AccountId: 011433970860
ContactId: 5c9f3a43-7488-4981-b35f-57b4180d8403
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 582479 ms
Total Talk Time (AGENT): 137813 ms
Total Talk Time (CUSTOMER): 159414 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/5c9f3a43-7488-4981-b35f-57b4180d8403_20250407T21:12_UTC.wav
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[CUSTOMER][NEUTRAL] She wanted it for a lab?
[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. How are you? My name is [PII].
[CUSTOMER][NEUTRAL] And um I'm here, I'm here with a member, an active member. I'm calling from the broker's office, by the way. I'm sitting here uh with a member that's been having a lot of issues with claims and um it's for an older policy. The policy terminated back in October of last year.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But she's been sent to collections on a couple of lab claims and the lab facility is telling her she went to the lab today and they kicked her, they, they kicked her out because she has too many outstanding balances.
[CUSTOMER][NEGATIVE] And uh they keep telling her that they've submitted a bunch of claims from [PII] to APL and APL hasn't paid.
[CUSTOMER][NEUTRAL] So I, you know, I'm here and I'm like, well, that's kind of strange because typically with labs, they, they sent them correct. So if APL hasn't sent them it's either they haven't sent it correctly to APL or there might be some missing info on those.
[CUSTOMER][POSITIVE] So I was hoping you can kind of give us some insights on, on these. We were trying to get into her portal too, but the computer's super slow and it's not downloading ELBs, so I just figured, you know what, I'm just gonna call. It's a lot easier.
[AGENT][NEUTRAL] OK, let's start with the policy number.
[CUSTOMER][NEUTRAL] So the policy number I'm seeing here um.
[CUSTOMER][NEUTRAL] Is 022.
[CUSTOMER][NEUTRAL] 67917
[AGENT][POSITIVE] Thank you, let me get that pulled up.
[CUSTOMER][NEUTRAL] It's for [PII].
[AGENT][NEUTRAL] Alrighty. And can you verify the last four of the social?
[CUSTOMER][NEUTRAL] [PII], what's the last 4 of your social? [PII]
[AGENT][NEUTRAL] OK, and the uh correct billing address that we should have?
[CUSTOMER][NEUTRAL] Um, should be [PII].
[AGENT][NEUTRAL] Thank you. And what about her date of birth?
[CUSTOMER][NEUTRAL] Uh, what's your date of birth? [PII].
[AGENT][POSITIVE] Perfect, thank you. And what was your name again?
[CUSTOMER][NEUTRAL] My name or hers?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, my name is [PII].
[AGENT][NEUTRAL] [PII]. OK. All right, perfect. All righty. um, OK, and what's a good callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] You can call me [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alright, perfect, thank you. Um, and is [PII] still a good email address for [PII]?
[CUSTOMER][NEUTRAL] Is your email the [PII]? Yes.
[AGENT][NEUTRAL] Alright, perfect. OK, so y'all are calling in regards to some claims, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, she has a bunch uh uh she has a bunch. I'm, I'm, I was trying to ask her for the data service, but she says there's a bunch, but it's from the same exact facility. The facility is called Quest Diagnostics.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], so
[CUSTOMER][NEUTRAL] She's saying there's some
[AGENT][NEUTRAL] What I'll have to do is I'll have to get you over to the claims and benefits department so they can further assist you because I'm in group villain um and I don't have anything to do with the claims part, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh my [PII].
[CUSTOMER][POSITIVE] OK, I thought I was talking to claims. Are, are you gonna fill them in on all the stuff I gave you, or? OK, thank you so much.
[AGENT][POSITIVE] Good
[AGENT][NEUTRAL] Yes, sir. Yes, sir.
[AGENT][POSITIVE] You're welcome. Just bear with me and I'll get someone on the phone for you, OK?
[CUSTOMER][POSITIVE] I appreciate that.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] You're welcome, but before I transfer you, is there anything else in group billing I could possibly help you with?
[CUSTOMER][NEUTRAL] No, that is it.
[AGENT][POSITIVE] All right. Well, thank you for calling APL and just hang on the line and I'll get someone to help you all out, OK?
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Furring
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], it's [PII] in group billing. I've got a um um an insured and an agent on the phone needing help with some claims. Um, the policy is, is lapsed in our system, um, but the, the claims were from back when it was still active and apparently.
[CUSTOMER][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, some claims or some bills from provider has gone to collections and uh she wasn't able to get some scans done or something today because she still had too many outstanding things with them. Um, so they are needing to get that looked at. Um, policy number is 2267917.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And I've got [PII] on the phone, but I also I have [PII], the agent.
[AGENT][NEUTRAL] Um, and the callback number is the one that they're calling from is, uh, this callback number is for [PII], but they are both there on the phone.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][POSITIVE] Alright, you ready? Here they come. Thanks.
[CUSTOMER][NEUTRAL] Mhm.