGENT][NEUTRAL] I have your cell phone.
[CUSTOMER][NEUTRAL] Um, my home address is.
[CUSTOMER][NEUTRAL] Uh, oh, OK. My home address is [PII].
[CUSTOMER][NEUTRAL] And the email address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you very much for verifying your policy for me, Ms. [PII]. OK, looking um at your claims, I show the last claim that was submitted.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For this year for [PII] was on [PII].
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEUTRAL] And let's look at it real quick.
[CUSTOMER][NEUTRAL] Wait a minute. The, the, tell me again when the, the, are you telling me when the, because I didn't have a blood transfusion on [PII]. I had one on the [PII].
[AGENT][NEUTRAL] Well that's the day that the claim was submitted.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] That's the day that it was submitted.
[CUSTOMER][NEUTRAL] OK, all I have is when I mailed them from here. I mean, I do have that. I don't know when y'all got it, but I do know when I mailed it from here. So how do you have, can, can you answer me this if you can? Do you, do you have date of transfusions there that would help if I could know the date of the transfusion because I don't have any way of knowing.
[CUSTOMER][NEUTRAL] When I mailed it when y'all got it so.
[AGENT][NEUTRAL] Right. So I'm showing, I'm showing that you, that you filed for uh chemotherapy and the date of service is [PII].
[CUSTOMER][NEUTRAL] Do you have that information?
[AGENT][NEUTRAL] You file from uh.
[CUSTOMER][NEGATIVE] You're breaking up real bad. That was a that was a drug called Ojara.
[AGENT][NEUTRAL] I don't have the drug name. I just all I can see is the claim and how it was processed.
[AGENT][NEUTRAL] I showed that it was for chemotherapy and it was from the date of service is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] OK, we're, you're breaking up bad but OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] I haven't gotten anything on that. Has that been?
[AGENT][NEUTRAL] And I also see.
[AGENT][NEUTRAL] It was processed on the [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the claim was paid 10.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] The claim was paid $10,000.
[CUSTOMER][NEUTRAL] OK. All right. So maybe I just haven't gotten anything yet.
[AGENT][NEUTRAL] And let me look at the.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Let me, um, let me pull up that check so I can give you the check number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was paid to you the $10,000 on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the issue date is also [PII], and let me give you the check number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it probably just hasn't got to you yet. It was
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, yeah, just must take a long time. I just wondered what because I sent it off in January, you know.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So, have any of the blood transfusions been processed?
[AGENT][NEUTRAL] Yes, yes, ma'am.
[AGENT][NEUTRAL] Let me check real quick.
[CUSTOMER][NEUTRAL] 1.
[CUSTOMER][NEUTRAL] I don't like to
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] One
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] You gotta be what.
[AGENT][NEUTRAL] Mm, that's OK. It's not bothering me.
[CUSTOMER][NEGATIVE] I'm having a hard time hearing.
[AGENT][POSITIVE] Oh, OK, I got you.
[AGENT][NEUTRAL] OK, so, um, you have some remarks on here. Let me, let me read the remarks to you. Uh, one was for blood, um, at Saint Francis Hospital, actually two were for blood at Saint Francis Hospital on ecology, and one was for a transfusion.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, from [PII] what the
[AGENT][NEUTRAL] Remarks are on this so.
[AGENT][NEUTRAL] The chemotherapy was paid.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] The blood, let's see what that.
[AGENT][NEUTRAL] They're asking for the blood.
[AGENT][NEUTRAL] For an itemized bill from the provider's office showing the procedure codes and charge amounts for each service rendered.
[CUSTOMER][NEGATIVE] Well, I sent, I sent itemized bills.
[CUSTOMER][NEUTRAL] With that, I mean, I, I keep a copy of everything I send y'all, but the lady in the office was, she, it's the one what y'all are wanting are the ones that have key codes on them. That's what I've been told before that and I sent a copy with all that. Everyone that I every in fact there's a lady that I found out in the office who can print that information for me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I have and I even highlighted them the P codes for y'all.
[AGENT][NEUTRAL] OK, so what I'm going to do.
[CUSTOMER][NEUTRAL] So there should there was.
[AGENT][NEUTRAL] What I'm going to do is I'm gonna have a claims examiner call you because you're stating that you sent in the information that you needed to send and that you highlighted it and everything so I'm gonna have a claims examiner call give you a call back so that you guys can go over what was received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and, and go over so that maybe that can be reprocessed, OK? So it's gonna be a, a brief hold. I'm gonna put you on hold while I fill out that request for somebody to call you back, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK. All right, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Miss [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Hi this is [PII] back with you again um I have that um request in for somebody from the claims department to give you a call back at the um phone number that you and I went over earlier, your cell phone number.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And they should be calling you back within 24 hours.
[CUSTOMER][POSITIVE] OK, thank you, [PII], I appreciate it.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] You're so very welcome, Miss [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] No, I think that's it. I was just kind of trying to find out the status on this. Like I said, I've had this policy for years and I've been blood transfusion dependent for years, so I have filed on stuff before and.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEGATIVE] I mean, I, I've always done it correctly and they sent the money. I don't understand why they're saying they need itemized statements because I look back over all my paperwork because like I said, I don't send anything to y'all that I don't make a copy of and there was an itemized statement attached to each one with the key codes highlighted.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, and I put that in the note that um you highlighted the P codes too for them so I put that in the note also for them so they know when they call you back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're so welcome. I hope you have a wonderful day today, Ms. [PII]. We thank you for calling APL. If there's anything else we can help you with, you think about later on, just pick up the phone, OK?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] I will thank you [PII]. Bye bye bye.
[AGENT][POSITIVE] OK. You're very welcome.
[AGENT][NEUTRAL] Bye-bye, Ms. [PII].
[CUSTOMER][NEUTRAL] Bye bye.