AccountId: 011433970860
ContactId: 8e89d0f5-4181-49ef-ac90-97538d5ec1ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 930219 ms
Total Talk Time (AGENT): 208995 ms
Total Talk Time (CUSTOMER): 207135 ms
Interruptions: 3
Overall Sentiment: AGENT=1.8, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/8e89d0f5-4181-49ef-ac90-97538d5ec1ca_20250115T20:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII] policy number 025.
[CUSTOMER][NEUTRAL] 04490
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I'm wondering about the benefits payment on, uh, my medical claim.
[AGENT][POSITIVE] OK, yeah, I can check on that claim for you [PII]. uh, really quick, can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And I'm just gonna verify some information really quick. Uh, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address that we've got on file for you. uh, looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you so much for verifying that information [PII]. Alright, give me just a moment let me check this claim.
[CUSTOMER][NEGATIVE] And I'm not good at email.
[AGENT][POSITIVE] That's perfectly fine. We just need to make sure we've got the right one.
[CUSTOMER][NEUTRAL] I get it through messages, but I'm uh.
[AGENT][POSITIVE] No worries, yeah, we just wanna make sure what we have is correct, sure.
[CUSTOMER][NEUTRAL] I'm not not too savvy with all of that, yep.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like we are missing some information for this claim, um, just to make sure this is we did receive this claim [PII]. Does that sound right to you?
[CUSTOMER][NEUTRAL] Possibly.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEGATIVE] I don't know why it's taken so long personally because uh this work was done back in July.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] How long have I been with you guys? Haven't I been with you since like [PII]?
[AGENT][NEUTRAL] Um, for this policy's effective date was [PII].
[AGENT][NEUTRAL] And this is the only policy you've had with us?
[CUSTOMER][NEGATIVE] That I don't understand.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And this is a medical policy, right?
[AGENT][NEUTRAL] Correct, it's a limited indemnity medical plan.
[CUSTOMER][NEGATIVE] Yeah and somebody's been taking money every month from me and I thought it was you guys and.
[AGENT][NEUTRAL] If you have other kinds of coverage, right, I would get with your, I would get with your employer um as this is the only policy you have with us oh OK.
[CUSTOMER][NEGATIVE] I'm paying something for something.
[CUSTOMER][NEUTRAL] What's that?
[CUSTOMER][NEUTRAL] I don't have an employer.
[CUSTOMER][NEUTRAL] I don't have an
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] I retired.
[AGENT][NEUTRAL] Oh, I see. OK, you're with uh BWA OK.
[CUSTOMER][NEUTRAL] A different
[CUSTOMER][NEUTRAL] I retired [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty well for this claim [PII] um we are missing some information so we are needing diagnosis codes for the dates of service and you can get those from the provider you went to for treatment, so we need to itemize sure no worries, let me know when you're ready.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hold on a second.
[CUSTOMER][NEUTRAL] I'm just going through some paperwork. I just talked to them too and they're wondering what's going on.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] It's not Blue Cross Blue Shield, I'll say that much.
[AGENT][NEUTRAL] No, this is a bit different.
[CUSTOMER][NEUTRAL] Very different. I don't have them with me currently they
[CUSTOMER][NEUTRAL] I think I sent everything to you guys. Someplaceun [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] I'm still going through some of your mailings too, so don't hang up on me too quick here.
[AGENT][NEUTRAL] No, no, you're fine.
[AGENT][NEUTRAL] So you think you did send us the itemized statements that show diagnosis codes?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, OK, so we can definitely review that [PII] if you don't mind I'm gonna put you on a brief hold and I'm gonna reach out to our claims specialist, OK? I'll be right back with you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] S
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] [PII], I really appreciate your patience. Bear with me just a moment. They're a little bit busy.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][POSITIVE] All right, thank you. Yes, sir.
[CUSTOMER][NEUTRAL] [PII], uh, [PII].
[CUSTOMER][NEUTRAL] Could I get your extension? Would you be able to talk to my medical provider?
[AGENT][POSITIVE] Um, we would be happy to. I don't have a personal extension, um, but you are more than welcome to give them this number that you called. We talk to providers all the time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because uh I, I think I sent you all the information.
[AGENT][NEUTRAL] OK, yes, and that's what I was wanting to verify, yes, that's what I was wanting to verify um I only see kind of like surface level um so that's why I was trying to reach out to um our claim specialists but they are just a little bit busy right now.
[CUSTOMER][NEUTRAL] You know, the item I billing and stuff?
[CUSTOMER][NEGATIVE] Right, and now they're wondering where their payment's coming from and stuff and now so here they just and I had some questions providing to the provider and uh they just sent me an explanation of what was going on in the July incident with me and uh it doesn't say anything about money it's just telling what they did and why they did it and uh.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So this has got really nothing that you guys can have but uh she's this gal is [PII], she's sort of stepping on handling this a little bit for me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And she'd probably be able to give you more information if I could get a hold of her and give you her number.
[AGENT][POSITIVE] That's perfectly fine um you are more than welcome to give them our number we would be happy to speak with them and kind of explain it to them um really quick though if you don't mind waiting just a little bit longer, I would like try to try to reach out to our claim specialist just so they can review that information.
[CUSTOMER][NEUTRAL] Or it would.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And like I say, I think I sent you all of the itemized billing stuff.
[AGENT][NEUTRAL] Right, right, and that's what I want to verify.
[CUSTOMER][NEUTRAL] OK. Oh, I, I'm.
[CUSTOMER][NEUTRAL] I will be on hold with you.
[AGENT][POSITIVE] All right, I sure appreciate it [PII]. I'll get back with you as soon as I can.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Certainly no agents staffed. Goodbye.
[AGENT][NEUTRAL] What?
[CUSTOMER][NEUTRAL] No agent staff. Goodbye.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No agents staffed. Goodbye.
[AGENT][NEUTRAL] What in the world?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] no agents staffed.
[AGENT][NEUTRAL] OK. Oh.
[CUSTOMER][NEUTRAL] I know agent staff. Goodbye.
[AGENT][NEUTRAL] Come in, all right.
[AGENT][NEUTRAL] All right [PII], sorry about that wait are you still there?
[CUSTOMER][NEUTRAL] Yep
[AGENT][NEUTRAL] Alrighty it looks like they might be backed up for quite a bit um and I'm not gonna keep you on hold forever because frankly I'm not quite sure when the next one would be available um but I will try to reach out to them um so we can get to the bottom of this, make sure that you know what.
[CUSTOMER][NEUTRAL] Yes I am.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEGATIVE] You lost me.