AccountId: 011433970860
ContactId: 3fb3a914-015d-47da-bc70-bddedf8979f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 518400 ms
Total Talk Time (AGENT): 291824 ms
Total Talk Time (CUSTOMER): 221335 ms
Interruptions: 7
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/3fb3a914-015d-47da-bc70-bddedf8979f5_20250214T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling to check the status of a claim that I had to resubmit.
[AGENT][NEUTRAL] Sure, I could check on a claim for you. um, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and then do you have your policy number?
[CUSTOMER][NEUTRAL] 259-736-3
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you uh it looks like it might be through an organization.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK perfect thank you for verifying that information. Alrighty, bear with me just a moment.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Apparently my policy was like still processing or something that went into effect [PII].
[AGENT][NEUTRAL] I don't
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that's what I was just looking at.
[CUSTOMER][NEUTRAL] So I had to resubmit the claim um to finish getting paid.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] OK, let's take a look here.
[AGENT][NEUTRAL] There we are, yep, I was about to say we don't have anything for that new pussy, but I did just look at the old one, so I do see we received claiming information. This was [PII]. Does that sound right to you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Take a look.
[AGENT][NEUTRAL] I've got it for Frick Hospital.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] OK perfect so yes we did pay a benefit for this claim uh we paid a benefit of $3000 and did you have a direct deposit set up?
[CUSTOMER][NEUTRAL] Yeah, so it was supposed to be for $4800 and some odd dollars, but.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because my new policy, which is for the $5000 for this year, was still processing.
[AGENT][NEUTRAL] Oh, I see what you're saying. OK, so you were supposed you were trying to apply this one to the newer policy.
[CUSTOMER][NEUTRAL] So it was supposed to go back up so I think.
[CUSTOMER][NEUTRAL] So I can get the remainder of the money that I put out.
[AGENT][NEUTRAL] I see. OK, give me just a moment, let me look because I think the biggest thing is going to be.
[AGENT][NEUTRAL] The data service which was.
[CUSTOMER][NEGATIVE] And I, they told me I didn't I talked to someone and they said I didn't have to submit it again that they had everything and then it was sent up to be relooked like to be redone so that they could pay that out but.
[AGENT][NEUTRAL] When you were [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Like I've been waiting for a long time and I put that money out not knowing that it was gonna take 2 months for the policy to be effective that was supposed to go effective [PII], so I'm kind of like in a bad position at the moment.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, that makes complete sense. OK, I'm sorry, I wanted to make sure we're on the same page, so that makes sense and frankly I'm not quite, oh you said that this one was being set up so it's possible they're still working on that because I do see.
[AGENT][NEUTRAL] A note from yesterday.
[AGENT][NEUTRAL] Did you call yesterday about it?
[CUSTOMER][NEUTRAL] I did, yes.
[AGENT][NEUTRAL] OK, OK, so I do see that note about having it reprocessed so if you would just for good measure, um, they might still be working on it right now but I'm gonna put you on a brief hold if you don't mind so I can reach out to the claims department um and just kinda see where it's at.
[CUSTOMER][POSITIVE] Yeah, that would be great.
[AGENT][NEUTRAL] OK, give me just a moment, I'll get right back with you, OK?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hello [PII], this is [PII] over on the care team. How are you?
[CUSTOMER][POSITIVE] I'm great. How about you?
[AGENT][NEUTRAL] Doing well thank you. I've got an insured on the line um kind of an odd situation I've never really encountered, um, so she filed a claim with us on her med link and she recently got a newer policy that had a higher amount, um, that would have taken effect during her effective date for this policy, um, but it went to the older one and paid a different maximum so she didn't get as much as she should have.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I do see a note from yesterday that she called to have it reprocessed and she wanted to check on that.
[CUSTOMER][NEGATIVE] Oh, OK. Well, I'll go ahead and take it. Yeah, it's gonna, it's gonna take like 55 working days to get it. Yeah, it's not gonna get.
[AGENT][NEUTRAL] That's what I figured, I figured.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, it's not gonna, it's it's not gonna happen overnight, so either you can tell her or I can tell her either way, but yeah, tell her to give it a.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh, I could tell her that's perfectly fine. Yeah, that's not a big deal. I just.
[CUSTOMER][NEUTRAL] Yeah, just tell her to give it a couple of days. Yes, ma'am, check that and say one day next week. Yeah, give it a couple of days.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got you alright I appreciate it thank you.
[CUSTOMER][POSITIVE] Well, yes, ma'am. Is that all I can help you with?
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Yes ma'am appreciate it have a great rest of your day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you too. Bye-bye.
[AGENT][NEUTRAL] Alright, bye bye.
[AGENT][NEUTRAL] OK, [PII], sorry about that wait are you still with me?
[CUSTOMER][NEUTRAL] Yes I am.
[AGENT][NEUTRAL] OK, so yeah, she did tell me that it could take a few days for that to complete, uh, reprocessing, but it is in progress. So I guess since today's Friday, um, if you wanted to call back sometime next week, I would say especially since they started it yesterday, I'd say closer to about maybe Tuesday or Wednesday next week, um, we should that should be completed by then, but I mean you can call any time you'd like next week, um, sure, go ahead.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] See, yeah, I was just checking because I didn't see anything processing and then the way that they the way that they explained it to me before was like oh yeah just call in and you know the claim's already been processed we just couldn't pay it all out because the new policy for more money wasn't effective yet and you know we'll just go ahead and pay the remainder so it's like the way they explained it to me I thought it was going to be a.
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It wasn't set up, right.
[AGENT][NEUTRAL] Oh, I see. Right, yes, sorry about the miscommunication. That's what I figured, but that's why I wanted to touch base with them, um, but yeah, it generally does can I would say maybe 3 to 5 business days typically for that reprocessed information. It could be quicker than that, but I'd say that's always gonna be a safe gas.
[CUSTOMER][NEUTRAL] Quick, you know what I mean?
[CUSTOMER][NEUTRAL] OK, and then will I be able to see it processing at any point on my portal?
[AGENT][NEUTRAL] You know I think you should um because that's how you did originally process it um well right it's in the works right now um so there's not really anything to see like on your new policy I'm not showing anything but on the old one is where I do see it so if you want to just for your records I don't know if you have this information or not but I can give you that original claim number.
[CUSTOMER][NEUTRAL] Because it
[CUSTOMER][NEGATIVE] It's not showing.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I, I do have that I guess I'm just, I'm just worried because on the original like if it's still pol if it's still trying to if it's still going under my old policy then it's saying that like my benefits were exhausted but that wasn't the case because this my new policy was effective [PII] and I didn't have the service until [PII] so uh that's just where I'm kind of like freaking out a little bit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][POSITIVE] Exactly
[AGENT][POSITIVE] No, you're fine and that's the first thing that I looked at no, no, because that is completely correct, um, and I think the hiccup was of course this newer policy actually being set up in time for that but that is where it should be, um, as this policy's effective date was [PII], so that would all be correct so don't worry about that we'll get it taken care of. I know I'm sorry it's taken a bit longer than you expected, but we'll get it for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate that thank you so much for your time today.
[AGENT][POSITIVE] Good, did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, that's all I'll just keep an eye on it.
[AGENT][POSITIVE] All right, sounds good. Well, I hope you have a great rest of your day, [PII]. Thank you. All right, bye bye.
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] You too bye bye.