AccountId: 011433970860
ContactId: 74291caa-85d6-4d01-a014-2365d41a9d74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 318070 ms
Total Talk Time (AGENT): 130180 ms
Total Talk Time (CUSTOMER): 57479 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/74291caa-85d6-4d01-a014-2365d41a9d74_20250303T14:25_UTC.wav
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[CUSTOMER][NEUTRAL] I
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is An[PII]How may I help you?
[CUSTOMER][NEUTRAL] Yes, my name is uh Bo[PII]ma'am.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Uh, my name is Bo[PII].
[AGENT][NEUTRAL] Hi, Mr. Fi[PII]How may I assist you today?
[CUSTOMER][NEUTRAL] Yeah, I was gonna try and check out the uh status of my claim.
[AGENT][POSITIVE] OK, I can definitely help you with the claim status. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] 87[PII]
[AGENT][NEUTRAL] [PII]hank you for that and your policy number?
[CUSTOMER][NEUTRAL] It's 256-603-0.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] And can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] 0,[PII].
[CUSTOMER][NEUTRAL] Bo[PII]mailing address, I mean, uh, street address 90[PII].
[CUSTOMER][NEUTRAL] Oh, the PO[PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and the claim is for you or your or your wife?
[CUSTOMER][NEUTRAL] Oh, for me.
[AGENT][NEUTRAL] OK, so I see.
[AGENT][NEUTRAL] A claim that came in on Fe[PII]nd then a claim that came in on Fe[PII]Are you looking for the 27[PII]?
[CUSTOMER][NEUTRAL] Yeah, the one I faxed the rest of that paperwork off to y'all last week.
[AGENT][NEUTRAL] OK. Yes, I do see we received it on the tw[PII]It is in processing, but there hasn't been a decision yet, um, but we did receive it on last Thursday.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Was that the paperwork that y'all needed?
[AGENT][NEUTRAL] Let me see if there's a way for me to see it. Hold on one moment.
[AGENT][NEUTRAL] Medical history.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And Mr. Fi[PII]do you mind if I place you on just a brief hold? I'm just trying to see if I can access the documents that were sent in.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, wait a minute.
[AGENT][NEUTRAL] OK, so he's doing this for.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Mr. Fi[PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Alright, thank you so much for holding. I apologize for that wait. So yes, I do see the billing that was received and it does show the procedure codes and the diagnosis codes and all the charges, um, so that's what was requested. So yes, it's in processing now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So would I pay for some of those bills that I have or not?
[AGENT][NEUTRAL] Um, I, I, it's hard for me to answer that question because I'm not an examiner, but if something isn't, isn't paid, once they do examine it, you'll you'll receive the explanation of benefits with the denial reason, um.
[AGENT][NEUTRAL] But so far from what they asked, that's that's, that's what you submitted, so it's definitely all here.
[CUSTOMER][POSITIVE] OK, I should be able to get that, hopefully.
[CUSTOMER][NEUTRAL] How long do you know how long it takes for me to hear from them again?
[AGENT][NEUTRAL] So, we usually say for um our cancer claims is a 7 to 15 business day turnaround, but because this was already processed, this is just additional information, it might not take that whole time, we just say it just in case.
[CUSTOMER][POSITIVE] OK then. Thank you for your help, ma'am.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] I know I just get it done. That's all I say because I need it.
[AGENT][NEUTRAL] I know, I understand. Uh, well, as soon as it's finished processing, we'll give you the decision and I um I hope everything goes through for you, OK?
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][POSITIVE] Well thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Thanks for calling API Mr. Fi[PII]Have a great week.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Mm mm