AccountId: 011433970860
ContactId: 68bc99ed-51bc-4886-bae7-337b095aef83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 465329 ms
Total Talk Time (AGENT): 90372 ms
Total Talk Time (CUSTOMER): 122246 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/68bc99ed-51bc-4886-bae7-337b095aef83_20250606T14:45_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing good. Um, I have an insured's mother on the other line. She's trying to figure out what we're looking for to process this claim. Um, can you look at this with me, or, oh, I'm gonna have to transfer her because I don't know what else to tell her, but, uh.
[AGENT][NEUTRAL] OK, what's your policy number?
[CUSTOMER][NEUTRAL] It's 244-622-2.
[CUSTOMER][NEUTRAL] It's for part two.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] See, we denied it.
[CUSTOMER][NEUTRAL] And it's the last claim we process and the first claim we processed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you say we need evidence of the documented evidence of cover a document.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So when I pulled up the last claim that we processed, all we received was like, it's just a letter from the doctor.
[CUSTOMER][NEUTRAL] So then I told her, you know, I, after I told her what I saw, I gave, I told her to deny reason and what we need and then she said, well, I already sent all that in. So I looked at the first claim we processed.
[CUSTOMER][NEUTRAL] And I mean on the claim form, it does give a description and she has like physical therapy notes and stuff. Is there a particular type of notes we're looking for? I didn't know what else to tell her.
[AGENT][NEUTRAL] Give me one second. I'm trying to pull it up my own place. It's going slow.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, mine is too.
[AGENT][NEUTRAL] I found it crazy.
[CUSTOMER][NEUTRAL] Very.
[AGENT][NEUTRAL] [PII] down to my camp for see for the following overuse injury extra with that basketball da da da.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One second, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] OK, nothing there. Alright, send her on over. Let's see what we got here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] All right, hold on one moment. Thank you.
[CUSTOMER][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Alright, thank you so much for holding I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII], and how can I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I need a [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I was calling about my son, [PII]'s playing.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, the lady I spoke with.
[CUSTOMER][NEUTRAL] You know, she thought for herself that there's been a, there's a lot of documentation that's been sent in for his claim and it was processed for $0.
[AGENT][NEUTRAL] OK, and this was for an accident that he had on uh [PII], is that correct?
[CUSTOMER][NEUTRAL] Oh, this is in May.
[AGENT][NEUTRAL] He had an accident in May also.
[CUSTOMER][NEUTRAL] [PII], it should be just one.
[CUSTOMER][NEUTRAL] Checks on the [PII].
[CUSTOMER][NEUTRAL] Yeah, I think it was buzz back in February. Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and so the information that was sent in in May, that was just the diagnosis code for the accident in February, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes. I also sent in um the information from the physical therapist and everything cause he had to go, he had to do 10 weeks of physical therapy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he had X-rays done, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One second, I'm reviewing the information that was sent in.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And Ms. [PII], is there any way I can give you a call back, uh, let me research this one to see exactly what we're needing to finish processing the claim and then I'll give you a call right back.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what's a good call back number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, uh, give me just a second to get try to get this research and then I'll give you a call back so you know exactly what we're needing.
[AGENT][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] Now, if I don't answer, can you just leave a voicemail because I have to go to the store.
[AGENT][POSITIVE] OK. Yes, ma'am. I can do that.
[CUSTOMER][NEUTRAL] So I may or may not answer.
[AGENT][POSITIVE] OK, I can do that. No problem. Bye bye.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Uh,