AccountId: 011433970860
ContactId: 6789fb7f-d5df-46b9-a0fc-056ef04dc29a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392440 ms
Total Talk Time (AGENT): 134748 ms
Total Talk Time (CUSTOMER): 89936 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/6789fb7f-d5df-46b9-a0fc-056ef04dc29a_20250414T17:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Uh, yes, I'm, I'm checking up on my claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I can give you claim status. Can I please get your name and your callback number?
[CUSTOMER][NEUTRAL] Sure, my name is [PII], and my callback number is [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And then may I also have your policy number?
[CUSTOMER][NEUTRAL] Uh yes. Um,
[CUSTOMER][NEUTRAL] Um, that would be.
[CUSTOMER][NEUTRAL] Outpatient.
[AGENT][NEUTRAL] Either either number will pull it in for me.
[CUSTOMER][NEUTRAL] OK. 02476599 ML 8.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], for security reasons, can you please verify your policy for me? Uh, first, can you give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number, and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Um, address is [PII].
[CUSTOMER][NEUTRAL] Uh, phone number is [PII] and email address should be [PII].
[AGENT][POSITIVE] Thank you. I appreciate you verifying your policy, Ms. [PII]. All right, so I do show that
[AGENT][NEUTRAL] We have a claim that was reported on [PII]. Is that the one you're searching for?
[CUSTOMER][NEUTRAL] Yes, I sent multiple backups, right, mhm.
[AGENT][NEUTRAL] For Cleveland Clinic?
[AGENT][NEUTRAL] OK, let me.
[CUSTOMER][NEUTRAL] For a 26 service, I think.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so it's asking.
[AGENT][NEUTRAL] It says receipt of the reference claim is acknowledged. However, in order for us to process this claim, we need the explanation of benefits that matches the claim in.
[CUSTOMER][NEUTRAL] I sent that already multiple.
[AGENT][NEUTRAL] That matches the claim information.
[CUSTOMER][NEGATIVE] I don't see why it's not matching. What do you mean it doesn't match?
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] I can't see the information right, I can't see the information that was sent in. I can only, you know, verify how the claim was processed, but that's what it's asking for.
[CUSTOMER][NEUTRAL] Because the date's there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yes, I understand that's why it's frustrating.
[CUSTOMER][NEUTRAL] Yeah, but if you can't see it, how can you help me?
[AGENT][NEUTRAL] I can give you the remarks on the claim now if you need me to, I can get somebody from the claims department to call you back and they can go over the claim with you.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold while I get that information ready and get the request sent in. I'll be right back with you, OK?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Thank you. Mhm.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII] can you see.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you very much Ms. [PII] for holding for me. So I do have that request sent in for somebody to give you a call back a claims specialist.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you should be receiving a call within 24 hours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 24 hours. OK. Should I, um, can they, are they gonna leave a message?
[CUSTOMER][NEUTRAL] Because yeah, I get a lot of scam calls, so I don't pick up. I just wanna make sure that they would leave a message.
[AGENT][NEUTRAL] Uh-huh, yes.
[AGENT][NEUTRAL] Right, if they, if you, if you don't pick up, they will leave you a message. Yes, ma'am.
[CUSTOMER][NEUTRAL] If I don't pick up
[CUSTOMER][POSITIVE] Oh, perfect. Thank you so much. OK.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with, Miss [PII]?
[CUSTOMER][POSITIVE] No, that's nothing else. Thank you.
[AGENT][POSITIVE] All right, well, you have a good week and thank you for calling APL ma'am.
[AGENT][NEUTRAL] Mm bye-bye.