AccountId: 011433970860
ContactId: 62aa1c88-a1b7-44ed-b3af-169481fd0c73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 652739 ms
Total Talk Time (AGENT): 124860 ms
Total Talk Time (CUSTOMER): 243801 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/62aa1c88-a1b7-44ed-b3af-169481fd0c73_20250129T20:21_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi [PII], um, I submitted a claim, a faxed a claim for an accident my wife had, um, and I was wanting to see if I could check to make sure y'all got it because I faxed it through the email program and I just, I, I just wanna make sure it went like it was supposed to.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They had said they had said I would get a confirmation when from my email and I never did so uh I was hoping you could see if it came in because I sent it uh today.
[CUSTOMER][NEUTRAL] Day before yesterday.
[AGENT][NEUTRAL] OK, I can definitely check and see if the client has been received for you. Um, may I have a good contact number in case we're disconnected and your name?
[CUSTOMER][NEUTRAL] Yes, the number is [PII].
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][NEUTRAL] Thank you for that. And Mr. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 1289078.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] All right, now I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII] and email is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alrighty and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. And for this claim, um, it was for your accident policy.
[CUSTOMER][NEUTRAL] Yes, my wife dislocated her shoulder back in October.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And you said you sent it by email?
[CUSTOMER][NEUTRAL] Uh, no, I sent it. I, I sent it through my email, but it, it, it was supposed to go as a fax because since I don't have the a policy anymore with y'all, it had to be done by fax instead of me logging in, but.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm just, since I don't have a fax machine I use my company's way to fax things by using it through the email but it you should have got it into your your fax.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's what I'm just trying to confirm that that did happen correctly.
[AGENT][NEGATIVE] I'm not showing that it has. I don't even see anything here. When did you say you sent it? You faxed it on.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Day, day before yesterday.
[AGENT][NEUTRAL] So Monday.
[CUSTOMER][NEUTRAL] Am I checking too soon?
[AGENT][NEUTRAL] Um, no, let me see if I can check the faxes and see if it's there. Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] That'll be fine, uh, if you'll hang on just a second, let me confirm when.
[CUSTOMER][NEUTRAL] I sent it um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It might help, uh, because I think it was in the evening.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh sorry, hang on, where did I file it?
[CUSTOMER][NEUTRAL] Health and vision.
[CUSTOMER][NEUTRAL] Accident claim form, yes, [PII].
[CUSTOMER][NEUTRAL] At [PII], so Monday night.
[AGENT][NEUTRAL] OK, um, hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[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][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. So I've looked through the um accident claims examiner's folders for their faxes, but I don't see it anywhere, um.
[CUSTOMER][NEGATIVE] OK, well, I, I'll have to get back with my company about how I'm supposed to send a fax through the computer, so I must have done something wrong but.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] But that's the only way I can get it to you, right? It's through fax.
[AGENT][NEUTRAL] No, you can mail it as well, um.
[CUSTOMER][NEUTRAL] Well, I meant I can't email it to you.
[AGENT][NEUTRAL] Oh, no, sir, we don't accept only because of HIPAA, we can't accept the claims documents through the email.
[CUSTOMER][NEUTRAL] Alright, OK, well, I will figure out, uh, let me double check, do I that I have the right fax number, uh, is it [PII]?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] OK, alright, well there's just something I didn't do right in in sending it via email, but it's, it's supposed to be able to do that.
[AGENT][POSITIVE] Well, the good thing is there's no um timely filing, so you don't have like a deadline to try to reach or anything. As soon as we receive it, we'll go ahead and process it for you.
[CUSTOMER][NEUTRAL] But I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] In the email, I mean in the the fax that I sent through email I put a little explanation about what it's for but you know, along with the claim form information um the the is that necessary?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because if otherwise if I'm gonna need to do that I'll need to print out a separate page.
[AGENT][NEUTRAL] Um, necessary to give a description. No, as long as the claim form paperwork is filled out, um.
[CUSTOMER][NEUTRAL] To fact
[AGENT][NEUTRAL] And you have your doc, you know, whatever documents you're submitting. No, you should, you should be fine. You don't have to give a description.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, and it, and of course it'll have the backup from the hospital, the UB04.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] And, and I talked to somebody the other day about the attending physician statement, and they said if I as long as I have the UBO4 I may not need that attending physician statement because I didn't get that completed. I didn't realize I should that that that was part of it and it's been 3 months since we saw him and he might be kind of difficult to get him to do that so I'm gonna send it through, get it to you somehow.
[CUSTOMER][NEUTRAL] Uh, and then y'all will let me know if we, if I definitely need that statement filled out.
[AGENT][NEUTRAL] Yes, or if, um, now if they do request um a description, they'll let you know, um, claims will let you know that they need it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Great. OK, well, thanks a lot, [PII].
[AGENT][POSITIVE] You're very welcome, Mr. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEGATIVE] No thanks.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Appreciate it you too.
[AGENT][POSITIVE] Thank you. Bye-bye.