AccountId: 011433970860
ContactId: a51c334e-c809-4129-a550-71388c84deff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452799 ms
Total Talk Time (AGENT): 154540 ms
Total Talk Time (CUSTOMER): 123518 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/a51c334e-c809-4129-a550-71388c84deff_20250530T18:46_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. I was calling and I spoke with a representative earlier and I'm trying to see if the new documentation, um, that I uploaded into the portal is sufficient enough for my my claim to be processed.
[AGENT][POSITIVE] Right, um, I can check on that for you.
[CUSTOMER][NEUTRAL] I was um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 2054422
[AGENT][NEUTRAL] 205-042-2
[CUSTOMER][NEUTRAL] No, 205 4422.
[AGENT][POSITIVE] Oh, I'm sorry about that.
[CUSTOMER][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] And let me look that up real quick.
[AGENT][NEUTRAL] And [PII], can I get you to verify your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In the mailing address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much for verifying that.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] OK, it looks like you just submitted it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, some of the options I was um in the note, she said an itemized list because they were lacking the code that the anesthesia was for, so they needed to see something so I didn't, when I called.
[CUSTOMER][NEUTRAL] The hospital, they told me this is normally what supplemental insurance is what I download and that that was what was sent to me. So I want to know if that was sufficient.
[AGENT][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment, let me talk to our claims department and see and see if they're able to see it since it was just uploaded, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], it's [PII] with the care team. Um, I'm calling, I, I guess I need more information just in case to see if this is right. I have an insured on the line and she said that she had submitted a claim and they needed more information on it. She just uploaded it today. Um, is claims able to see what she, she sent in already because I do see a confirmation number, but I don't see a stat date or anything.
[AGENT][NEUTRAL] Um, I'm still new at this, so I don't know. Are you guys able to see what she?
[AGENT][NEUTRAL] Sent in and see if that's enough or if that's sufficient.
[CUSTOMER][NEUTRAL] Um, so I mean we can see like when the claim come in if it hasn't have a claim number just yet, um, but we, you know, uh, we would allow in order for us to be able to tell her whether or not it's sufficient or not would be after the claim has been reviewed.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, um, yeah, because it's still like she just sent it, it has claim number and it's all the zeros, um, so are you able to see if the item if that was the itemized bill if it went through?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh yeah, I can see what what we have. Uh, what's the policy number?
[AGENT][NEUTRAL] It's 02054422 and it's Ms. [PII].
[CUSTOMER][NEUTRAL] OK, [PII]. OK, I do see that we did receive something today and she's asking if it's an if it's an itemized bill.
[AGENT][NEUTRAL] Yeah, I guess that's what we're needing from her past claim is we needed an itemized bill for I guess anesthesia and she was wondering if that was if that was correct.
[CUSTOMER][NEUTRAL] OK, give me just a second.
[AGENT][NEUTRAL] I think she was confused on what type of, what the document should look like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it looks like we actually need to verify the diagnosis code which I do see that that those are on here, um.
[CUSTOMER][NEUTRAL] Let's see, yeah, so I would just let her know that we currently have the claim and currently in line to be reviewed.
[AGENT][POSITIVE] OK, thank you so much, [PII].
[CUSTOMER][POSITIVE] Oh sure, no problem. Is there anything else I could do to help you today?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, no, thank you.
[CUSTOMER][POSITIVE] Sure, thank you and have a good day.
[AGENT][NEUTRAL] Alright, bye.
[AGENT][NEUTRAL] [PII], are you on the line still?
[CUSTOMER][NEUTRAL] I am.
[AGENT][NEUTRAL] All right, I spoke with claims. They said they are able to see the information that has that you just submitted um with the diagnosis and everything. Uh, it is in line to be reviewed currently. Uh, I don't have a processing date yet. Um, I would give it a few days. So maybe call back, um, yeah, call back sometime next week. Um, but I did confirm that they were able to see the documents and it did have um a diagnosis on there.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, that's
[CUSTOMER][NEUTRAL] OK, I just wanted to ensure that that was sufficient so that so the process could continue but.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, is there anything else I can help you with?
[CUSTOMER][POSITIVE] OK, so thank you for that. That was it.
[AGENT][POSITIVE] All right. Well, thank you so much for calling APL [PII]. I hope you have a great day.
[CUSTOMER][NEUTRAL] You do the same.
[AGENT][NEUTRAL] Alright bye.
[CUSTOMER][POSITIVE] Thank you bye bye.