AccountId: 011433970860
ContactId: 44f18d2c-2929-4eee-82dd-0b08e410bb24
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 390570 ms
Total Talk Time (AGENT): 160237 ms
Total Talk Time (CUSTOMER): 197181 ms
Interruptions: 4
Overall Sentiment: AGENT=1.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/44f18d2c-2929-4eee-82dd-0b08e410bb24_20250421T22:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling the APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] [PII], this is, uh, [PII] and I went online and, uh, established the dashboard and everything, and I believe I submitted a claim. Can you double check for me? I couldn't pull up. I couldn't see it just, I, I submitted it and it didn't, I couldn't see that I submitted it, and although it did say later on submitted, but I didn't see what I submitted. Norly when you submit something you can see what it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Did you get a claim for me? Can I give you the information you need?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir. I can check. Absolutely. um, Mr. [PII], can you first give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah [PII] it's [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your policy number, sir?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] It is confusing. Yeah, I'm glad you asked me that. On the certificate schedule I have the policy number, uh, is different from what the last lady I talked to. She said my certificate number was my policy number. She said it was 2532534.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] 253-253-4. OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Yeah, I have a 0 in front.
[CUSTOMER][NEUTRAL] Yeah 02532534.
[CUSTOMER][NEUTRAL] Apparently the 0 is not important.
[AGENT][POSITIVE] OK, thank
[AGENT][NEUTRAL] Yes, sir. I do have, um, your policy pulled up now. It's your cancer policy.
[AGENT][POSITIVE] I, and I was able to pull it up.
[CUSTOMER][NEUTRAL] Correct, and that was the right policy number?
[AGENT][POSITIVE] Yes, sir. That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK and then um just for security reasons I'll need for you to verify your date of birth for me, sir.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] I don't want to tell you I'm old.
[CUSTOMER][NEUTRAL] Alright, [PII]. I'm up there.
[AGENT][NEUTRAL] Thank you, sir. And then what is your address, a phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Alright, should be [PII]. My email should be [PII].
[CUSTOMER][NEUTRAL] What was the other thing you wanted?
[AGENT][NEUTRAL] Your cell phone number that we have on file for you?
[CUSTOMER][NEUTRAL] And the number I'm calling at [PII].
[AGENT][NEUTRAL] Thank you sir. OK, so did you submit the claim for yourself?
[AGENT][NEUTRAL] We were you the patient? for your wife? OK, let me look.
[CUSTOMER][NEUTRAL] No, for my wife.
[CUSTOMER][NEUTRAL] No, my wife.
[AGENT][NEUTRAL] I do show that we did get a submittal from the online service center today.
[AGENT][NEUTRAL] Uh, you should have got a confirmation number to show that we received it. Let me give that to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is that number?
[AGENT][NEUTRAL] It's O as in Oscar, S as in Sam, C as in cat.
[AGENT][NEUTRAL] 96998.
[CUSTOMER][NEUTRAL] OK, uh, Oscar Sam Charlie 96998.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] I submitted 5.
[AGENT][NEUTRAL] And we do have it.
[CUSTOMER][NEUTRAL] 55 sheets does it tell you the number of sheets or just says it was submitted.
[AGENT][NEGATIVE] It just shows that it's submitted um it doesn't come to me directly it comes to the claims department and they can't see it until they download it, uh, and then once you get the claim in, it takes 7 to 10 business days to process it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you verify what my um the policy number is uh no the group number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] My certificates all screwed up. It says my certificates, uh, uh, and the number that's my policy, and it says my group number.
[CUSTOMER][NEUTRAL] Is well, the policy number is 24842, but that's actually my group number, correct? That's what the lady told me before.
[AGENT][POSITIVE] Yes, that's correct. That is your group number.
[CUSTOMER][NEUTRAL] OK, and she said that whenever we.
[AGENT][NEUTRAL] Yes, Prosper Independent School District.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And whenever we go to a doctor or a hospital or a CT scan where they give them the uh the policy number, the group number and and you all's phone number, is that correct?
[AGENT][NEUTRAL] Yes, sir. And then also we have a payer, we have a payer ID number. Let me give that to you because that's how the doctor's office can file electronically with us.
[CUSTOMER][NEUTRAL] Permitting a
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, just let me know when you're ready. OK, it's 60.
[CUSTOMER][POSITIVE] I'm ready to go.
[CUSTOMER][POSITIVE] I'm good.
[AGENT][NEUTRAL] 801.
[CUSTOMER][NEUTRAL] It's all five digits 60801.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, I'll add that on there because we're, we're going to the doctor tomorrow for chemo to, to learn how she's gonna do the chemo and what to expect and everything so.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I'll give them this information.
[CUSTOMER][NEUTRAL] So I give him the payer ID number, the policy number, group number, and y'all's phone number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And the name of the company is APL.
[AGENT][POSITIVE] Yes sir, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I can't think of it. I asked if I not asked anything that I should have asked.
[AGENT][NEUTRAL] Mm. Well, you know, if you come up with something later on, Mr. [PII], you are always welcome to pick up the phone and call us.
[CUSTOMER][NEUTRAL] I created the dashboard.
[AGENT][NEUTRAL] And um we're open from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and then not on the weekends, she told me that.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, very good. Well thank you for helping me and uh it's almost time for you all to leave and thanks for answering the phone and hope you have a good rest of whatever the evening brings.
[AGENT][POSITIVE] Well, you too. I appreciate that. Thank you so much and I hope you guys have a good appointment tomorrow, sir.
[AGENT][POSITIVE] Thank you very much for calling APL.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] All right thanks [PII]. All right, bye.
[AGENT][NEUTRAL] Mm bye bye, sir.