AccountId: 011433970860
ContactId: 7186a9a2-abab-4b04-8d3d-d738c115f3fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 495899 ms
Total Talk Time (AGENT): 234072 ms
Total Talk Time (CUSTOMER): 187856 ms
Interruptions: 6
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/7186a9a2-abab-4b04-8d3d-d738c115f3fd_20250618T14:31_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi. Um, I
[CUSTOMER][NEUTRAL] I am trying to figure out how to um.
[CUSTOMER][NEUTRAL] Put put the rest of the information in for my daughter's claim. I see it's on here. It's um pending or there's something that says processed and then it's saying it needs more documents. Where would I upload those documents? And I, I'm sorry.
[AGENT][NEUTRAL] Can I have a policy number cause it sounds like you're frustrated. It sounds like you're about to cry. So we're gonna help you with this. What, let me get the policy number. It's not, we're gonna get it together.
[CUSTOMER][NEUTRAL] OK, I just haven't had to do this before, so I'm just not sure. It's 231-0082.
[AGENT][NEGATIVE] Yeah, you sound frustrated. You can't let it get the best to you.
[AGENT][NEUTRAL] What's your name?
[CUSTOMER][NEUTRAL] Computers sometimes [PII].
[AGENT][NEUTRAL] And [PII], what is your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII] and it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I've never saw this type of policy before. What type of policy? So which policy are you calling about? So what type of claim are you submitting so I can verify what type of policy? Because you have several policies.
[CUSTOMER][NEUTRAL] Um, accident.
[CUSTOMER][NEUTRAL] It's the accident.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] [PII], what is your daughter's name and date of birth so I can pull it up?
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so let me see.
[AGENT][NEUTRAL] OK, before I start, [PII], what is the email address that we have on file for you and a good call back number?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] Thank you, let me see what's going on with your claim.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] In order to complete the processing of your claim, we need an itemized statement of services provided listing your charges diagnosis.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] Do you, so what do you have? What are you uploading?
[CUSTOMER][NEUTRAL] I have all of the explanation of
[AGENT][NEUTRAL] What do you have to upload?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All of the explanations of benefits. I have all of those for her, you know, her initial treatment, her surgery, all of that stuff. And then I also have the documents regarding the fact that she was in an organized sport.
[AGENT][NEUTRAL] Do you have something from the facility?
[CUSTOMER][NEUTRAL] That I need to upload
[AGENT][NEUTRAL] I don't think they need that documentation about the sports, but do you have something like, when they say an itemized statement or it's something like, do you have like, so what type of clinic did she go to? Did it, was it an urgent care or ER visit?
[CUSTOMER][NEUTRAL] Um, she went to a, um, orthopedic.
[CUSTOMER][NEUTRAL] After hours office.
[AGENT][NEUTRAL] So, do you have a patient portal?
[CUSTOMER][NEUTRAL] And then she starts seeing an orthopedic doctor.
[CUSTOMER][NEUTRAL] I have the itemized explanation of benefits from the insurance company that shows all the charges and services.
[AGENT][NEUTRAL] Mm, we need something from you.
[AGENT][NEUTRAL] We need, see, we need a diagnosis like the reason that she was there on diagnosis code, which is the ICDT code.
[AGENT][NEUTRAL] Um, I'm trying to see, does she have a patient porter? Have you ever established a patient portal for her for the physician's office?
[CUSTOMER][NEUTRAL] Yeah, um, but there's multiple different physicians, so she saw lot, lots of people and with the surgery and everything. It's not all in one place, unfortunately. Let me just
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So, on that, on that, on the patient porter, there should be like after visit summaries.
[CUSTOMER][NEUTRAL] Get on with this one.
[AGENT][NEUTRAL] Of each visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you can download each one of those, save it to your file, save it to a file, and once you have downloaded all of them for each visit, you can upload it in the system. It should be an option for you to upload additional documents. Is that, is there an option online?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] On your system, that's what I'm trying to find out. I don't see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know where I would do that.
[AGENT][NEUTRAL] Oh, you're not aware of this. So how did you submit the claim here to us?
[CUSTOMER][NEUTRAL] No, I submitted the claim.
[CUSTOMER][NEUTRAL] And then I wanted to add the rest of the documents, and I don't see any place for me to upload those.
[AGENT][NEUTRAL] So what do we ask you to do, file a claim?
[AGENT][NEUTRAL] Is that what it's saying file a claim because I, I haven't, I don't look so just click that because if it's not an option for like a like I know with the insurance company that I'm with it says additional documents, um, what.
[CUSTOMER][NEUTRAL] Um, yeah, it tells me you have to file a new claim.
[AGENT][NEUTRAL] Are you on [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Is that
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] The, yeah, [PII], yeah.
[AGENT][NEUTRAL] Because I don't see the website, so let me pull it up because.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] Claims and forms.
[CUSTOMER][NEUTRAL] And I sent that claim form to the doctor too.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I that
[AGENT][NEUTRAL] OK, claims and forms. So I guess you would because it don't look like it has an option for you to uh well, I, I don't have an account so I don't know if what it says when you log in, so, um.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] I guess you would file a claim.
[AGENT][NEUTRAL] It wouldn't be a new claim. It may be look like it's a new claim for you, but it won't be for us here it just be additional information so I guess you could just go like you're filing a claim and upload everything.
[CUSTOMER][NEUTRAL] I did.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I will do that. I'll try that and we'll separate.
[AGENT][NEUTRAL] You want me to, I can walk you through it while we're on the phone cause I'm, I'm here till [PII]
[CUSTOMER][NEUTRAL] Oh no, that's OK because I'm gonna, I'm gonna gather all of that and make sure it's all in one folder here so I can just upload it since I have to grab some of those other receipts. All right, I will try that thank you.
[AGENT][NEUTRAL] Yes, so cause, right, because that um on those, the office visits, the, the summary, it should have the diagnosis codes on there. It looks like that's what they're requesting from you, the diagnosis codes.
[CUSTOMER][NEUTRAL] OK. I will pull those and I'll just upload everything I have and let someone smarter than me figure it out. How does that sound?
[AGENT][NEUTRAL] No, no, no, no, you're gonna get it. You're gonna get the knowledge of it. And we're gonna take a deep breath in and blow out cause this, this computer is machine is not gonna get the best of us today, [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] You're gonna get the best of it.
[CUSTOMER][NEUTRAL] Yeah. They, they always.
[CUSTOMER][POSITIVE] They always get the best of me. They laugh at me at work because I can, can break something in about 2 seconds on the computer. But I'm gonna try. But thank you so much. I'll just try uploading that and then they can, can.
[CUSTOMER][NEUTRAL] Maybe match it from there, so.
[AGENT][POSITIVE] All right, well, it was a pleasure speaking with you. Thanks for calling APL and you have a great day.
[CUSTOMER][NEUTRAL] Who
[CUSTOMER][NEUTRAL] You too