AccountId: 011433970860
ContactId: 3f3420e8-4991-4db7-be2c-c6a44861feb2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 587260 ms
Total Talk Time (AGENT): 177330 ms
Total Talk Time (CUSTOMER): 267735 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/3f3420e8-4991-4db7-be2c-c6a44861feb2_20250226T21:30_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII]. I just got a letter in the mail, um, referring to one of my one of my son's claims.
[CUSTOMER][NEUTRAL] The letter is requesting records, I guess they've requested them numerous times from the facility.
[CUSTOMER][NEUTRAL] Um, can I, I don't know, and I can't remember her name, but she's in the claims, she's, I guess an adjuster. I can submit. I mean, I can go to the hospital and pick them up myself. I don't know if that's gonna be if they're gonna accept them, um, but apparently the letter said they have one more attempt.
[CUSTOMER][NEUTRAL] And after that, I guess it's considered like low, I guess.
[CUSTOMER][NEUTRAL] Or they'll have to tip to contact the provider. Could I speak to someone in the claims department about this?
[AGENT][NEUTRAL] Yeah, do you mind, um, do you have that claim number available or policy number?
[CUSTOMER][NEUTRAL] It doesn't on the letter it doesn't have the claim, but it does have the policy number.
[AGENT][NEUTRAL] Alright, what's that number please ma'am?
[CUSTOMER][NEUTRAL] 740,240.
[AGENT][NEUTRAL] All right, Ms. [PII], do you mind verifying your date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] Alright, thank you. What is a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And then do you mind verifying your date of birth?
[AGENT][NEUTRAL] I'm sorry, your current mailing address? I apologize.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Is this for?
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][POSITIVE] Let me just get everything pulled up and let's see what's going on for you.
[AGENT][NEUTRAL] Bear with me just one second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm waiting for [PII].
[CUSTOMER][NEUTRAL] [PII]. They said the gates were locked on that side.
[CUSTOMER][NEUTRAL] He's at after school.
[CUSTOMER][NEUTRAL] Bill?
[AGENT][NEUTRAL] Yeah, it looks like they did request some medical records.
[CUSTOMER][NEUTRAL] You want
[CUSTOMER][NEGATIVE] You have his location? Mm mm I mean it's here but he won't answer. I don't think he's got service.
[CUSTOMER][NEUTRAL] He's here cause he, he's, I told him I was here already.
[CUSTOMER][NEUTRAL] I'm sorry, I'm trying to get my son from school.
[AGENT][NEUTRAL] No, you're fine. Go ahead. I'm taking just a minute to look at this.
[CUSTOMER][NEUTRAL] OK, apparently they can't find them. Can you hold on one second?
[AGENT][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] OK, ma'am, I'm sorry I had to locate my kid.
[AGENT][NEUTRAL] You're fine. I hope you found him.
[CUSTOMER][NEUTRAL] Yeah, he's here at school, but the gates, the guy, a guy told me the gates were locked, so I came to the very front entrance and now they're, I guess they unlocked the gates for the kids, so I'm like going back and forth.
[AGENT][POSITIVE] Oh my goodness. No, you're fine.
[CUSTOMER][NEUTRAL] And ever since like with all these school shootings, they have these gates, I'm talking like down top security.
[AGENT][POSITIVE] That is good though, isn't it? That gives you a good feeling.
[CUSTOMER][MIXED] Yes. It is good, it is. It's a very good feeling, but it's like, oh, they got unlock gates, lock gates.
[AGENT][NEGATIVE] It's so sad.
[AGENT][NEUTRAL] Let's see, I think this may be that let's see.
[CUSTOMER][NEGATIVE] My only question is if they're gonna accept me going to, I mean, I can get the records say tomorrow. I get them faster than than you guys will because I can go to the hospital and, and get them. I just don't know if they're gonna accept them being they're coming from me and not the facility. So that's my question. I don't wanna waste my time because it's 30 minutes away to go get them and then they're gonna tell me, no, we need them from the facility because then I took an hour out of my time to go grab them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Absolutely. No, as long as they're from the facility, I mean, the, the records are from the facility, you can submit those.
[AGENT][POSITIVE] That's not a problem.
[CUSTOMER][NEUTRAL] I can
[AGENT][NEUTRAL] Mhm, you can just upload them on the policy from the portal.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As long as the facility will give it to.
[CUSTOMER][NEUTRAL] OK, cause you know it is a 30 minute, 30 minute there and 30 minute back and I didn't wanna go and then they're gonna tell me, well, no, we can't accept them from you. You gotta send them back. We have to get them from the facility itself. I just, I just wanna verify that before I make the drive to go grab them.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, let me just check with the claims department, but I don't think it'll be a problem, but let me hang on just a second, thank you.
[CUSTOMER][NEUTRAL] Yeah, I'm gonna get back to me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], it's [PII]. I have Ms. [PII], um, policy number 740,240.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She's calling i[PII] regarding to the claim for [PII], participant 5.
[AGENT][NEUTRAL] And she is stating, it looks like on claim number 3535266 we requested.
[AGENT][NEUTRAL] Medical records.
[AGENT][NEUTRAL] And she's stating that she can go and pick those up and wants to make sure that it would be acceptable if she goes and picks them up and submits them online.
[CUSTOMER][NEUTRAL] OK, I mean, yeah, they can always send in medical records for us to review, um.
[AGENT][NEUTRAL] That's fine. I told her that. She said, well, I just wanna make sure cause it's over 30 minutes one way, you know. And so I said, OK, hang on.
[CUSTOMER][NEUTRAL] Yeah, I mean
[CUSTOMER][NEUTRAL] Yeah, I mean, I mean as long as I mean we we'll still review it if we need any additional information I mean they, I mean I'm not saying it's like a guarantee whatever she's gonna send in is going to be gonna process the claim, but I mean we will always review whatever they send in yeah.
[AGENT][NEUTRAL] And get
[AGENT][NEUTRAL] Yeah, that's what, uh, do you mind just telling her that so she will be feel comfortable with it?
[CUSTOMER][NEUTRAL] Uh sure. She has to speak to a supervisor?
[AGENT][NEUTRAL] You know
[AGENT][NEUTRAL] Not a supervisor, but she wants to make sure and you know, sometimes being told the same thing from someone else.
[AGENT][NEUTRAL] It's just, but I mean, if you don't want to tell her that, I can go back to her and tell her because I've already told her that we would accept it.
[CUSTOMER][NEUTRAL] OK, I mean, yeah, if you, if you need me to tell her again then that's fine.
[AGENT][POSITIVE] Alright, if you don't mind, hang on just a second. Thank you, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Miss [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you for your patience. I do have [PII]. She is in our claims department. I did ask her and she stated that she can, that we can receive medical records submitted by the insured, but she will be happy to tell you that as well if needed.
[CUSTOMER][POSITIVE] Oh yes, thank you.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Here's [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yes, Mrs. [PII]. Thanks for holding. Uh how can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], I got a letter in the mail today and I apparently I guess AdventHealth is not cooperating with getting you guys the records for [PII]'s claims that I submitted back in November. Um, I was telling the, the lady on the phone, I can go pick them up at the hospital. Um, it's faster if I request them because we get them right then and there from them.
[CUSTOMER][NEUTRAL] But I don't know if the hospital's 30 minutes away from me, so I don't know if you guys, I didn't wanna go make a trip and then you guys not accept them because they're coming from me. Um, so I wanted to verify that if you guys will accept them for me coming from the hospital, I don't mind picking them up.
[CUSTOMER][NEUTRAL] Oh yes ma'am. Uh, so yes, whatever documentation you send us we will review as a part of your claim, um, and so it once the adjuster reviews them, I mean if there's any additional information that they need then they will probably should be sure to reach out to you or the provider but yes, we will accept and review any documentation that that you send for your claim.
[CUSTOMER][NEUTRAL] OK, because I did submit the medical records for me. If I'm correct, I believe I did, and they came.