AccountId: 011433970860
ContactId: 56ab6285-10d0-454b-90a5-d07ca3cfabaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 458579 ms
Total Talk Time (AGENT): 229551 ms
Total Talk Time (CUSTOMER): 187937 ms
Interruptions: 6
Overall Sentiment: AGENT=-0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/56ab6285-10d0-454b-90a5-d07ca3cfabaa_20250123T17:22_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], this is [PII] in customer service. How are you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm good. I have an insured on the line. Um, he, his policy number is 256-50007.
[AGENT][NEUTRAL] 256.
[CUSTOMER][NEUTRAL] Mr. [PII]? Yes.
[AGENT][NEUTRAL] 5007 [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, I've just done a claim for him. What's going on?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So he's calling about a claim or an authorization for his wife or his spouse that's listed on there he says he's, she's his fiancee um but apparently there's some issue with maybe an authorization that they're trying to get for approval for something.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm, we don't require an authorization for any services.
[CUSTOMER][NEGATIVE] I didn't think so. So I'm not really sure what's going on, but he's saying that we're not receiving something um for her to have the treatment. I don't, I, I don't.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, um, what's the callback number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It is the same as in the system [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have verified all of his information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see here, yeah, I'm not sure.
[AGENT][NEUTRAL] Let's you can go ahead and send him through. I'll let him know that whatever they're sending is not correct before you send them through, let me get my dog. Come here, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] She's acting like a nut cause the cat's sitting on the edge of the bed and she don't like that for some reason.
[CUSTOMER][NEUTRAL] Uh, yeah, I've got a cat and a dog too, so I know how it is. Anytime somebody pulls up.
[AGENT][NEUTRAL] I got 2 dogs and a cat, and I'm about to get my 3rd dog.
[CUSTOMER][NEGATIVE] Oh gosh, nope. I can barely handle the two I've got.
[AGENT][NEGATIVE] Yeah, well, the cat's not mine and it's my daughter's, and when she moves out, she's taking that devil.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yeah, I have a [PII] and she's gotten attached to the cat, so even if I wanted to give them away, I could not.
[AGENT][NEUTRAL] Yeah, like cat's history. It's a Maine Coon. Do you know what a Maine Coon is?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] Yeah, that's what that cat is, and it's a devil.
[CUSTOMER][MIXED] They're really pretty, but they're, oh.
[AGENT][NEUTRAL] The cat weighs 17 pounds and my dogs weighs 10 pounds.
[CUSTOMER][POSITIVE] Oh my gosh. Wow.
[AGENT][NEGATIVE] Yeah, so he's a devil. I hate that cat.
[AGENT][NEGATIVE] God, I hate it. OK, you can um send him through and I'll, I'll figure out what's going on because we don't require an all, so I don't know why.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, I, I didn't get that either, but I figured maybe you could look at what they're trying to do and see if it's a covered benefit maybe that's what it is. I, I'm not really sure.
[AGENT][NEGATIVE] Oh yeah, I don't even, I can't even pronounce this chick's name anyway, so I don't even see anything that's been sent through for her.
[CUSTOMER][NEUTRAL] Yeah, he said something about we possibly couldn't have we may not have received it. I, I don't know honestly.
[AGENT][NEGATIVE] Yeah, we haven't received anything for her, not unless it's on accident.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. Well, uh, here he comes. Thank you, [PII].
[AGENT][NEUTRAL] OK, yeah, you can send it through.
[AGENT][POSITIVE] All right, thanks. Bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hey [PII], this is [PII] in the claims department. How are you?
[CUSTOMER][NEUTRAL] All right, and you?
[AGENT][NEUTRAL] I'm good. I understand um there's an issue with an authorization, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, um, I can definitely um try to help you out here.
[AGENT][NEUTRAL] So your fiance is going to have a procedure and they're trying to obtain an authorization, is that correct?
[CUSTOMER][NEUTRAL] Well, I guess it's a payment authorization or claim.
[AGENT][NEUTRAL] Is it for your fiance?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] OK, so if it's for, if it's not for a payment, if it's for a proce procedure or data service, APL does not require any authorization for any services.
[AGENT][NEUTRAL] That's, um, I guess first and foremost. Now, as far as your fiance, any dates of service, um, if any facility or provider's office.
[AGENT][NEUTRAL] We haven't received any claims on your accident or your HR.
[AGENT][NEGATIVE] I don't have anything.
[CUSTOMER][NEGATIVE] What do you mean so y'all have not received.
[AGENT][NEUTRAL] I don't have anything on file that we've received anything. No, sir. Is it for a different policy that you have with us? Because
[CUSTOMER][NEUTRAL] No, no, just a.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Let's see here, that's.
[AGENT][NEUTRAL] Let me take a look at all your policies. Give me just a second.
[AGENT][NEUTRAL] OK, I do, would it be for dental?
[CUSTOMER][NEUTRAL] It might be.
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] OK, let me just take a look and see what this is. Give me just a second. I do see that there's something that was submitted, um.
[CUSTOMER][NEUTRAL] Haven't been there yet.
[AGENT][NEUTRAL] Under dental
[CUSTOMER][NEUTRAL] I mean,
[AGENT][NEUTRAL] But let me see what it is.
[CUSTOMER][NEUTRAL] Oh, we ain't been to dental.
[CUSTOMER][NEUTRAL] I hear you, I hear you, but she checking in to see if it's something that came through and.
[CUSTOMER][NEUTRAL] The only thing she find is something for dinner, but we ain't been to no dentist.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, let's see here.
[CUSTOMER][NEUTRAL] So they might be found it wrong.
[AGENT][NEUTRAL] Give me just a second here, Mr. [PII].
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][POSITIVE] See that good for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] If they have a point? No, no, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, what, what is this provider's office? Is it a multicare health system?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Doctor
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Irwin
[CUSTOMER][NEUTRAL] Uh yep.
[AGENT][NEUTRAL] OK, so I did find a claim, um, we just received it this morning.
[CUSTOMER][NEUTRAL] Because I, I know they she had them file another one this morning.
[AGENT][NEUTRAL] OK, yes, we just received one claim and we just received it this morning, um.
[CUSTOMER][NEUTRAL] If you.
[AGENT][NEUTRAL] So what I'm gonna do, it was indexed um under a different policy here. It was indexed under your policy, but it was indexed under the dental policy, so I'm gonna get it moved to the correct policy.
[CUSTOMER][NEUTRAL] Yeah, now I'm trying to figure out what they said.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] OK, that might explain why then.
[AGENT][POSITIVE] Yes, we're gonna get it um indexed under the correct policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So we'll get it moved and um just know that whenever we do receive a claim it can take us up to 10 business days to get a claim process for you guys.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so just give us a little bit of time to get this claim processed, but we did receive a claim this morning.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] Yes, sir. Um, is there anything else that I can take a look at for you?
[CUSTOMER][NEUTRAL] No, that'd be all.
[AGENT][POSITIVE] OK, alright, well, um, I'll definitely get this claim reindexed and we'll get it processed for you, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Uh, yes, sir. Well, thank you for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Alright bye bye.
[CUSTOMER][NEUTRAL] Bye bye.