AccountId: 011433970860
ContactId: 68203bc9-2c76-4d81-9f34-0693ad850b6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318959 ms
Total Talk Time (AGENT): 155224 ms
Total Talk Time (CUSTOMER): 110399 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/68203bc9-2c76-4d81-9f34-0693ad850b6c_20241231T15:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm a broker. I'm just calling to check on a claim for one of our customers.
[AGENT][NEUTRAL] I can help you, [PII]. And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, it is 249-5072.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you and can you verify the uh employee's name and date of birth for me?
[CUSTOMER][NEUTRAL] Um, the employee is [PII]. Um, I could tell you his last 4-6988. He lives at [PII]. For some reason my file attachments is not showing on here for date of birth.
[AGENT][NEUTRAL] OK, OK, and verify the city and state and zip for me for the address.
[CUSTOMER][NEUTRAL] For the address it is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Is the claim for [PII] or a dependent?
[CUSTOMER][NEUTRAL] It actually is for as dependent [PII], and I think we paid this like 2 months ago. I'm just trying to double check.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is the data service?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] See if I see it on here.
[CUSTOMER][NEUTRAL] I have written down 9:30 and 10:14. Let me see why I have that normally on my APL site I have my attachments, but under files it's saying the um no files for me to view.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No worries, let's see you said the date of service is in September or July?
[CUSTOMER][POSITIVE] I love
[CUSTOMER][NEUTRAL] Yes ma'am, I believe so, um, it should be the only one for [PII] or or any claim I believe under this policy, so it should show up under claim number 761 and 901.
[AGENT][NEUTRAL] OK, so that's date of the date of service is [PII] or [PII]. I do see the claim numbers.
[CUSTOMER][NEUTRAL] Last 3.
[CUSTOMER][NEUTRAL] OK, perfect. It, it, I'm not sure which one it might be both.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] 27 6.
[AGENT][NEUTRAL] So I have 351-9761 and what was the other claim number?
[CUSTOMER][NEUTRAL] 351-4901. Yes ma'am.
[AGENT][NEUTRAL] 4901.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's all related to the same data service we were just requesting additional information looks like, so we're gonna go with the 351-9761. That was the last time this date of service was processed.
[AGENT][NEUTRAL] And that was on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is from.
[AGENT][NEUTRAL] Cotiana Acute Care?
[CUSTOMER][NEUTRAL] I believe so.
[AGENT][NEUTRAL] OK, so it was an emergency room physician's charge.
[AGENT][NEUTRAL] And just outpatient, let me check to see.
[AGENT][NEUTRAL] Um, looks like the, um, we paid 100, but I believe it was because the outpatient maximum benefits for emergency room.
[AGENT][NEUTRAL] No, the maximum benefit for the emergency room is $100.
[CUSTOMER][NEUTRAL] OK, so we did pay $100 on this one?
[AGENT][NEUTRAL] Oh we did pay $100.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's perfect. That's all I needed to know is make sure that it was actually processed because this is one that fell between the cracks. I didn't know if it was actually paid, so that one was paid.
[AGENT][NEUTRAL] OK, and it, it was processed under the claim ending in 9761.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome do you show that the check was cashed?
[AGENT][NEUTRAL] Let me check that for you.
[AGENT][POSITIVE] On my end I still show that it's outstanding and it was issued to [PII].
[CUSTOMER][NEUTRAL] OK, so that might be why they were asking questions. OK, so it was sent.
[AGENT][NEUTRAL] And let me look at.
[AGENT][NEUTRAL] Uh, go ahead.
[CUSTOMER][NEGATIVE] Uh, so it was sent out but it was never cashed so it could be a situation where they never received it.
[AGENT][NEUTRAL] Correct, um, and I can verify whether it has been cashed. If not, we can reissue the check, um, and the address that you provided is correct, it hasn't changed, right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] As far as you, OK.
[AGENT][NEUTRAL] So we can verify whether it has cleared.
[AGENT][NEUTRAL] And if we get record uh note that it hasn't then we can void this check and get it reissued and mailed to the address that was verified.
[CUSTOMER][POSITIVE] OK perfect that's perfect.
[AGENT][NEUTRAL] I'm gonna go ahead and do that.
[AGENT][NEUTRAL] Since this was back in October.
[AGENT][NEUTRAL] And so it usually takes um we're closed tomorrow we'll make the request today.
[AGENT][NEUTRAL] Um, but the check, if it has not cleared, it'll probably be reprocessed, um, after the [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm. The check may be reissued after the [PII].
[AGENT][POSITIVE] Since we're closed tomorrow. OK, very good.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] And did you have any other questions, [PII]?
[CUSTOMER][POSITIVE] No, ma'am, that's it. I appreciate your time.
[AGENT][POSITIVE] Oh, absolutely. Thank you for calling ATL and have a happy holiday, OK, and a happy new [PII].
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][NEUTRAL] Uh-huh, bye-bye.
[CUSTOMER][NEUTRAL] OK bye bye.