AccountId: 011433970860
ContactId: a3b5bcc1-cbaf-4832-90ff-be69ac1b9872
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 490820 ms
Total Talk Time (AGENT): 216060 ms
Total Talk Time (CUSTOMER): 109697 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/a3b5bcc1-cbaf-4832-90ff-be69ac1b9872_20250610T19:07_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I just wanted to check the status of my husband's claim.
[AGENT][NEUTRAL] OK, I can help you with the claim status. And may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Give me just a second, I'm trying to get the information. The claim, 00, the policy number I don't have, but I do have the claim number.
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, the claim number is fine.
[CUSTOMER][NEUTRAL] OK, 306.
[CUSTOMER][NEUTRAL] 886-2, and telephone number?
[CUSTOMER][NEUTRAL] [PII]. My husband's name is [PII]. My name is [PII]. I am
[AGENT][NEUTRAL] Wait, hold on one second, hold on one second. The phone's going in and out. I only heard from the phone number. It's OK. Um, can you repeat the phone number? I just, I just heard [PII].
[CUSTOMER][NEUTRAL] Third party.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and then what was your name and and your husband's name sounds like you were giving me all's name.
[CUSTOMER][NEUTRAL] Yes, his name is [PII]. My name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and hold on one moment while I pull the claim.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And, and the claim number, um just to make sure I have it right, it's 306-8862?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, here we go.
[CUSTOMER][NEUTRAL] 360. I'm sorry.
[AGENT][NEUTRAL] 360. OK. Hold on one moment.
[CUSTOMER][NEUTRAL] Uh-huh, 3608862.
[AGENT][NEUTRAL] OK, here we go. Hold on one moment because I was pulling up a different name and I'm like, well, maybe I misunderstood what she said.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm. No.
[AGENT][NEUTRAL] OK, it's pulling up now. Hold on one moment.
[CUSTOMER][NEUTRAL] How are you today?
[AGENT][POSITIVE] I'm doing well. How are you doing?
[CUSTOMER][POSITIVE] Pretty good trying to make it home before this rain starts.
[AGENT][NEUTRAL] Right, it just got dark here.
[CUSTOMER][NEUTRAL] Yes, here too.
[AGENT][NEUTRAL] Alright, so I'm pulling, pulling up the notes.
[AGENT][NEUTRAL] And Miss Mrs. [PII], do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Alright, so he doesn't have any authorized, so why?
[AGENT][NEUTRAL] Documents submitted doesn't have diagnosis and it'll be processing does not have a diagnosis code, so we need those to be able to continue processing claims about stated is the same issue would inform her with the insurer being discharged and treated in a different hospital, we would need a diagnosis code, verify the treatment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Previous verified on file to speak to spouse. What does that mean? I thought it was only for one call.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] So then they need to put it in CLHIP.
[AGENT][NEUTRAL] I'm writing that down because I didn't even have to, she's been on hold for 2 minutes and it's
[AGENT][NEUTRAL] 2025 HIPA received.
[AGENT][NEUTRAL] Put in CHIP.
[AGENT][POSITIVE] And about, so the next person doesn't have to go through the notes. Just go, Lord. All right. So let's see what [PII] saying so I can know how to help her.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 36062.
[AGENT][NEUTRAL] DH.
[AGENT][NEUTRAL] Cause I wanna have the answer for it when I get back on the line.
[AGENT][NEUTRAL] DH 2217.
[AGENT][NEUTRAL] Hello Mrs. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. Um, can you verify Mr. [PII]'s date of birth and the mailing address on file?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh-huh. [PII]. Our address is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And what questions did you have in reference to this claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, I updated. I mean, they needed an itemized bill, uh, itemized statement with the diagnosis code on it. I was just checking the status of that since I've submitted that.
[AGENT][NEUTRAL] OK, now I do see that it came in on the [PII] and it is in processing, but there hasn't, there's like no update, they're processing it though I see all the zeros, um, but it did come into us on the [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Right, that was the original claim was before that and then they closed it and said that it needed the paperwork, so OK.
[CUSTOMER][NEUTRAL] We're just waiting.
[AGENT][NEUTRAL] Yes, ma'am. So once they finished going through the documents that you um sent in this the second time here, they'll go ahead and give you the new decision and also so that the next person doesn't have to put you on hold. I had to go through the notes to see that you are already authorized. So I'm going to let my supervisor know there's a screen that we have that I just list your name. So next time the next person can see that.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Somebody said they were gonna do that last time.
[AGENT][NEUTRAL] Well, they didn't. I'm sorry, um, but I already did. So she, she has customer service adding it, so I'm, I'm sorry, um, but that's what took me so long because I'm like, is, am I allowed? So, um, I'm like, well, let's just put it on there. So we um we fixed it. I'm sorry, I don't know who you spoke with previously. Um, you're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] I appreciate that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] No, ma'am, I was just trying to see what the status was. I know sometimes, uh, you can go to the claims person and see, you know, have them go ahead and add the form. We've had to do this quite a bit over this last year with him in the hospital so much, so I just wanted to know what was going on with it. That's it.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APM Ms. [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] You as well. Thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.