AccountId: 011433970860
ContactId: 7163d18e-c840-474e-b3e6-7c753dc34926
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254589 ms
Total Talk Time (AGENT): 151262 ms
Total Talk Time (CUSTOMER): 109535 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/7163d18e-c840-474e-b3e6-7c753dc34926_20250331T17:02_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APO this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII]. I think you just left me a message.
[AGENT][POSITIVE] Yes, thank you so much for calling me right back.
[AGENT][NEUTRAL] Uh, how are you today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] Doing well, thanks for asking. OK, I was working on your claim and I saw that you have baby [PII] listed here, but we do not have a date of birth for him because I was gonna try to have him added to the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh sure, so it's uh [PII]. The, the claim I submitted was for the childbirth.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] OK, I just wanted to, to definitely make sure. And what about his last name, uh, so we can make sure that's correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII], [PII]
[AGENT][NEUTRAL] OK. All right. That's good. And one more thing, I don't have diagnosis codes for you or him. I know this is, I can tell that it is for the birth of a newborn, and I know he's a newborn, but we have to have something like from the facility. Um, maybe, do you have like your discharge papers from the hospital after you have the baby? OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do, I do actually have those. Would that be helpful to submit?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, it would so that way I can at least go ahead and look up a diagnosis code and get your claim paid for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I actually saw a form online to that for for like Medlink to allow you to reach out to the hos the hospital. Is that something I should fill out and send in as well?
[AGENT][NEUTRAL] Um, if we do reach out to them.
[AGENT][NEUTRAL] Uh, it would probably take longer than you sending in though because we would have to send them the authorization and then they may want us to request the medical records and I don't know how long that would take.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, fair enough, OK.
[AGENT][NEUTRAL] Very
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I'll, I'll go ahead and submit the, the discharge paperwork then for you and hopefully that'll have everything you need.
[AGENT][NEUTRAL] Mhm, yeah, I just need something that's showing, you know, that actually that there was a a birth that you went in due to a birth.
[CUSTOMER][POSITIVE] Yes, OK, I can send that in for you.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and I just hold on to this until I get that so that we don't have to keep going back and forth.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right. Is there anything else you need?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] That is it that I can see at this time.
[AGENT][NEUTRAL] And so I'm gonna go ahead and have uh [PII] added to the policy so that way we can try to get his claims processed as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Gotcha, gotcha. OK. And I actually have a question while I have you, so I tried to submit and back when my daughter was born. My daughter's 2 1/2 now. I, I tried to submit and didn't have the right paperwork and I kept just forgetting to go back and put it in. They never offered to to add her to the policy when I was submitting that paperwork, maybe because the paperwork didn't go through, um, but I plan to kind of come back and try to get if this works out with what I sent to you and it's everything that you need, then I can go back to the hospital and get the same.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Paperwork and submit for those old claims. Would I be submitting stuff for her as well, or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm, I was just confused on that.
[AGENT][NEUTRAL] I did see that there was some, um, yes, some charges back in [PII].
[AGENT][NEUTRAL] Uh, let me see what we were needing for some of those.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] And they just kept saying I didn't have the right paperwork submitted and then life happens and you've got a, a little baby, and I just, you know, kept forgetting to come back to it. Um, but now that I'm home again with a new, new one, I was like, oh well, I gotta try again. I have this, this benefit. I should be using it, right? You know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's correct. I agree. Uh, for the hospitalization for that baby, uh, the same thing that you sent us, uh, the explanation of benefits that shows the amount applied to your deductible and also the same thing, something from the hospital showing that you went in for, for a delivery.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Of the baby and also the explanation of benefits for the baby.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And uh I would need her her name, her full name and her date of birth as well so we can have her added to the policy also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All right, perfect. I'll work on gathering all of that. Thank you for, for explaining it further.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No problem.
[AGENT][POSITIVE] Alright then thank you so much for calling me back.
[CUSTOMER][POSITIVE] Alright thank you so much I'll submit that here shortly.
[AGENT][NEUTRAL] OK, bye bye.
[CUSTOMER][POSITIVE] You got it bye bye.