AccountId: 011433970860
ContactId: 94cf96e2-7776-4078-9af1-d245b18907a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294320 ms
Total Talk Time (AGENT): 55921 ms
Total Talk Time (CUSTOMER): 140558 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/94cf96e2-7776-4078-9af1-d245b18907a0_20250326T22:09_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, Ms [PII], this is [PII] in the care team.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I've got um Ms. [PII] on the phone.
[CUSTOMER][NEUTRAL] Her policy number is 256-9668.
[CUSTOMER][NEUTRAL] The number she is calling from is a good call back number and she's calling because.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] saw that her claim was pended for medical records from Doctor [PII] on claim number.
[CUSTOMER][NEUTRAL] Let me give you the claim number. Well, it doesn't it's 30, you have it good. OK. Well, she said that Doctor [PII] said that they have not received anything from us and she wants to verify the fax number that we have compared to his fax number to make sure we're sending it to the right place.
[AGENT][NEUTRAL] I have
[AGENT][NEUTRAL] Give me one second just to pull that information up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you can send her on over.
[CUSTOMER][POSITIVE] OK, thanks, Ms. [PII]. You have a blessed night.
[AGENT][POSITIVE] You as well thanks.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes we can't do $100. Um, hello, my name is [PII]. I am calling today because I am trying to confirm that you have the correct fax number because the last step in my claim approval or denial was depending upon you all receiving medical records. When I contacted them today, they claimed that no one has, uh, reached out to them from your establishment. So I just wanna verify you have the correct that information for them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what fax number should we be faxing the information to?
[CUSTOMER][NEUTRAL] Um, I'm uncertain. What do you have?
[AGENT][NEUTRAL] Mm, oh, so did they tell you what fax number that we need to fax it over to?
[CUSTOMER][NEUTRAL] Yes, that
[AGENT][NEUTRAL] OK, alright, so what the fax number that she faxed it to was [PII] I'm [PII].
[CUSTOMER][POSITIVE] Yes ma'am, that's correct, so they did get something for the lot I think.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I was just backtracking because they, uh they've been known to say, oh we didn't get this or we didn't get that, and I have to call them daily for like weeks to get them to do what they're supposed to do. So yeah, it's good to know it went to the right place, so they did receive it.
[CUSTOMER][NEUTRAL] Huh, that's interesting. Um, after receiving the medical record, how long does it normally take, uh, for you guys to examine and move forward with the decision?
[AGENT][NEUTRAL] Um, after we get the medical records back, they'll have to be reviewed by our medical director.
[AGENT][NEUTRAL] And uh it just depends on how long it takes, it could be anywhere between a week, maybe.
[AGENT][NEUTRAL] But we don't really know.
[CUSTOMER][NEUTRAL] OK, um, and as far as what you guys have reviewed thus far as everything else in the clear, the last piece needed is the medical record, is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, alrighty then.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, and is there any, any feedback you can give me as far as like what you guys have reviewed so far?
[AGENT][NEUTRAL] No, ma'am, not at this time. At this time we're just waiting on the medical records to review those, to have those reviewed.
[CUSTOMER][NEUTRAL] They haven't required any additional document.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK great and lastly, do you know specifically what you're looking for in the medical records?
[AGENT][NEUTRAL] I do not.
[CUSTOMER][POSITIVE] You do not. OK, well, that's all I need. Thank you so much. You have a lovely evening.
[AGENT][POSITIVE] You as well thanks for calling APO.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] Thank you. Goodbye.
[AGENT][NEUTRAL] OK.