AccountId: 011433970860
ContactId: 5a46469e-7fc6-44dd-bab7-c1e805da91a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 600000 ms
Total Talk Time (AGENT): 110049 ms
Total Talk Time (CUSTOMER): 93169 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/5a46469e-7fc6-44dd-bab7-c1e805da91a1_20250507T17:37_UTC.wav
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[AGENT][NEUTRAL] Hello, thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. Can I give you a claim number?
[AGENT][NEUTRAL] [PII], can I have a callback number for you so the call won't be disconnected and I can give you a call back if it does?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Are you the provider or the insured?
[CUSTOMER][NEUTRAL] In short,
[AGENT][NEUTRAL] Can I have your policy number, [PII], and then you can provide me with the claim number.
[CUSTOMER][NEUTRAL] 02249403
[AGENT][NEUTRAL] Could you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] [PII] birthday [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], are you the policy holder or dependent?
[CUSTOMER][NEUTRAL] Depended.
[AGENT][NEUTRAL] You're calling about a claim about on your your own behalf for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, what is the claim number?
[CUSTOMER][NEUTRAL] 354-3151
[AGENT][NEGATIVE] Looks like the check was voided.
[AGENT][NEUTRAL] For the provider and resubmit it.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Right, say that again.
[AGENT][NEGATIVE] Look like the check was voided and resubmitted.
[CUSTOMER][NEUTRAL] That they sent out a new check or?
[AGENT][NEUTRAL] Let me see, it looks like.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it says claim information received but cannot process need additional information so it looks like you like the insured submitted the claim also, the check was voided for the provider. I place you on a brief hold because I'm not sure why it was voided, so I have to research.
[CUSTOMER][POSITIVE] I think I have an idea. I might be able to help you.
[AGENT][NEUTRAL] What is your idea?
[CUSTOMER][NEUTRAL] So I spoke with them about this last week.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] With the medical provider Saint Joseph's Medical.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] They're claiming the check never got to them.
[CUSTOMER][NEUTRAL] Um, and you guys, you guys sent that.
[AGENT][NEGATIVE] And the check was voided.
[CUSTOMER][NEGATIVE] Yeah, you got, so you guys sent out a check and I, I believe the check got returned to you for the improper address.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] They asked me to send um.
[CUSTOMER][NEUTRAL] And correct the claim with the right address when I called the provider to verify the address, they said the address that's on the claim is right, um.
[CUSTOMER][NEUTRAL] It should be [PII].
[CUSTOMER][NEUTRAL] [PII]. That's the correct mailing address.
[AGENT][NEUTRAL] So did they send in an updated claim cause they, that is their job to send an updated claim.
[CUSTOMER][NEUTRAL] I don't know. I'm just.
[AGENT][NEUTRAL] Being that they submitted the claim.
[AGENT][POSITIVE] I know they're giving you the runaround sound like.
[CUSTOMER][NEUTRAL] Well, I I submitted the claim.
[AGENT][NEUTRAL] You submitted it the 2nd time or the 1st time?
[CUSTOMER][NEUTRAL] Uh, maybe the first time.
[AGENT][NEUTRAL] Cause the first time it was sent to the provider and if you submitted the claim, it would have went to you instead.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me place you on a brief hold so I can reach out to the adjuster to see if she reprocessed this claim because in the system it doesn't show that it's been reprocessed.
[AGENT][NEUTRAL] 41025. You're welcome, [PII]. Hold one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Alright thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding. I apologize for the inconvenience.
[AGENT][NEUTRAL] Um, I've spoken with the adjuster and she's gonna reprocess the claim.
[AGENT][NEUTRAL] And send the payment out to the provider.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] No, that's it thank you for your help.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and you have a great day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thanks, goodbye.