AccountId: 011433970860
ContactId: 5fe8b2ac-360f-4891-bfe7-479f89021dfb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 527719 ms
Total Talk Time (AGENT): 126435 ms
Total Talk Time (CUSTOMER): 186747 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/5fe8b2ac-360f-4891-bfe7-479f89021dfb_20250512T14:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] in the care team. I have um Mr. [PII] on the phone with me and his policy number that he gave me is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2552435
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he's looking for the claim that was submitted um in May and it tells us to refer back to policy number 2451623.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I do show that the claim was paid under the member, um, the account holder [PII].
[CUSTOMER][NEGATIVE] But it's for a different data service that he gave me was for March um and it should have been for part 3.
[CUSTOMER][NEGATIVE] And I'm not, I'm, I'm thinking that part 3 did not get paid according to this. It wasn't for him it was for his son [PII], but he's on the other line. He's just wanting claim status, but I don't know what to tell him because it looks like.
[CUSTOMER][NEUTRAL] Looking on my end it looks like it was paid for his son and not for um for him and not his son, and they're both of their names are [PII].
[AGENT][NEUTRAL] Alright, give me a second.
[AGENT][NEUTRAL] Give me 1 2nd to pull it up. 1 2nd.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] And he doesn't know any of the information I just told you he's just basically trying to get claim status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Come on, on babe.
[CUSTOMER][NEUTRAL] I'm gonna go back to him and let him know that you're you're pulling it up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that we haven't forgot about it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] Thank you [PII] for let me do that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So he hasn't, I wonder has he received the payment?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] He said that he saw that the, the payment has been processed but it said $0 amount but he also gave the um first policy number that I gave to you, the 2552435.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you can, you can send him on over because we processed this back in November so he should have already received that payment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK. All right. Thank you, Ms. [PII]. You have a good week.
[AGENT][NEUTRAL] And so he said he submitted something.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And yes he submitted it in May.
[AGENT][NEUTRAL] And we have nothing on file, but you can go ahead and send them over.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Alright thanks [PII] bye bye.
[AGENT][POSITIVE] Good morning. Thanks for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, yes, I was calling. Some transferred you to me. I was calling because um my claim says processed and then payout was $0 but I'm trying to um see why, um, she said she also told me that it was filed up under uh an old policy, I mean policy number, but I put my current one, so I'm just trying to get information on my claim from data service 325.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, 25.
[AGENT][NEUTRAL] OK, and that was you said it was on your son?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alright, so we, we did not make a payment on that claim?
[AGENT][NEUTRAL] Uh, because we are actually, uh, needing the diagnosis code. So we need something showing the diagnosis code, which is the reason he went to the ER on [PII].
[CUSTOMER][NEUTRAL] OK. I uploaded it because it won't let me upload all three documents the itemize it will be and the, the discharge paper together so I upload it separate, but I see you guys added it all on the one, so, um, it says viral syndrome on, on this discharge paper.
[AGENT][NEUTRAL] OK, give me one second to pull that information up, OK?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] OK one moment. It's taking a minute for this image to come up. I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, I do see that information, uh, we'll get this client reprocessed for you.
[AGENT][NEUTRAL] Uh, let's see, let me, let me make sure.
[CUSTOMER][NEUTRAL] OK, but you do see it. OK, yeah.
[AGENT][NEUTRAL] Yeah, let me make sure that we, there's nothing else that we're needing when I have you on the phone one second.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] That
[AGENT][NEGATIVE] Oh, come on.
[AGENT][NEUTRAL] I apologize. It just takes a minute for these images to come up to open.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][POSITIVE] Alright, OK, yeah, looks like we need we have everything that we're needing and we'll go ahead and get this reprocessed for you.
[CUSTOMER][NEUTRAL] OK, so question, will it take the whole processing time like it did, or will it be much faster because it was already processed, you just have to make a correction.
[AGENT][NEUTRAL] Actually, we just have to make a correction because they just processed it on today so we just need to go in and add the diagnosis code and we can um make sure we can make the benefit adjustment. Let's see.
[CUSTOMER][NEUTRAL] OK, so it will be processed today as well, or?
[AGENT][NEUTRAL] Yes, sir. Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And, and after we get off of this call, will I be able to log in and check the status and see that, or?
[AGENT][NEUTRAL] Uh, maybe you wanna check back after lunch just to be sure because I'm gonna have to send it back to the examiner.
[AGENT][NEUTRAL] But then to uh to review it.
[AGENT][NEUTRAL] And then maybe check back after lunch, check online after lunch, and it should be corrected by that time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Around [PII] time.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, OK. Um.
[CUSTOMER][NEUTRAL] OK, so that pretty much do everything then.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alrighty, if there's go ahead. Alright, if there's nothing else, thanks for calling ATL and have a great rest of your day.
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] All right, you
[AGENT][NEUTRAL] OK bye bye.