AccountId: 011433970860
ContactId: 73b45498-7260-40eb-bfd0-a1fdd1786316
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378910 ms
Total Talk Time (AGENT): 101425 ms
Total Talk Time (CUSTOMER): 186953 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/73b45498-7260-40eb-bfd0-a1fdd1786316_20250214T15:26_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] in Broker Resources. I have [PII], uh, with our one of our broker's offices calling to see if this gentleman has filed a claim. I guess he gave her a claim document because he doesn't know if it was filed with us, and I told her I can't see the claims and I would get someone from claims to help her. Um, let me give you the policy number. Let me know when you're ready.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] OK, it's 245-7924.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she said the data service she says it's, let's see I wrote down December but I guess I didn't write down the date um it's [PII] OK it's Reyes radiology. Her callback number is [PII] and I will pull her on the line when you're ready.
[AGENT][NEUTRAL] That's fine.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK, hold on one second.
[CUSTOMER][POSITIVE] [PII], yes, hi, I have [PII] from our claims department on the line and she's gonna help you with that, OK? Have a great day. Thank bye bye.
[AGENT][NEUTRAL] Hi [PII]. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I was calling to find out about, um, find out whether or not a, a member of one of our groups has filed a claim with you. He doesn't know if he did or not.
[AGENT][NEUTRAL] OK, I can help you with that. Is it on his, uh, medical, accident, dental?
[CUSTOMER][NEUTRAL] Medical, this group didn't have any other.
[CUSTOMER][NEUTRAL] So she transferred you and didn't give you any of the information, the group number nothing, right?
[AGENT][NEUTRAL] She gave me the policy number, but the policy number she gave me was for an accident policy. That's why I was asking.
[CUSTOMER][NEUTRAL] No, it's 21042 Exotech.
[CUSTOMER][NEUTRAL] It's not an accident policy.
[AGENT][NEUTRAL] And who's the patient's name?
[CUSTOMER][NEUTRAL] The Last name is [PII] [PII] is the first name.
[AGENT][NEUTRAL] OK, hold on just a moment. I didn't pull that name up. 02457.
[AGENT][NEUTRAL] Are you calling about like a policy, a certain person's policy that was send the claiming?
[CUSTOMER][NEGATIVE] I, I'm calling. This is a I can't believe that. I just went through 10 minutes with somebody they, they ignored everything I said and transferred me to claims, and now I like I, I am a broker. I'm calling about one of our groups. The policy number is 21042. The group is called Exotech.
[CUSTOMER][NEUTRAL] Within the group we have a member who is not sure whether he filed a claim for a particular date of service and I'm trying to find that out.
[AGENT][NEUTRAL] OK, and I'm trying to help you and I have to find his policy number to look up the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know that I only know the group's name and the group group number. I don't have [PII]'s individual so I don't have his individual group number for his policy.
[AGENT][NEUTRAL] OK, do you have his social?
[AGENT][NEUTRAL] OK. And his name is [PII], is his first name, and what's his last name and I.
[CUSTOMER][NEUTRAL] [PII] If you need his social, I can look it up. I wasn't told I needed any of that, so if you need his social I.
[AGENT][NEUTRAL] That's OK, hold on, I'll try to look it up by his name.
[CUSTOMER][NEUTRAL] I have a social in front of me if you need it.
[AGENT][NEUTRAL] OK, I'll take the social then.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment please.
[AGENT][NEUTRAL] OK, and what date service was it for, do you know?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] No, ma'am. I do not see a claim for that data service.
[CUSTOMER][NEGATIVE] And never filed.
[CUSTOMER][NEUTRAL] OK, OK, he never filed the claim, so since he already went to the doctor and everything, he would need to contact APL to file the claim directly, right?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] He doesn't need to contact us, he just needs to send in an itemized bill with procedure code and diagnosis code and his explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From United Healthcare.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, hold on for me one second, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So many windows open.
[CUSTOMER][NEUTRAL] What is going on here?
[CUSTOMER][NEUTRAL] Um, OK, where would he send that information?
[AGENT][NEUTRAL] He can upload it on our online service center or he can fax it or he can mail it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and what's the customer service number for him to call?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] If he needs help with the portal mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It can't be emailed correct?
[AGENT][NEUTRAL] No, ma'am. We're not taking email. Right.
[CUSTOMER][POSITIVE] It can only be uploaded. You got it. Yeah, no problem. I just wanted to get, let them know they have a new HR person and she doesn't really understand, so I just wanted to give her all the rules. OK, thank you, thank you so much.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] You're welcome. Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.