AccountId: 011433970860
ContactId: 427e0822-a4d6-4773-808d-b4e9f49b55a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396339 ms
Total Talk Time (AGENT): 100054 ms
Total Talk Time (CUSTOMER): 251345 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/427e0822-a4d6-4773-808d-b4e9f49b55a8_20250421T15:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, Ms. [PII]. Um, I accidentally
[CUSTOMER][NEUTRAL] Hung up on one of the little agents that was looking into my claim, um, [PII].
[AGENT][NEUTRAL] OK. Uh, do you have your policy number, [PII]?
[CUSTOMER][NEGATIVE] Uh, not right offhand.
[AGENT][NEUTRAL] Oh, OK. Uh, let's see, I can look it up by your last name. What was that?
[CUSTOMER][NEUTRAL] [PII], it's underneath my husband's name, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'm under him.
[AGENT][NEUTRAL] OK, let me get that pulled up. One moment.
[CUSTOMER][NEUTRAL] She was looking into 4 claims that y'all denied.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I had another phone call coming in and.
[AGENT][POSITIVE] You have a good callback number, Ms. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I'm sorry, what was your husband's name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I keep sending out kind of paperwork to uh y'all and they keep saying we have, you know, we don't have enough information. So I'm here at my cancer place that I do on my treatment side and stuff, and I wanna make sure that I have everything y'all need.
[CUSTOMER][NEUTRAL] Because I've never received a dime from y'all from my claims.
[AGENT][NEUTRAL] OK, let me see what we've got here.
[AGENT][NEUTRAL] OK, so it looks like you submitted some claims for, uh, looks like for October.
[AGENT][NEUTRAL] November.
[CUSTOMER][NEUTRAL] Yeah, well, the one in October they keep saying that um.
[CUSTOMER][NEUTRAL] That's the one, that's the one that I did my, uh, the scope in my throat.
[CUSTOMER][NEUTRAL] And they keep saying that which, which entry did they go through and I'm like, but it's just only one entry, you know.
[CUSTOMER][NEUTRAL] And I had sent that paperwork in and she's like, no, we need the um the codes and different things. So I don't even, because I started out in [PII], now I'm in [PII].
[CUSTOMER][NEUTRAL] The one in November is my bronkowski. That's whenever they did the biopsy of my lungs, which is there's one way to go in through my throat.
[CUSTOMER][NEUTRAL] You know, and I just don't know what more y'all want.
[CUSTOMER][NEUTRAL] And then now over here I started seeing uh my trio of doctors [PII].
[CUSTOMER][NEUTRAL] Uh, I asked you about the, the mileage. Well, we need proof that you went to [PII]. So now I'm over here, over trying to get something showing that we did come to since November, I mean, December. Since then, I did chemo. Since then, I've uh had a major operation. They took half of my lung. So I'm just tired. I mean, I don't know what else to, to give y'all.
[CUSTOMER][NEUTRAL] The lady was I'm I'm over here at Billings and she was wondering if y'all need the, the UVO4.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Or the 1500.
[AGENT][POSITIVE] Yes, we need both of those. That's, that includes everything that we.
[CUSTOMER][NEUTRAL] You need both of them.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, so that actually includes everything that we're gonna need, um, and then there shouldn't be any other issue, cause that's gonna have the procedure codes, your diagnosis codes, that actually is perfect of what we actually need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because at the beginning and I think in December we did send the um.
[CUSTOMER][NEUTRAL] The automized statements.
[CUSTOMER][NEUTRAL] You know what I'm saying? And then so I think you'll have that and then I sent in for my chemo, so you need the UB04 and the 1500 forms.
[AGENT][NEUTRAL] Yes, yeah.
[AGENT][NEUTRAL] Yeah, so the, the UBO4 is the hospital claim form and then the 1500 is the doctors, so they're part of the procedure.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] Well, I'll tell them that's what they need, that y'all need that.
[AGENT][POSITIVE] Yes, that's exactly
[AGENT][NEUTRAL] Yeah, that's exactly what we
[CUSTOMER][NEUTRAL] Because I talked to one of the ladies and she's, I said I don't just don't understand why.
[CUSTOMER][NEGATIVE] Yo, he ain't even pay me for my mileage, and she's like, oh well, we need to know and I'm like, oh my [PII], so yeah.
[AGENT][NEUTRAL] Did you fill out the actual one of our claim forms? Have you completed one of those?
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] OK, so I have the little lady here that I'm over here at [PII] [PII]. You're telling me that you need, uh, both the UBO4 and the 1500 because she said the UBO4 is the hospital. OK, so that's the 1500 also on the.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Go ahead, go ahead, you good, ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hello? OK, so you're needing the 1500 also?
[AGENT][NEUTRAL] Yes, um, we just have to have something that shows the CPT codes and then the ICD 10s of what services were rendered, so that would be perfect if we could get the actual claims, yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, but what I'm asking, we have a UBO4 and a 1500. At the first lady said UBO4. Now you're saying 1500 or both?
[AGENT][NEUTRAL] Both, um, that way we can determine what part of her policy we can pay out on.
[CUSTOMER][NEUTRAL] OK, and what date?
[AGENT][NEUTRAL] Um, any dates that she was treated for the cancer. So anything that's gonna have an ICD 10, uh, that indicates a cancer diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, and then what's gonna show when I went to the doctor for my travel? OK, OK, alright, OK, thank you so much.
[AGENT][NEUTRAL] OK. Anything else I can help with today, Ms. [PII]?
[CUSTOMER][NEGATIVE] I'm just tired. I mean, I've been doing this for 5 months and I just still never got anything. So that's when she says call them up and let them tell me, so hopefully I can get that to you.
[AGENT][POSITIVE] OK, well, I'm so sorry. OK, well, thank you. I hope you have a good day. OK, bye.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You too bye.