AccountId: 011433970860
ContactId: 47ec7060-9737-421e-bc17-6d391f2e5d30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 410149 ms
Total Talk Time (AGENT): 148307 ms
Total Talk Time (CUSTOMER): 141572 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/47ec7060-9737-421e-bc17-6d391f2e5d30_20250414T15:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I work in, uh, I'm a from a broker's office, [PII]'s office, um, we went up to see one of our clients this past weekend or uh last week actually at the end of last week, and their renewal is coming up and the, the person who is the principal of the group had a claim last August and he does not know if he filed a claim with APL for this surgery.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any way you can tell me if a claim was filed last August on behalf of I don't, I don't wanna know anything about the claim. I just wanna know if there was a claim on file for him in [PII]. Can you tell me that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, actually um I'm gonna pass you along to our claims department um but before I do that, can I get a little bit more information for you like um the group number and name?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Uh huh, the group number is 13,530.
[AGENT][NEUTRAL] 0 and um do you by chance have the person's name?
[AGENT][NEUTRAL] Employee's name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm so sorry, it, it broke out in the beginning. What was the first name? [PII], was it?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK, perfect. Let me put you on a brief hold and I'll connect you with claims, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] No
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in Broker Resources. How are you doing today?
[CUSTOMER][NEUTRAL] Hey [PII], OK, so I'm so glad you're from Broker Resources because the phone did not say anything at all. It was just silent. So maybe it's because it was internal. I'm like, that's why I hesitated.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][POSITIVE] No, you're good. No, you're good. Do not worry about it. It it happens because sometimes it's, it says like on my end it'll be like broker resources and I'm like what is that?
[CUSTOMER][NEUTRAL] It was just silent and then I'm like, thanks for calling. OK, sorry. OK, what you think actually, I'm sorry, that was weird.
[AGENT][NEUTRAL] No, you're good. No, you're, you're good. Um, is this claims correct?
[CUSTOMER][NEUTRAL] Is this claims? No, this is the care team.
[AGENT][NEUTRAL] Care team. Is there any way if you could see
[CUSTOMER][NEUTRAL] You're trying to get the claim?
[AGENT][NEUTRAL] Yes, I, I thought this was claims.
[AGENT][NEUTRAL] Or is there any way do you can you guys see if a claim was submitted on an employee?
[CUSTOMER][NEUTRAL] Mhm. Uh, what's the, um,
[CUSTOMER][NEUTRAL] Policy number.
[AGENT][NEUTRAL] I'm so sorry, the house number?
[AGENT][NEUTRAL] Or did you say policy num? Oh, OK, policy number is 1341904.
[CUSTOMER][NEUTRAL] Uh, the policy number.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 1341904
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Yes, it was in last August, they said.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm, um.
[CUSTOMER][NEUTRAL] Yes, we have [PII].
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] We have some claims.
[AGENT][NEUTRAL] And um do you know if they were paid?
[CUSTOMER][NEUTRAL] Let's see, hold on one second.
[CUSTOMER][NEUTRAL] So 3 were paid and 1 was denied. You want me to give you like the claim? Are, are y'all looking for like a specific provider?
[AGENT][NEUTRAL] No, so I guess um the group, the broker met with the group last week and they didn't even know the status of the claim and so they were like, well, we can follow up for you um and see maybe it would be best if I connect them to claims so they can explain maybe why some of it was denied.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, you can send, if, if that's all they want, yeah, you can send them to me. I can help.
[AGENT][POSITIVE] Oh, OK, perfect. I'll connect the two of you. Her name is.
[CUSTOMER][NEUTRAL] Is this the broker or the um
[AGENT][NEUTRAL] So this is the broker um she she's not the broker but she works with the broker I think maybe as like an admin.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK perfect I'll have her join.
[CUSTOMER][NEUTRAL] And do you know if she, has she been verified?
[AGENT][NEUTRAL] No, I, I don't know how we verify them. We just normally like look and see if it's matched in line um to the broker's name like, uh, OK, OK, perfect. I'll have her join.
[CUSTOMER][NEUTRAL] Oh, it's OK.
[CUSTOMER][NEUTRAL] No, I'll verify it's fine. OK, and what's her name?
[AGENT][POSITIVE] OK perfect.
[AGENT][NEUTRAL] Her name's [PII].
[CUSTOMER][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Things that
[AGENT][NEUTRAL] Hey [PII], are you still there?
[CUSTOMER][NEUTRAL] Yeah, I am talking to myself if you heard me when you.
[AGENT][POSITIVE] No, you're good you're good, do not worry about it. I have, I have [PII] on the phone with us as well, and she's gonna be able to help you with that um claim. She did verify that there was one in August and she can speak to you more about that, OK?
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][POSITIVE] All right thank you bye bye.