AccountId: 011433970860
ContactId: 8df33c06-46bd-4340-9b1d-4b97f20ad267
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 526159 ms
Total Talk Time (AGENT): 126974 ms
Total Talk Time (CUSTOMER): 50423 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/8df33c06-46bd-4340-9b1d-4b97f20ad267_20250113T21:59_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] So I'm checking on claim number 353-6335.
[AGENT][NEUTRAL] OK, and you're calling from a provider's office or this is your personal policy?
[CUSTOMER][NEUTRAL] It's my personal policy.
[AGENT][NEUTRAL] OK. May I have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, let me.
[AGENT][NEUTRAL] OK, for security, may I have your date of birth, the email address and mailing address on file?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII]
[AGENT][NEUTRAL] Thank you. OK, so it looks like um that is a request for medical records.
[AGENT][NEUTRAL] That we have sent out and how may I assist you with this claim?
[CUSTOMER][NEUTRAL] It was sent already.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] The medical records were sent already.
[AGENT][NEUTRAL] OK, let me check and see if we received this one moment.
[CUSTOMER][NEUTRAL] And this was back since November. You mean to tell me that not since November you have guys have not received medical records.
[AGENT][NEUTRAL] Um, bear with me. Let me go through the notes and see if we have or not. OK, one moment. The number you.
[CUSTOMER][NEUTRAL] That's a long time.
[AGENT][NEUTRAL] Yeah, the number you gave me, uh, the, the information you gave me, just pulled that document indicating that we asked for medical records, but I'll have to go through the account to see if anything else happened.
[AGENT][NEUTRAL] Bear with me.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me pull this other document and see what it is. Do you mind holding for me?
[CUSTOMER][NEUTRAL] No, I don't.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding and being patient for Ms. [PII]. OK, so, uh, yeah, the most recent documents is a claim you submitted, um, recently. Um, we have not received the, the medical records. It looks like the medical records request was sent in on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I know, but when I called the lady whoever I spoke with, I don't even know if she noted the account, she said I could send them in, so I printed them and sent them in.
[AGENT][NEUTRAL] OK, I pulled the the information you sent in.
[AGENT][NEUTRAL] Um, let me check, um, if I see the UBO4.
[AGENT][NEUTRAL] I have the emergency documentation. Let me see if I got the medical records.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so it looks like you sent the, the um emergency documentation, um, you send 35 pages, um.
[AGENT][NEUTRAL] I'm not sure if that's why she's gonna need to process the claim because usually when we ask for medical records, we um we get the medical records directly from the hospital. Um.
[AGENT][NEUTRAL] And whenever we receive documents, it takes 7 to 10 business days for it to be processed and we receive this on the [PII].
[AGENT][NEGATIVE] The deal not review.
[CUSTOMER][POSITIVE] OK alright thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I'm gonna help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] Yeah. Thank you.
[AGENT][POSITIVE] OK, you're welcome. Thank you for calling APL. Have a good afternoon, Mr.