AccountId: 011433970860
ContactId: 957111fb-65e9-4cd0-b7c1-0260abb6a4bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 457440 ms
Total Talk Time (AGENT): 173835 ms
Total Talk Time (CUSTOMER): 162120 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/957111fb-65e9-4cd0-b7c1-0260abb6a4bb_20250603T14:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm sorry, who is this?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Hi, [PII], it's [PII]. I think you and I have spoken before. How are you?
[AGENT][POSITIVE] I'm doing well, Ms. [PII]. How are you doing today?
[CUSTOMER][NEUTRAL] Good, thank you. Hey, can I have somebody in cancer claim?
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] I may be able to help you, Ms. [PII], I'll get you over to Cancer claims. Can I please get your callback number, ma'am?
[CUSTOMER][NEUTRAL] Um, hold on.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you ma'am and then are you calling for yourself or are you a provider?
[CUSTOMER][NEUTRAL] No, we are, um, OK, so then you and I haven't spoken before. I'm with NAS and we we're like a DA, but we're not a GA so we have a lot of groups with you guys with different uh brokers, and there's a claim, yeah, there's a claim that we asked for immediate attention on because it looks like they underpaid.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'm trying to follow up on that, but we received, let me see, we received an email this morning. Please in my policy after carefully reviewing the policy, I'd like to clarify that the diagnosis falls outside of the coverage parameters under the internal.
[CUSTOMER][NEUTRAL] OK. So let me read this because we just got this email and I'll call back if I need to, OK?
[AGENT][NEUTRAL] You won't need to, Ms. [PII], if you can give me the um claim number that's on the email, can you just verify your last name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you if I can just get the claim number that's on the EOB, I'll get you directly over to the claims department.
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] They didn't put, they didn't, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I'm, I'm, um, um, I'm, um, um.
[AGENT][NEUTRAL] Or even the patient name and policy number?
[CUSTOMER][NEUTRAL] Yeah, I can give you, I can give you, so it's the group number is 26773.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The please provide.
[CUSTOMER][NEUTRAL] I'm surprised they didn't give a claim number. Normally they always do. Hold on.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[CUSTOMER][NEUTRAL] This is from the care team. Um.
[CUSTOMER][NEUTRAL] So, the name of the individual is [PII]. Let me, let me go online and come to the OSC and get you her policy information. Hold on.
[AGENT][NEUTRAL] OK, in the meantime I'll be looking at trying to find her under the group.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] It's cancer, not that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's [PII]? Is that how you spell it?
[CUSTOMER][NEUTRAL] [PII], first name [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, good. Uh, I guessed it right, yay.
[AGENT][NEUTRAL] Let me find her.
[AGENT][NEUTRAL] It's gonna be just a minute. There's there's a large group, so it's pulling in.
[AGENT][NEUTRAL] 267-773.
[AGENT][NEGATIVE] OK, and it's gonna be her cancer, her
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yes, the cancer is the one I'm calling about.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I think I have found it. It's 257-093-0.
[CUSTOMER][NEUTRAL] Wait, 252, wait, 257.
[AGENT][NEUTRAL] 257
[AGENT][NEUTRAL] Yeah, let me, let me double check and make sure because she's um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] GC 14 is right there. It's 257-093-0.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And then I'm gonna go ahead and try to find the.
[CUSTOMER][NEUTRAL] Oh wait, hold on, hold on, hold on. I just, I just, hold on, hold on, Tory, I just found an email with a claim number.
[AGENT][NEUTRAL] Claim number
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, claim number 3606059.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3606059. OK. All right. I'm gonna go ahead and transfer you now on over to um.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] The claims specialist so that they can help you, yes, ma'am.
[CUSTOMER][NEUTRAL] Cancer?
[AGENT][POSITIVE] It's gonna be a brief hold, Ms. [PII]. You're very welcome. I hope you have a good rest of your day. Thanks for calling APL ma'am. Bye-bye, Ms. [PII].
[CUSTOMER][POSITIVE] Perfect, thank you.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good morning. Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Good morning, [PII]. This is [PII]. I've got Miss [PII] on the phone. Um, she is with NAS, she's the broker, um.
[AGENT][NEUTRAL] She's on our hot list, so she's one of the ones we treat special. She's calling about um claim number 3606059 on policy number.
[AGENT][NEUTRAL] 257-093-0 and she received an email today but I'm showing the claim was paid but she received an email today that she's wanting to talk about the claim.
[CUSTOMER][NEUTRAL] Um, did she say what the email was about?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] 6159 OK.
[AGENT][NEUTRAL] She just immediately when I talked to her, she said, I need cancer claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And everything's been verified for her Tory.
[AGENT][NEUTRAL] Yes, ma'am. Yes, it has.
[CUSTOMER][NEUTRAL] And and it's for [PII] Is Campa, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thanks, [PII]. Bye-bye.
[CUSTOMER][NEUTRAL] You're welcome to go ahead and transfer me.