AccountId: 011433970860
ContactId: 3686ad21-e62b-4f5f-bdfd-b1d60af64848
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 831919 ms
Total Talk Time (AGENT): 193493 ms
Total Talk Time (CUSTOMER): 257192 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/3686ad21-e62b-4f5f-bdfd-b1d60af64848_20250610T17:49_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] Hi [PII], this is [PII] with the care team. I have a broker, [PII] on the line, um, in regards to policy.
[CUSTOMER][NEUTRAL] 2589.
[CUSTOMER][NEGATIVE] 809 um she didn't want to speak to me at all. She wanted someone, there's no claim that she's mentioned um she just wants to talk to someone for uh a cancer policy, the cancer claim or something like that um.
[CUSTOMER][NEUTRAL] When I asked her how I could help her, she just wanted to be sent straight to claims.
[AGENT][NEUTRAL] OK, so you don't know what she's calling in regards to?
[CUSTOMER][NEUTRAL] No, I asked for the date of service of the claim because I only see one on file for part one, and she said she just wanted information on the claim. I've already verified her as a broker, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And verified part one.
[AGENT][NEUTRAL] OK, you said her name is [PII]?
[CUSTOMER][NEUTRAL] No, that's my name. Her name is [PII].
[AGENT][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] She did ask if I worked in billing. I was like, not a day in my life.
[AGENT][NEUTRAL] OK, OK, you can send it to, to me.
[CUSTOMER][NEUTRAL] All right, and, and what is your name, [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright, I'll I'll uh introduce you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright [PII], I have [PII] from claims support and she'll be able to help you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Hi, [PII]. This is [PII]. How can I help you today?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hi, I'm with NAS and I filed a cancer claim for A Alberto Du Vernal.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And I had uploaded all of the documents to the portal and then I reached out to you guys and you guys the care team indicated they didn't go through so I did it again um and we're just wondering.
[CUSTOMER][NEUTRAL] If there's any movement on that claim.
[AGENT][NEUTRAL] OK, let me take a look.
[AGENT][NEUTRAL] OK. I do show we did receive it. I show it's in, it's currently in line for processing. I don't show that it has been processed yet. It is in line for processing. I show it was received on the [PII], [PII].
[CUSTOMER][NEUTRAL] OK, so you did get finally get the when I redid it on the [PII] and it's in line for processing?
[AGENT][NEUTRAL] Yes, I told it's a total of 15 pages that was sent.
[CUSTOMER][NEUTRAL] Yeah, it was quite a few. Um, any idea how long these cancer claims take?
[AGENT][NEUTRAL] Normal processing time is at least 7 to 10 business days for processing.
[AGENT][NEUTRAL] Um, let me look at the documents that we received here to make sure that they're all legible. Give me one moment.
[AGENT][NEUTRAL] Cause I'm glancing through, some of them looks some of the documents look dark.
[AGENT][NEUTRAL] Let's see here.
[AGENT][NEUTRAL] Some of the pages look black.
[AGENT][NEGATIVE] Not legible to read on some of the documents. It looks like we can, I can read pages 1 and 2.
[AGENT][NEUTRAL] Um, it looks like the pages where it is.
[AGENT][NEUTRAL] Looks like a baseside ambulatory center. Those documents look, they're not legible. They're dark.
[CUSTOMER][NEUTRAL] OK, hold on, let me, let me pull the documents with you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now I just went on the OSC because we were told that if we file the documents we can't see the EOB but we can see the claim that we filed.
[CUSTOMER][NEUTRAL] And it's not showing, is that because of the new OSC?
[AGENT][NEUTRAL] On the actual document, you're not able to access the actual document?
[CUSTOMER][NEUTRAL] Do you know?
[CUSTOMER][NEGATIVE] I don't see anything that's why I was concerned because when I go on the portal, I don't see any of the documents I uploaded for him.
[AGENT][NEUTRAL] OK, let me check on that for you. I'm gonna put you on a brief hold. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding, [PII]. I'll have to check a little further into that and research that for you and get back with you regarding that if you're able to fully access that same information.
[CUSTOMER][NEUTRAL] OK. Um, can you go through the documents with me so I can make sure you have what you need?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so I labeled one document number one and it, it's um it's actually in Spanish, but it says Bayside Ambulatory Center, um 512 surgery.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Total bill was 18093 and then 668. Do you see that one?
[AGENT][NEUTRAL] Let me take a look.
[CUSTOMER][NEGATIVE] It was like a short pain.
[AGENT][NEUTRAL] The only page that I'm seeing that is what it looks like it says Bayside Ambulatory Center. It looks like there's uh an amount for
[AGENT][NEUTRAL] Looks like a data service of [PII] for it looks like $18,0093.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, and then below that it says 668.
[AGENT][NEUTRAL] And then below it looks.
[AGENT][NEUTRAL] OK, yes, I do show we have that, that document.
[CUSTOMER][NEUTRAL] OK, so that's one down.
[CUSTOMER][NEUTRAL] That you can read. #2, the one I labeled as #2.
[AGENT][NEUTRAL] I can read it. It is actually it is dark, but I can, I can kinda enlarge the kind of cipher through, through it to see what it says, but it is dark as well.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] I don't know how we can.
[CUSTOMER][NEUTRAL] Light.
[CUSTOMER][NEUTRAL] Oh, I see. Um, but you can read it?
[AGENT][POSITIVE] Yeah, I can, I can read it.
[CUSTOMER][NEUTRAL] OK. The second one is the EOB from Cigna.
[CUSTOMER][NEUTRAL] And it's actually just page one.
[CUSTOMER][NEUTRAL] And it says um 1889736.
[AGENT][NEUTRAL] OK, maybe these documents are not in the same orders. So,
[AGENT][NEUTRAL] After, let me see if I can even find that one.
[CUSTOMER][NEGATIVE] They should have come in with the name. Yeah, it should have come in with the name I gave them.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I, I identified them at the beginning of the name of the document with number 12345, and 6.
[AGENT][NEUTRAL] OK, so that's not how I see the documents. Yeah, they definitely uh are different on my end.
[AGENT][NEUTRAL] I just see a total of 15 pages. They're not broken up by document one document, anything like that. So let me go through them and see if I see an EOB.
[CUSTOMER][NEUTRAL] Uh, is it
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Well, this one was 5, that's 6, that's 7.
[CUSTOMER][NEUTRAL] This one
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] 5678
[CUSTOMER][NEUTRAL] 89 1011 12.
[CUSTOMER][NEUTRAL] 1213, 1415. OK, yes. So why don't we do this instead, [PII]? Why don't you tell me the one you can't see?
[AGENT][NEUTRAL] OK. It looks like it's possibly might be the path pathology report. Those documents look all black.
[CUSTOMER][NEUTRAL] The one that
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, let me see what else is here.
[CUSTOMER][NEUTRAL] OK. Can I, can I email this to you in a secured email?
[CUSTOMER][NEUTRAL] So that you can compare them and make sure you got what you need.
[AGENT][NEUTRAL] Yes, you can send it to our claim support email. I can give you that email address.
[CUSTOMER][NEUTRAL] Is that the [PII]?
[CUSTOMER][NEUTRAL] Yada yada.
[AGENT][NEUTRAL] It is um the care team.
[AGENT][NEUTRAL] Is the [PII]?
[CUSTOMER][NEUTRAL] I have one that says [PII].
[CUSTOMER][NEUTRAL] And then I have another one that says [PII].
[AGENT][NEUTRAL] So it will go to the care team [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Who is head of the cancer claims? Is it [PII] or is she only gap claims?
[AGENT][NEGATIVE] She is over all claims.
[CUSTOMER][NEUTRAL] She is, OK.
[CUSTOMER][POSITIVE] Thank you very much, [PII].
[AGENT][POSITIVE] You're welcome. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, I appreciate it. You have a wonderful day, OK?
[AGENT][POSITIVE] You too, thanks for calling [PII] bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.