AccountId: 011433970860
ContactId: 30c9236a-7293-45cc-9ca3-890b0954393c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 704010 ms
Total Talk Time (AGENT): 207620 ms
Total Talk Time (CUSTOMER): 259565 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/30c9236a-7293-45cc-9ca3-890b0954393c_20250613T14:05_UTC.wav
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[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name's [PII]. I'm calling from Carolina Center for Eatonics, and I spoke with someone just a little bit ago in reference to a claim for a patient that was denied because of term of coverage, and they were going to fax it over to me and I just wanna make sure that that's happening and.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because I haven't received it yet.
[AGENT][NEUTRAL] OK. What's that policy number?
[CUSTOMER][NEUTRAL] 01628999.
[AGENT][NEUTRAL] OK, and let's see.
[CUSTOMER][POSITIVE] Alright, I will get that over to you right now.
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is, sorry, [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me see what's going on.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] She told me that
[AGENT][NEUTRAL] Um for claim for data service 43 and 423.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] It's actually 42 and 4:23.
[AGENT][NEUTRAL] 421 423.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And give me one moment, look at this claim, make sure and
[AGENT][NEUTRAL] And do you have a callback number in case you call up?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] I'm sorry, I just mind blanked there [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] It happens. It's a Friday.
[CUSTOMER][NEUTRAL] I, I always wanna give my [PII] number because that's where I came from. No, you're good, you're fine. I'm sorry. Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Funny, were they supposed to send you the EOB?
[CUSTOMER][NEUTRAL] Yeah, they were gonna send me a copy of the EOBs because she said they were denied they were sent to us on [PII] because coverage was terminated on [PII]. The weird thing is that I do have in in this patient's chart that um benefits were checked on [PII] and it showed like they had active coverage so.
[CUSTOMER][NEUTRAL] I'm not sure if this is like a retro or.
[AGENT][NEUTRAL] Um, and.
[AGENT][NEUTRAL] I'm sorry, my brain just went complete.
[CUSTOMER][POSITIVE] Hey, I'm with you. I get it.
[CUSTOMER][POSITIVE] I appreciate you, you're good.
[AGENT][NEUTRAL] It might have shown that there was no term date when the person probably calls, so we technically cannot say the policy is term until it shows in our system, so it probably showed that it was active at the time. But um what's your fax number? I don't know if they sent it or not, but I can definitely send this to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, please thank you it's [PII].
[AGENT][NEUTRAL] [PII]. OK, [PII].
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK. Yes, ma'am. I will send these over to you in a few moments. Um, if you do not receive it, just give a call back or I can do it while I'm on the phone with you so you can make sure you receive it.
[CUSTOMER][NEUTRAL] Alright
[AGENT][NEUTRAL] Let's see
[CUSTOMER][POSITIVE] That would be awesome if you wouldn't mind. I appreciate you.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] I just, I called the patient and spoke to her and she said she was waiting for a call back from you.
[CUSTOMER][NEUTRAL] Because she didn't know why her coverage was terminated, but
[AGENT][NEUTRAL] She may have to contact you to BA her employer.
[CUSTOMER][NEUTRAL] Uh, yeah.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, I, I don't know if you're fine. She asked me what the balance was and to send her a bill so she must know something and it's just playing.
[CUSTOMER][NEUTRAL] You know how that goes.
[AGENT][NEUTRAL] Uh yeah. You don't wanna, yeah, I get it.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] You, yeah, exactly, exactly. So you're fine. No, no problem.
[AGENT][NEUTRAL] I stall a little bit, yeah.
[CUSTOMER][NEUTRAL] Yep, yep.
[AGENT][NEUTRAL] And I, and I completely get it though, but.
[CUSTOMER][POSITIVE] Yeah. 0, 100%. I mean, it's $1000 so I get it, yeah, exactly.
[AGENT][NEUTRAL] Uh yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Or I just hope maybe they can.
[CUSTOMER][NEUTRAL] I get it, but I don't if that makes any sense.
[AGENT][NEUTRAL] Yeah, I get it.
[AGENT][NEUTRAL] It's just being human.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, give me a moment. My computer just knows it's Friday.
[AGENT][NEUTRAL] Oh, there you are.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] And the one for the uh 423, what was that total charge just to make sure I'm gonna send the correct one.
[CUSTOMER][NEUTRAL] Sure, give me one second, um, $1620.
[CUSTOMER][NEUTRAL] So 423 was 1620 and 42 was 280.
[AGENT][POSITIVE] OK, thank you. Just wanna make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me get this one out.
[AGENT][NEUTRAL] Let's see 910573405.
[AGENT][NEUTRAL] She uh
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, one more thing. I'm sorry it's taking a while. Thank you so much for being patient with me.
[CUSTOMER][POSITIVE] You're good. I appreciate your help and you doing this, so thank you.
[AGENT][NEUTRAL] OK, I've just sent it, so give it a few moments.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'm sitting right next to the fax machine, so I'm kind of staring at it, my co-workers laughing at me.
[AGENT][POSITIVE] Blessed.
[CUSTOMER][NEUTRAL] Did it come through.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, it didn't come through yet.
[AGENT][NEUTRAL] Oh, is still not? Oh.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] It's going slow thinking about it.
[AGENT][NEUTRAL] But I just sent it.
[CUSTOMER][POSITIVE] Yeah, exactly.
[AGENT][NEUTRAL] Let's see. If it doesn't come through fax, then we'll try another way.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I haven't received confirmation yet, so it's probably still thinking about it.
[CUSTOMER][NEUTRAL] Yeah, cause I never, we never got the initial denial that you guys sent back in April, so that's why we're calling on it, so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh no, I understand.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Me too.
[CUSTOMER][NEGATIVE] Our server keeps going off and every time it goes off, we think it's the printer and we're like, oh no, it's just the server like.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] It doesn't seem to be coming through yet. Do you wanna send it by email?
[AGENT][NEUTRAL] I can. Uh, what's the email address? I can, yes, ma'am.
[CUSTOMER][NEUTRAL] Or can you?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, give me one second. I just wanna make sure that I give you which email do you want me to have her send it to?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it [PII] yeah [PII].
[CUSTOMER][NEUTRAL] For the number endo.
[CUSTOMER][NEUTRAL] Dot com.
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] And watch soon as I send it, it's gonna like, oh, we got it.
[CUSTOMER][POSITIVE] Oh here we go, yeah, that's how it always works, but you know.
[CUSTOMER][NEUTRAL] I think it might have just came through on the fax.
[AGENT][NEUTRAL] Yeah,
[AGENT][POSITIVE] Too much fun. Just let me know cause um I'm just giving a half a minute and I have to do one more thing.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'll probably send it anyway that way.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, I think it came through, well, part of the APL came through. One page of it did, so, I mean, I, it's coming. There's just the.
[CUSTOMER][NEUTRAL] You know, so
[AGENT][NEUTRAL] Uh, does it show from Kiki, Kikiki?
[CUSTOMER][NEUTRAL] It's starting.
[AGENT][NEUTRAL] Or care team.
[AGENT][NEUTRAL] Like on the cover sheet, probably can't, well, I don't know if it goes from the bottom to the cover sheet or.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It just says from APL care team.
[AGENT][NEUTRAL] OK, good. That's probably me.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, so 12 pages of it, the cover letter and that one, so yeah, it's, it's coming, it'll come through, so I appreciate you.
[AGENT][POSITIVE] OK, good deal.
[AGENT][POSITIVE] Uh, you're welcome. Uh, thank you so much for calling APL. Have a great day.
[CUSTOMER][POSITIVE] All right. Thank you.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] You too bye bye.