AccountId: 011433970860
ContactId: 7e3512c1-0b18-44c8-869e-643af71d4ee9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 470660 ms
Total Talk Time (AGENT): 154029 ms
Total Talk Time (CUSTOMER): 132905 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/7e3512c1-0b18-44c8-869e-643af71d4ee9_20250514T19:54_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, I'm calling. I filed a claim.
[CUSTOMER][NEGATIVE] Oh, several months ago and then it got sent back and I needed something else, but I heard from them yesterday and they paid on two separate dates but they did not pay on a 3rd.
[CUSTOMER][NEUTRAL] Anyway, I'm just calling about the claim.
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][NEUTRAL] 9 A.
[CUSTOMER][NEUTRAL] 95556
[AGENT][NEUTRAL] OK. Can I verify your name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. And can you give me a good callback number in case we are disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, just need to verify two other pieces of information. What is your address and email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Are these claims for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see. Um, yes, I see that we processed one claim.
[AGENT][NEUTRAL] Um, made a payment of 672, and then did you say there was another one that we denied that you were checking on?
[CUSTOMER][NEUTRAL] The one for [PII], you have on the remarks.
[CUSTOMER][NEUTRAL] That I needed a pathology report.
[CUSTOMER][NEUTRAL] And I've already sent that I sent it with the other two.
[AGENT][NEUTRAL] Uh, just for looking over these, seeing what I can.
[AGENT][NEUTRAL] What's going on here? Um, just give me one moment.
[AGENT][NEUTRAL] OK, let me pull up what we received and see if I can locate that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I see the pathology report. Um, I'm not sure what.
[AGENT][NEUTRAL] Um, do you mind if I get you transferred to our claims department and they can, um, review this claim? Not sure why, saying we need the pathology report because I see it in here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, can you hold on one moment?
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII] on the care team. I was gonna see if you can help me with a claim.
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][NEUTRAL] That's 97675.
[CUSTOMER][NEUTRAL] On a [PII].
[AGENT][NEUTRAL] Yes, um, it's for the most recent claim that 359-876-9.
[AGENT][NEUTRAL] Um, the, the denial code says we need the pathology report, but I see it on on Base and on-base, so I'm not sure if I, I'm missing something or what's going on.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] So you see the path for the [PII]?
[AGENT][NEUTRAL] Um, let's see, I've got.
[CUSTOMER][NEUTRAL] Let me pull up the mail.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] See what we got on that piece of mail. OK, let me pull it up and see.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Well, it says no evidence of residual basal cell carcinoma.
[CUSTOMER][NEUTRAL] Yeah, looks like this wasn't the uh the initial path report. We need the initial path report. Looks like this was another one, another biopsy that they done.
[AGENT][NEUTRAL] Why?
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Yeah, it looks like they're, I guess maybe.
[AGENT][POSITIVE] OK. OK. So this one doesn't say actual cancer. OK. OK, that makes sense. OK, perfect. OK, thank you so much.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It doesn't. Nope.
[CUSTOMER][POSITIVE] Mhm. You're welcome.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] OK, so sorry about that. OK, I do see the pathology report, but is there a separate one that you have because this one that was sent, it says no evidence of residual basal cell carcinoma.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if you have the original path reports, that's
[AGENT][NEUTRAL] Shows cancer or cause that's, that's what we're going on.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK, for the [PII] 1 is the one you're looking at?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] And it and it says what?
[AGENT][NEUTRAL] It says collected.
[CUSTOMER][NEUTRAL] The, the pathology report.
[AGENT][NEUTRAL] Yeah, it says inflammation and fibrosis consistent with prior sight, no evidence of residual basal cell carcinoma.
[CUSTOMER][NEUTRAL] OK, so I'll see what else I need to get.
[AGENT][NEUTRAL] OK, yeah, if we can just get something that indicates that, that's, that's what we're looking for, so.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, so what it's.
[CUSTOMER][NEUTRAL] Tell me again what it says so I can tell the people, no, no cancer shown or what?
[AGENT][NEUTRAL] Um, no.
[AGENT][NEUTRAL] Yes, no evidence of residual basal cell carcinoma.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I will get that with them and see what we need. Thank you so much for your help.
[AGENT][NEUTRAL] OK, anything else I can help with today?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] OK, well, thank you so much for calling API. Hope you have a great afternoon.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye bye.