AccountId: 011433970860
ContactId: 8d39ebc2-dd66-4149-8740-5d78c5f4d8b9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 498489 ms
Total Talk Time (AGENT): 121668 ms
Total Talk Time (CUSTOMER): 155265 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/8d39ebc2-dd66-4149-8740-5d78c5f4d8b9_20250319T13:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. Sorry, I
[CUSTOMER][NEUTRAL] Um, I'm calling you guys back. I submitted two claims that you guys had to like resubmit and then request medical records from the facilities, and I got a voicemail back saying that you kind of were at a standstill because you weren't able to get the medical records.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, and unfortunately I wasn't able to call back right away and now I just see that like the cases have been closed.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Oh, let me take a look at them for you. Um, I can definitely check the claims for you and see if there's an update or let you know what we need to do next or get claims if we need to. May I have a good contact number in case we're disconnected, [PII]?
[CUSTOMER][NEUTRAL] Um, yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] Oh shoot, um.
[CUSTOMER][NEUTRAL] Can I give you my social or something else? I don't have to.
[AGENT][NEUTRAL] Sure, that's fine. Mhm.
[CUSTOMER][NEUTRAL] 355-764844.
[AGENT][POSITIVE] OK, hold on one moment, thank you for that.
[CUSTOMER][NEUTRAL] So I have a HIPAA release form signed for you guys to go and try and get more information, but apparently I guess um.
[CUSTOMER][NEUTRAL] Uh, the actual facility needs to have my consent to release it as well.
[AGENT][NEUTRAL] Wait a minute, wait, wait, wait. Let me, I want to make sure I'm following. You said you got a HIPAA consent, so, so that a HIPAA consent form for us?
[CUSTOMER][NEUTRAL] So I, so I signed a HIPAA consent so that you guys can go and get any kind of medical records if you needed to get any additional stuff. They reached out to.
[AGENT][NEUTRAL] Oh, you released information. OK, I got it. I'm trying to make sure I follow so I can give you the right thing.
[CUSTOMER][NEUTRAL] And yeah.
[CUSTOMER][NEUTRAL] And so then I guess that they reached out but then they were stopped because I guess the facility needs me to sign some sort of HIPAA release so that they would release the medical records to you guys. So I'm trying to figure out how to get in touch with like the medical records.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It's not that easy. Let me see, but I just don't know where we are with you guys.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] OK, let me, when I put in
[AGENT][NEGATIVE] There's nothing coming. Do you know, there's nothing coming up with the social. It might not be on there. It might not have came over with the social.
[CUSTOMER][NEUTRAL] It's, it's, it's probably under now that I'm thinking, I don't know if they have my name or my social associated because um it's my husband's policy.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Let me get that, let me get that, uh oh shoot.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Let me get
[CUSTOMER][NEUTRAL] I need to log on here to get the account number.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Policy number is 2145011.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, and I have you here and um [PII], if you can just verify your last name, your date of birth, and the mailing address on file.
[CUSTOMER][NEUTRAL] Last name is [PII]. Uh, date of birth is [PII].
[CUSTOMER][NEUTRAL] Um, address is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So the claims, are they for you or your husband or um one of the children?
[CUSTOMER][NEUTRAL] They're for me.
[AGENT][NEUTRAL] For you? OK, hold on one moment, let me go to you.
[AGENT][NEUTRAL] So would it be these two claims here that came in on [PII], these last two?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me take a look.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I look at the two claims?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEUTRAL] I'm gonna go run and grab a pen myself, so it's just, I, if I.
[AGENT][NEUTRAL] Oh, sure.
[CUSTOMER][NEUTRAL] I'll be right back.
[AGENT][POSITIVE] OK, take your time.
[CUSTOMER][POSITIVE] But you can go and do what you need to do too. I'll be right back.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, not that again.
[AGENT][NEUTRAL] So then it's really this claim.
[AGENT][NEUTRAL] DA 8258.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] What's the correspondence that we sent so I can know what's been sent out.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Why is everything going so slow? Come on.
[AGENT][NEGATIVE] What? Mm, something ain't right.
[AGENT][NEUTRAL] Oh no, we're gonna have to restart.
[AGENT][NEUTRAL] But I need to know.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] So is it just this or are all of them like this?