AccountId: 011433970860
ContactId: 4efc904c-d05b-44e0-9abb-b6dcc6829002
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 182860 ms
Total Talk Time (AGENT): 82652 ms
Total Talk Time (CUSTOMER): 71439 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/4efc904c-d05b-44e0-9abb-b6dcc6829002_20250519T15:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, good morning, [PII]. My name is [PII]. I'm calling from a facility to follow up on a, um, explanation of benefits we received for a member, not really understanding what you're doing on that, so I'm hoping you could walk me through.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Sure, no worries, yes, I can get some clarification on that for you. uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] I have a direct line that is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you and do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, uh, that is 02541657.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] I'm [PII] with the date of birth of [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that uh do you have the claim number we're looking at?
[CUSTOMER][NEUTRAL] I do. Let me just scooch this over a little bit. Claim number 3593575.
[AGENT][NEUTRAL] 5. OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so as this is a secondary medical policy, [PII], we would need a copy of the primary EOB. According to this information, we did receive an explanation of benefits. However, it does not list the amounts applied towards deductible, co-pay, or co-insurance. So essentially we need a more detailed copy of the explanation of benefits that show those amounts.
[CUSTOMER][NEUTRAL] OK, I'm not sure what they sent to you, but I'm looking right at the primary it's pretty well spelled out so they obviously sent something different to you. How can I get this primary explanation of benefits to you?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure. So I've got a mailing address and a fax number.
[CUSTOMER][NEUTRAL] Uh, I can try faxing, uh, email you said or mailing.
[AGENT][NEUTRAL] Uh, no, uh, mailing mailing address and a fax number.
[CUSTOMER][NEUTRAL] Let me do a fax number.
[AGENT][NEUTRAL] Sure, uh, are you ready for it now?
[CUSTOMER][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] OK, that is 877.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, any specific uh department attention to?
[AGENT][NEUTRAL] Uh, just claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Let me get that out to you today. Uh, do you provide reference numbers for the calls?
[AGENT][NEUTRAL] Yes ma'am, that would just be my first name, last initial, and today's date and so my name is spelled [PII] last [PII] And was there anything else I could help you with?
[CUSTOMER][POSITIVE] Not at this time. Thank you so much.
[AGENT][POSITIVE] Of course, thanks for calling APL have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye.