AccountId: 011433970860
ContactId: a7611a3e-7266-40ce-8afa-df5cfaf29a8a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 577919 ms
Total Talk Time (AGENT): 234693 ms
Total Talk Time (CUSTOMER): 122103 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/a7611a3e-7266-40ce-8afa-df5cfaf29a8a_20250512T14:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Hello, I'm calling because um I filed a claim and um I submitted all my documents but um it was not, um, the payout it says process and the payout says $0.
[AGENT][NEUTRAL] OK, I can check your claim status for you sir can I please get your name and your call back number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] OK, my name is [PII]. Callback number is [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your policy number?
[CUSTOMER][NEUTRAL] Um, 2552435.
[AGENT][NEUTRAL] OK, let me pull that up real quick for us.
[AGENT][NEUTRAL] OK, [PII], can you please um verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yes, um, [PII].
[AGENT][NEUTRAL] Thank you sir and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Um, my address is [PII]. Email address is [PII].
[AGENT][NEUTRAL] OK, thank you. And I see that the phone number you gave me to call you back on, that's your cell phone number?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] Thank you, sir. OK, let me see what it's saying to us. Um, if there's any remark.
[AGENT][NEUTRAL] It's gonna be just a minute while I pull it in.
[AGENT][NEUTRAL] OK, can you please tell me what day you sent in the claim?
[CUSTOMER][NEUTRAL] Um, I submitted a claim on.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so, and who was the um the provider that you went to? Can you give me the name of that and the amount?
[CUSTOMER][NEUTRAL] Uh, yeah, it was West.
[CUSTOMER][NEUTRAL] Um, west side, ACA West Side.
[AGENT][NEUTRAL] Westside Hospital?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] What was the amount of the claim?
[CUSTOMER][NEUTRAL] Yes, HCA.
[CUSTOMER][NEUTRAL] The amount of the claim was 1000.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that claim was processed according to the records that I'm looking at now, the claim was processed on your previous policy of 2451623. Can you verify the date of service?
[AGENT][NEUTRAL] What day it was.
[CUSTOMER][NEUTRAL] The data service is [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] And it's for
[CUSTOMER][NEUTRAL] It's for dependent on my um.
[CUSTOMER][NEGATIVE] Of my um insurance, and it would be to burn the joint.
[AGENT][NEUTRAL] OK, it's gonna be for which member?
[CUSTOMER][NEUTRAL] [PII]. It just says [PII] on my, it doesn't have the [PII] on there, but it's under dependent and um it says process.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] I'm still looking.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold and transfer you on over to a claims specialist so that they can talk to you about your claim and give you answers OK [PII]?
[CUSTOMER][NEUTRAL] All right, yeah.
[AGENT][POSITIVE] Alright, thank you for holding for me it's gonna be a brief hold while I transfer you over and I hope you have a good week.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], it's [PII] in the care team. I have um Mr. [PII] on the phone with me and his policy number that he gave me is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2552435
[AGENT][NEUTRAL] And he's looking for the claim that was submitted um in May and it tells us to refer back to policy number 2451623.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I do show that the claim was paid under the member, um, the account holder [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] But it's for a different data service that he gave me was for March um and it should have been for part 3.
[AGENT][NEUTRAL] And I'm not, I'm.
[AGENT][NEGATIVE] I'm thinking that part 3 did not get paid according to this, it wasn't for him it was for his son [PII], but he's on the other line. He's just wanting claim status, but I don't know what to tell him because it looks like.
[AGENT][NEUTRAL] Looking on my end it looks like it was paid for his son and not for I mean for him and not his son, and they're both of their names are [PII].
[CUSTOMER][NEUTRAL] Alright, give me a second.
[CUSTOMER][NEUTRAL] Give me 1 2nd to pull it up. 1 2nd.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And he doesn't know any of the information I just told you he's just basically trying to get claim status.
[CUSTOMER][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm gonna go back to him and let him know that you're you're pulling it up.
[CUSTOMER][NEUTRAL] Come on, on babe.
[AGENT][NEUTRAL] And that we haven't forgot about it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hey [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII], hey, I just wanted to let you know that I've got um a claim specialist on the other line and she's just pulling up documents right now so that she can give you claim status. I just didn't want you to think I forgot about you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a hold for you.
[AGENT][POSITIVE] Thank you [PII] for letting me do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So he hasn't, I wonder has he received the payment?
[AGENT][NEUTRAL] He said that he saw that the, the payment has been processed but it said $0 amount, but he also gave the um first policy number that I gave to you, the 2552435.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you could, you could send him on over because we processed this back in November so he should have already received that payment.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] OK, alright. Thank you, Ms. [PII]. You have a good week.
[CUSTOMER][NEUTRAL] And so he said he submitted something.
[AGENT][NEUTRAL] And yes, he submitted it in May.
[CUSTOMER][POSITIVE] Alright, thank you.
[CUSTOMER][NEUTRAL] And we have nothing on file, but you can go ahead and send them over.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thanks, [PII]. Bye bye.
[CUSTOMER][POSITIVE] Thank you.