AccountId: 011433970860
ContactId: 75e777da-1e84-41f1-baad-ca9e6ae8224e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 290279 ms
Total Talk Time (AGENT): 134939 ms
Total Talk Time (CUSTOMER): 96091 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/75e777da-1e84-41f1-baad-ca9e6ae8224e_20250225T15:58_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, I'm calling regarding uh a claim. Um, I just received a text message saying that it was, it was completed, but then when I clicked on the um on the link it says, um, actually let me give you the uh claim number.
[AGENT][NEUTRAL] All right. What's that claim number, sir?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 356.
[CUSTOMER][NEUTRAL] 7717.
[AGENT][NEUTRAL] And what is your name and date of birth, please?
[CUSTOMER][NEUTRAL] First name [PII], last name [PII], and [PII].
[AGENT][NEUTRAL] All right. Thank you, Mr. [PII], and can you verify your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII] was the last thing you asked me?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Email you were doing good.
[CUSTOMER][NEUTRAL] Email
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Um, oh, I'm sorry, email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] I appreciate that verification.
[AGENT][NEUTRAL] Now, uh, when you receive that text message, it does take up to 24 hours to be able to view on our policy. You'll get uh instant.
[AGENT][NEUTRAL] Notification once the claim has been processed, but it does take up to 24 hours to be able to do so but I am looking at that and they're needing an itemized statement of services providing the listing the diagnosis code. Was this for an.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] Yeah, I saw that on the thing.
[AGENT][POSITIVE] Yeah, that's what's needed.
[CUSTOMER][NEUTRAL] I thought I faxed this, I thought I faxed this over um.
[CUSTOMER][NEUTRAL] It was a bunch of pages. They had to be about 89 pages last week. They had the, um, so the UVO4 that has all the diagnostic codes, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Yeah, so I did send that over.
[AGENT][NEUTRAL] OK, let me check.
[AGENT][NEUTRAL] Let's take a look.
[AGENT][NEUTRAL] Give me just one moment to pull that up if you don't mind.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then in the future just to let you know it an option is to let the hospital file for the benefits as well and then we pay them direct. So that's also an option for the next time.
[CUSTOMER][NEUTRAL] OK, wouldn't that come directly to me though, the payment?
[AGENT][NEUTRAL] So if the hospital files a claim, it would go directly to them. If you file a claim, then it comes directly to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's what, that's what, why would the hospital file a claim but uh it's all paid.
[AGENT][NEUTRAL] Just sometimes it's, yeah, sometimes it's just easier and then the payment goes directly to them.
[AGENT][NEUTRAL] But, uh, it's just an
[CUSTOMER][NEUTRAL] And then they said
[AGENT][NEUTRAL] Just an option.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm looking now. I see the itemized bill, so let me continue to check. I don't see the UBO4 yet.
[AGENT][NEUTRAL] But I'm gonna continue to check, so bear with me just one second.
[AGENT][NEUTRAL] I do see the itemized hospital bill.
[AGENT][NEUTRAL] But it does not have the diagnosis code listed.
[CUSTOMER][NEUTRAL] Oh, it doesn't, OK.
[AGENT][NEUTRAL] So the UBO4 is actually the same claim that the hospital uses same form that they use to submit claims, but I don't see it on file.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But you, do you have that UBO4 available?
[CUSTOMER][NEUTRAL] I, uh, actually, do I have it here? Is it no I actually left it at the office, but um.
[CUSTOMER][NEUTRAL] I mean, I can
[CUSTOMER][POSITIVE] I think I can redownload it again.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes sir, you can upload it directly on your policy you have that active online account right?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] If you've got it just upload it on your policy and they'll continue processing the claim.
[CUSTOMER][NEUTRAL] OK, so.
[AGENT][NEUTRAL] That's what they need.
[CUSTOMER][NEUTRAL] Alrighty, yeah, because like I said I sent, um, I mean unless there were a couple pages missing so um.
[CUSTOMER][NEUTRAL] Alright, um, I'll, I'll have to look into it, um, I, I'll call back thank you.
[AGENT][POSITIVE] My pleasure. Is there anything else I can help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, I think I'm all set.
[AGENT][POSITIVE] Well, thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.