AccountId: 011433970860
ContactId: 5d4dd742-e5f3-4fd2-8e81-2d20100301a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364709 ms
Total Talk Time (AGENT): 174422 ms
Total Talk Time (CUSTOMER): 85638 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/5d4dd742-e5f3-4fd2-8e81-2d20100301a0_20250130T21:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Thank you, I'm trying to find out about a claim please.
[AGENT][NEUTRAL] Yeah, I can look at a claim for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Thank you and then do you have the policy number?
[CUSTOMER][POSITIVE] Uh, yes, I do. It's gonna be.
[CUSTOMER][NEUTRAL] 1, no sorry, 02486627 M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you and what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] [PII], it's gonna be [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that [PII] and uh what was the date of service for this claim?
[CUSTOMER][NEUTRAL] Uh, data service is going to be, uh, [PII] for $295.
[CUSTOMER][NEUTRAL] Pom pom pom.
[AGENT][NEUTRAL] OK, I'm sorry, that was, uh, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, I might need to look because this policy was its effective date was [PII]. Give me just a moment, let me see if she had one that was active at that time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or he this is for [PII]. OK, yes, they did give me just a moment.
[AGENT][NEUTRAL] Was this with uh is it Holy Cross urgent care?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so we did receive this claim looks like, well, looks like it was a duplicate. Bear with me just a moment let me try to find the original.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, she had asked me to send in a Humana EOB so I did that too and faxed it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, bear with me just a moment. I appreciate your patience.
[CUSTOMER][POSITIVE] No, take your time, take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] What am I gonna do, yell, cause you're helping me?
[AGENT][POSITIVE] I just want to let you know that I appreciate your patience. I hope you don't yell.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I used to be on your side. I know what it's like.
[AGENT][NEUTRAL] Yeah, computers, um, I think.
[AGENT][NEUTRAL] Do you kind of know kind of sort of when um you sent us the EOB?
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] Of this month?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well that might be why then um because I don't show any of course this is for his well I did have to go back and look at the older policy when this was effective and I don't see that we received anything then but let me see if it might have gone to the new one it's possible that it's still.
[CUSTOMER][NEGATIVE] You can't see it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, in line for processing, so let me take a look here.
[CUSTOMER][NEUTRAL] No, I get it. Uh, I'm just early.
[AGENT][NEUTRAL] Sure, OK, well, I don't show anything for him either.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Did you say you faxed it?
[CUSTOMER][NEUTRAL] Mhm. The fax the 877-365, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, all right, well.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][POSITIVE] I can give it a couple more days.
[AGENT][NEUTRAL] Well, I'm wondering because it does show that we've received the claim a few times. I'm trying to look back through all of those um because if it if it was mistaken as a duplicate that you it was a part of that I wanna make sure so let me check to see what was actually received bear with me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Ah, OK, well, it looks like and I can send you this EOB if you'd like um I do have the last thing that we received the last time we received this claim looks like that was uh [PII] of last year and one of the said duplicates was um the insured had filed this claim and that's where the benefit was paid.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] So we paid the benefit to the insured already.
[CUSTOMER][NEUTRAL] To the patient.
[AGENT][NEUTRAL] Correct, he it looks like he filed or they filed the claim, uh, themselves.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want me to send you this EOB that has that information?
[CUSTOMER][POSITIVE] Yes, can I have it? I'm gonna need it.
[AGENT][NEUTRAL] Absolutely, yeah, I was gonna say that's me. Um, let's see, do you have a fax number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] and just put attention [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty I will go ahead and get that sent to you now. Uh, you should get it here in maybe 10-15 minutes depending on how busy your machine is. Um, did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, and actually what's funny is, uh, it probably won't be that busy due to the fact that I'm the last person here, so.
[AGENT][POSITIVE] Oh awesome well then you should get it here pretty soon.
[CUSTOMER][NEUTRAL] It's fine.
[CUSTOMER][POSITIVE] OK, I really appreciate it.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Yeah of course alright well there's nothing else I can help you with. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Sure. I hope you have a good day and a good weekend.
[AGENT][POSITIVE] Thank you. You too. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye.