AccountId: 011433970860
ContactId: 8040ca97-91ae-47cd-a04d-36d8d1d13b9d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 438279 ms
Total Talk Time (AGENT): 92665 ms
Total Talk Time (CUSTOMER): 164838 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/8040ca97-91ae-47cd-a04d-36d8d1d13b9d_20250416T18:46_UTC.wav
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[CUSTOMER][NEUTRAL] a
[AGENT][POSITIVE] Thanks for calling APL. This is St[PII]How can I help you?
[CUSTOMER][NEUTRAL] Hey St[PII]uh, I had a question about, uh, explanation of benefits one that I got where they said that they need more information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I was trying to find I was trying to find out what additional information I need to provide.
[AGENT][NEUTRAL] OK, I can help you look at that claim. Um, do you have a policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, the policy number is 01206176.
[CUSTOMER][NEGATIVE] Don't care what your policy.
[AGENT][NEUTRAL] OK. And what was your name?
[CUSTOMER][NEUTRAL] Wi[PII].
[AGENT][NEUTRAL] OK, Mr. Tu[PII]and what is your birth date?
[CUSTOMER][NEUTRAL] 92[PII]
[AGENT][NEUTRAL] [PII]K, thank you. And do you have a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] 46[PII]
[AGENT][NEUTRAL] [PII]K, and just need 2 more pieces of information. What is your address?
[CUSTOMER][NEUTRAL] 72[PII].
[AGENT][NEUTRAL] OK, thank you. And lastly your email address?
[CUSTOMER][NEUTRAL] Wi[PII]If it's not that one, I have another one.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, looks like that's the correct one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK, and which claim are we looking at that you were questioning?
[CUSTOMER][NEUTRAL] Uh, we're looking at.
[CUSTOMER][NEUTRAL] Unit number 0 that's the that's the uh policy number claim number 358.
[CUSTOMER][NEUTRAL] 7044.
[AGENT][NEUTRAL] OK, let's pull that up.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, it looks like we made a payment on that for $100.
[CUSTOMER][NEUTRAL] Yeah, you did.
[AGENT][NEUTRAL] OK, let's see what.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] If you look at the uh
[CUSTOMER][NEUTRAL] Service uh description.
[CUSTOMER][NEUTRAL] I have uh one daily hospital benefit and then the other attending physician benefit, and I have one by those.
[CUSTOMER][NEUTRAL] The remarks
[CUSTOMER][NEUTRAL] And when I look at one, it says that in order to give consideration to this date of service, we will need more, we need a full itemized hospital slash facility billing with all charges fully identified. The, the, uh, attachment that I sent was a uh example of was was a statement.
[CUSTOMER][NEUTRAL] And it was for the date that I went in the hospital and the date that I was discharged.
[CUSTOMER][NEUTRAL] With all the information in between, so I'm from and they had some codes on there as well. So I'm trying to figure out what is it that what else.
[CUSTOMER][NEUTRAL] When they say fully automized.
[CUSTOMER][NEUTRAL] Uh, bill, what else do I need to send?
[CUSTOMER][NEUTRAL] Uh, other than that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, let me pull up what we received. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Can I place you on a brief hold?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, thank you. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you for holding um I need to get you over to our claims department they'll be able to look on the claim. I'm having trouble accessing it, um, and they'll be able to tell you exactly what what we need to get that processed. Um, do you mind if I transfer you over there?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, no problem.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is Ma[PII]peaking. How can I help you?
[AGENT][NEUTRAL] Hi, this is St[PII]n the care team. I've got a member on the line that has a question on what exactly is needed to get his claim processed. Um, I would try to help him, but my OnBase is not working, and I don't know if I, I, I'm gonna have to restart my computer, so I was gonna see if you could help him.
[CUSTOMER][POSITIVE] Certainly I'd be happy to St[PII]what's the policy number please?
[AGENT][NEUTRAL] Policy number is 1206176.
[CUSTOMER][NEUTRAL] And for Mr. Wi[PII]?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, and um, has he been verified, St[PII]?
[AGENT][NEUTRAL] Yes, I've verified him.
[CUSTOMER][NEUTRAL] OK, and that phone number listed on the 46[PII]s this call back?
[AGENT][NEUTRAL] Yes, and then I've got the claim number.
[CUSTOMER][NEUTRAL] Sure, go ahead with that when you're ready.
[AGENT][NEUTRAL] Uh, claim number is 3587044.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, and I will take it from here when you're ready, go ahead and transfer.
[AGENT][POSITIVE] OK, thank you so much. Here he is.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hi, good afternoon, Mr. Tu[PII]Yes.