AccountId: 011433970860
ContactId: 5fac9fef-efc1-426a-98ea-93a9d1148b63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364989 ms
Total Talk Time (AGENT): 156865 ms
Total Talk Time (CUSTOMER): 137539 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/5fac9fef-efc1-426a-98ea-93a9d1148b63_20250522T18:52_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Hello, this is [PII], and I was calling on some claims I submitted that I see it looks like they were processed and probably denied.
[AGENT][NEUTRAL] OK, [PII], so you have questions regarding claims, is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. And what did you say your last name was? I'm sorry, there's our connection is not very good.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your policy number please, [PII]?
[CUSTOMER][NEUTRAL] 1536509
[AGENT][NEUTRAL] Did you say 1536509?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One moment while I get your information pulled up. Once I do, I will have to verify several things with you first for security and also any information provided would be a verification of benefits and not a guarantee of payment. So first off, if you'll please verify the primary policy holder's name and date of birth.
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we would have for Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII] or [PII].
[AGENT][NEUTRAL] OK, thank you and the claims that you're wanting to check on for status or for yourself, is that correct?
[CUSTOMER][NEUTRAL] Uh, I think it was.
[CUSTOMER][NEUTRAL] I don't know. I have to look. It may have been for my kids.
[CUSTOMER][NEUTRAL] I don't know, let me look.
[CUSTOMER][NEUTRAL] Uh, looks like one that was processed was for [PII] with the date of service of [PII].
[AGENT][NEUTRAL] OK, so give me just a moment. And what's [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Well just go to Walmart to get some yogurt.
[AGENT][NEUTRAL] And you said the date of service is [PII]?
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] wash your hands
[AGENT][NEUTRAL] OK, so I do see that that this claim was received, and do you have the claim number there?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have a confirmation number I guess is that it?
[AGENT][NEUTRAL] I have a claim number.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Yeah, I have the claim number.
[AGENT][NEUTRAL] 3603704
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I, the remark on this claim [PII] states we are in receipt of a claim form that was completed by you. However, there are no charges submitted. If you are needing to file a claim, please submit the itemized charges in order for benefits to be considered. As soon as we receive this information, we will be able to complete the processing of your claim. Until then, your claim will be placed in an inactive status.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because before I submitted.
[AGENT][NEUTRAL] So you
[CUSTOMER][NEUTRAL] A document that had a claim but I maybe I didn't or maybe I.
[CUSTOMER][NEUTRAL] Maybe that was when I did.
[AGENT][NEUTRAL] We received
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I could be wrong.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm just gonna look at the documents.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So yes, ma'am. This is just the claim form. It did not have any other documents with it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, OK, I guess I failed to submit that, but can I, and I can, can I go back.
[AGENT][NEUTRAL] OK. Well, you can just.
[CUSTOMER][NEUTRAL] Into that specific claim and upload it or no?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, you will just upload like if you were submitting a new document, and then we will know that that was a missing piece of information for a claim that was currently being reviewed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] OK, so I just do I just upload like a totally separate deal and don't go back into that one, right?
[AGENT][NEUTRAL] Correct, you cannot open that information or attach it to that claim, but again the system will recognize that that was a missing piece of information for this data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, I appreciate it.
[AGENT][POSITIVE] OK. Well, you're very welcome. Is there anything else I could help you with today?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, no, that was it.
[AGENT][POSITIVE] OK, well then, thank you for calling AP over [PII] and I hope you have a very nice afternoon.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah