AccountId: 011433970860
ContactId: 4c4f7d9f-ba24-413f-8950-5e0a44640e26
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 543390 ms
Total Talk Time (AGENT): 154185 ms
Total Talk Time (CUSTOMER): 133168 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/4c4f7d9f-ba24-413f-8950-5e0a44640e26_20250612T19:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], how are you?
[AGENT][POSITIVE] Good how are you?
[CUSTOMER][NEUTRAL] Good. I'm calling on behalf of SBL Freightliner.
[CUSTOMER][NEUTRAL] And I'm calling on behalf of uh [PII]. She's a member and I have a claim number. I'm just looking for the status on the claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, give me just one moment, um, can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] All right, and what is your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] Last name. Mhm. Last name [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And are you a broker?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, give me just one moment.
[AGENT][NEUTRAL] Um, what is the policy number?
[CUSTOMER][NEUTRAL] It is 1719399.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] All right. And um I'm sorry, what was the patient's name again?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] She's a dependent. Last name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I do have a different name for her. Um, what is the date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, I'm sorry I'm saying [PII], it's [PII].
[AGENT][NEUTRAL] OK. Uh, what is her date of birth?
[CUSTOMER][POSITIVE] Um, good question.
[CUSTOMER][NEUTRAL] I, I mean, I have the claim number. Do you want the claim number?
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Um, can I verify your email real quick?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, and do you know who filed the claim?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I believe either the employer or [PII] himself.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a confirmation number, claim number, all all of that.
[AGENT][NEUTRAL] Uh, what is the claim number?
[CUSTOMER][NEUTRAL] It's 361-2300.
[AGENT][NEUTRAL] OK, it looks like we did process that claim. Uh, we received it on [PII]. It was processed on [PII], um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] But since I don't see you as an authorized representative for um to speak on their behalf, I can't give you much more than that. I can see that the claim was denied.
[CUSTOMER][NEUTRAL] Is it denied for missing information.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] Do you know what's missing?
[AGENT][NEUTRAL] Yes, but unfortunately because you're not on the list of uh representatives for me to speak with um in order to give more detailed information I would need uh whoever filed the claim.
[AGENT][NEUTRAL] Uh, and it looks like with OSC.
[AGENT][NEUTRAL] It looks like it would be the policy holder um they would have to call so that I can give them that information.
[CUSTOMER][NEUTRAL] I, I mean, I've been working with APL for a very long time and I mean I don't need any HIPAA protected information. I just wanna advise I mean this is the owner of the company for our mutual client so.
[AGENT][NEUTRAL] OK, give me just a moment, let me.
[CUSTOMER][NEUTRAL] It's yeah, I definitely have from it. I mean I have an email of them asking me to get the information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Let me see what we're doing here.
[AGENT][NEUTRAL] Uh let's see what they need. Give me just one moment to pull that up.
[CUSTOMER][POSITIVE] I appreciate you.
[AGENT][NEUTRAL] It looks like we need a copy of the explanation of benefits from the primary.
[CUSTOMER][NEUTRAL] From the primary.
[AGENT][NEUTRAL] The, the primary insurance carrier.
[AGENT][NEUTRAL] Or medical, yeah.
[CUSTOMER][NEUTRAL] OK, so there's no EOV.
[AGENT][NEUTRAL] Right, we don't have one on file.
[CUSTOMER][NEUTRAL] Weird. I, I mean, I saw what what was submitted. They definitely submitted an EOB.
[CUSTOMER][NEUTRAL] That seems weird.
[AGENT][NEUTRAL] Um, if you would like, I can get someone from claims and they'll be able to look into the documents a little bit further. Um, I'm unable to do that, but if you'd like I can transfer you to claims and they can try and look into what I was sent.
[CUSTOMER][POSITIVE] Yeah, that would be great just so I can help them out they.
[CUSTOMER][POSITIVE] Yeah, I appreciate it.
[AGENT][NEUTRAL] Alright, give me just one moment.
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] no agent staff. Goodbye.
[AGENT][NEUTRAL] Hi [PII], are you there?
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][NEUTRAL] It looks like they are all staffed right now. Would you like me to have you placed um on a call back and they can call you back whenever they're available?
[CUSTOMER][NEUTRAL] Um, yeah, that's or I can hold I don't mind holding if that's.
[CUSTOMER][NEUTRAL] If if a call back is the only option that's fine, but I also don't mind holding if you could do that.
[AGENT][NEUTRAL] OK, yeah, it wouldn't let me put you in, um, so I'm gonna need to provide a call back, um, because I, I tried that, right? And can we call you at the [PII]?
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, I'm so sorry about that.
[AGENT][NEUTRAL] All right, and is there a specific time of day um that works best for you or just any time throughout the day?
[CUSTOMER][POSITIVE] As soon as possible is great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I will let them know to give you a call back, OK?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Alright, thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too. Bye now.