AccountId: 011433970860
ContactId: 81b51335-e329-45ed-a0c2-9409557a474e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 745840 ms
Total Talk Time (AGENT): 265861 ms
Total Talk Time (CUSTOMER): 272316 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/81b51335-e329-45ed-a0c2-9409557a474e_20250515T15:59_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So would you put me to Misty V please?
[AGENT][NEUTRAL] [PII], um, I can check and see if she's available. May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And let me have a call back number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, Mr. [PII], one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, she's in a call. Let me send her a message, OK? One moment. Do you have a policy number that I can provide to her?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, she, I've talked with her before. She called me back, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Working on that right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I do have a policy number. Uh, I'd have to pull it up. Hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Where do I have that?
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] That's not where it was. It was here.
[CUSTOMER][NEUTRAL] Come on.
[AGENT][NEUTRAL] OK, and I'm waiting on her response, OK?
[CUSTOMER][NEUTRAL] Policy number, I want to make sure this is a critical care.
[CUSTOMER][NEUTRAL] Yes, 18, uh, excuse me, 2182087.
[AGENT][NEUTRAL] OK. Um, Ms. [PII] is letting me know that she's in a meeting if she can call you back.
[CUSTOMER][NEUTRAL] Well, I'm trying to file a a I filed a critical.
[CUSTOMER][NEGATIVE] Claim file and they didn't.
[CUSTOMER][NEUTRAL] Connected correctly. I'm trying to fill out one of the uh files again.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And I'm having some issues. I just wanted to talk with her about it.
[CUSTOMER][NEUTRAL] So I don't know whether to talk with her or somebody.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, let's see what we can do.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] I'm gonna go ahead and pull your information and see if I can help you, OK?
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEGATIVE] You aggravate it, that's all calm down.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] But she can call you back if you want her to. No, it's fine. Yes, I understand, trust me. Mhm.
[CUSTOMER][NEUTRAL] Talking to myself.
[CUSTOMER][NEUTRAL] I'm just
[CUSTOMER][NEGATIVE] I, I don't understand the issue though.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] At any rate,
[CUSTOMER][NEGATIVE] It wasn't nice.
[AGENT][NEUTRAL] OK. And the claim is for, for yourself or for [PII]?
[CUSTOMER][NEUTRAL] It's for.
[AGENT][NEUTRAL] OK. All right. Um, let me verify some information with you. May I have your date of birth, mailing address and email address?
[CUSTOMER][NEUTRAL] Man, every time. [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I see that we have processed a claim and there is a direct deposit that is going in um probably today or tomorrow.
[CUSTOMER][NEGATIVE] Yeah, but it's, it's stupid. It's $50 is what they're sending.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And she had a heart attack.
[CUSTOMER][NEUTRAL] And she had uh CPR performed, then she was in the ICU. Then she had a stent put in on the right artery which was 90% blocked. And then I'd sent all this information in one time. I've already told this all to uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] M
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEGATIVE] I sent it all in and apparently they didn't.
[CUSTOMER][NEGATIVE] They said I uploaded it and I talked to a lady when I uploaded and sent it to y'all and everything said received and she said she had it. I asked her if I needed to fill out another form. She said no.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So now they're coming back and they say I need I need to fill out the critical illness claim forms.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, now I go through the critical illness claim form and it starts at, it's 9 pages, right? And then it starts with uh.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, where is it now?
[CUSTOMER][NEUTRAL] You know, it goes through all the different uh planes.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] And everything and it uh.
[CUSTOMER][NEGATIVE] Now I don't know what they need.
[CUSTOMER][NEUTRAL] What part of this they need, I know they don't need some of this that they're asking for in here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Looks like with the paperwork that they're sending, they're sending you the part or the form that you need to fill out. So I don't know if you wanna wait for that or if you want just to get the generic form and send it in, um, but I see that in the notes it's indicating that they're sending you the form that you need to fill out.
[CUSTOMER][NEUTRAL] Well, they sent me a form. That's what I'm trying to say, but all right, so in this form, in this form.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They're asking about bone marrow transplants, severe burns, cancer, cardiac arrhythma.
[CUSTOMER][NEUTRAL] And I don't need to fill all of that out, do I?
[AGENT][NEUTRAL] If it's not applicable.
[CUSTOMER][NEUTRAL] There's only portions of this.
[AGENT][NEUTRAL] Yeah, if it's not applicable, you don't have to fill that part out, no. You only will fill out the ones that are applicable.
[CUSTOMER][NEUTRAL] So coronary heart disease, heart attack.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Heart valve surgery, I guess, because she had a stent put in.
[AGENT][NEUTRAL] Yes, mhm. Mhm, yes.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, I don't need coma. I don't need car.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, cardiac arrhythmia, certified cardio recommended really don't get a heartbeat.
[CUSTOMER][NEUTRAL] I don't know whether that applies or whether it doesn't.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Loss of sight, loss of speech, all that. I don't need to fill out.
[CUSTOMER][NEUTRAL] Alright, and it says primary diagnosis says code.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] The diagnosis code you get through the doctor. You can just ask them to see what is that diagnosis code and just put it in the paperwork.
[CUSTOMER][NEUTRAL] Yeah, but I sent, I sent, I sent a complete bill.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I've sent a complete bill from the hospital, an itemized bill from the hospital. I sent an itemized bill from the Coronary Institute of the South.
[CUSTOMER][NEUTRAL] With all the doctors stuff with it.
[CUSTOMER][NEUTRAL] And y'all have that apparently.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] What the heck are you at? I don't know what.
[CUSTOMER][NEUTRAL] I don't know what you want.
[AGENT][NEUTRAL] OK, OK, uh, I'm gonna, um, OK, so [PII] is an examiner. She works in the claims department, OK? And so the examiners are the ones that process the claims and they're the ones that request any information that is needed.
[CUSTOMER][NEUTRAL] I think
[AGENT][NEUTRAL] So I think the best thing is to have [PII] um talk to you directly and explain to you exactly what she's gonna need because she works in that department where they process the claims. What I have in front of me is just the information indicating what is needed and what we have sent to you um for you to fill out and send back to us um but based on mhm.
[CUSTOMER][NEUTRAL] Well, if you look back and if you look back in that file.
[AGENT][NEUTRAL] We
[CUSTOMER][NEUTRAL] You'll see where I sent those documents on [PII], I mean [PII] I believe it was.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And y'all received it.
[AGENT][NEUTRAL] Um, yes, Mr. [PII], we, we don't handle the claim. We only have the information of the claim. So, yeah, Miss.
[CUSTOMER][NEUTRAL] I can't help it. I mean, you got to.
[AGENT][NEUTRAL] Yes, I understand. [PII] is the one that can give you that information because she goes and handles the claims she process claims so she can give you better information than we can in this department. So if you don't mind, let me go ahead and have [PII] call you right back once she's done with that meeting. Is that OK?
[CUSTOMER][NEUTRAL] Yes, but I'm, I'm trying to work and I can't do both.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] So I'm having a hard time getting in contact and all that stuff and apparently it's just a pain.
[AGENT][NEUTRAL] Yeah, oh, she, she's gonna call you if she cannot get you in the first try, she'll call you again. Um, I'll let her know that you're working and to call you several times until you answer, but yeah, she's the best person to talk to because she works in the claims and she can look at all the paperwork you send.
[AGENT][NEUTRAL] OK, she can do a review. OK? All right.
[CUSTOMER][POSITIVE] Very good.
[CUSTOMER][NEUTRAL] Do you have any idea how long that's ma'am? Do you have any idea how long that's gonna be?
[AGENT][NEUTRAL] I'm not
[AGENT][NEUTRAL] I'm not really sure because she's in a meeting right now. Um, again, I'm just exchanging messages for her. She's in a meeting but she is asking me to see exactly what you need. I did send the information on what you're needing and what's happening, and she just said that she will give you a call back once she's out of the meeting.
[CUSTOMER][NEUTRAL] Would you text her and see how long she's gonna be in that meeting because I work outdoors.
[CUSTOMER][NEUTRAL] And I'm gonna either leave and go do that or I'm gonna stay here and talk to her.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] But some of this doesn't make sense to me.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] I'm waiting for her response, OK.
[CUSTOMER][NEUTRAL] What?
[AGENT][NEUTRAL] OK, so she said it's gonna be um probably an hour, so around [PII].
[AGENT][NEUTRAL] To [PII].
[CUSTOMER][POSITIVE] Oh wonderful.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Nothing else I can do, so I guess that's what I'll do.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, but yeah, she'll be calling you back around that time, so you, you can just go ahead and be on the lookout for that call.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.