AccountId: 011433970860
ContactId: a94ad72a-e30a-4e49-9ca9-e294c04d53c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 418179 ms
Total Talk Time (AGENT): 139920 ms
Total Talk Time (CUSTOMER): 121248 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/a94ad72a-e30a-4e49-9ca9-e294c04d53c4_20250204T16:03_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I'm calling for uh the status on one of our claims for our policyholders here in the office.
[AGENT][NEUTRAL] OK, I can help you. What's your name?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] And the policy number?
[CUSTOMER][NEUTRAL] Is 2291621.
[AGENT][NEUTRAL] What's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Is uh [PII] and then the date of birth is [PII].
[AGENT][NEUTRAL] All right, thanks for verifying that information for me, [PII], and you said you're checking claim status?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Alright, what's the date of service in charge?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I am not showing that date of service received for for the patient.
[CUSTOMER][NEUTRAL] A
[CUSTOMER][NEUTRAL] OK, it could, uh, the policy holder's name is [PII]. Do you need the policy holder or the, the claimant name?
[AGENT][NEUTRAL] Mm. She's a dependent under [PII]'s policy, so I see her information.
[AGENT][NEUTRAL] What type of claim was it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was a wellness claim for.
[CUSTOMER][NEUTRAL] Mhm wellness claim for a lipid panel.
[AGENT][NEUTRAL] OK, so that's the policy number that you gave me is for critical illness policy. Uh, let me look at the other policy that she has, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said the date of service is [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh sorry, I thought when you said 25 I think you meant the year yeah it is uh [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Don't show a wellness screening for.
[AGENT][NEUTRAL] For [PII]
[AGENT][NEUTRAL] She followed on one of the other dependents.
[CUSTOMER][NEUTRAL] This one was for [PII].
[AGENT][NEUTRAL] Is it for the same day?
[CUSTOMER][NEUTRAL] Uh, no, the one for [PII] was on the [PII] and then this one was on the [PII]. I have the claim number if you need that by chance.
[AGENT][NEUTRAL] Yeah, I see them, but they're, they're like they're processed under the opposite than what you're saying. Give me a second, so I see one for [PII], but it says 120 25, and you're saying his is 1212.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] No, his is 120 2025.
[AGENT][NEUTRAL] OK, so for [PII] that one was processed at 50, let's see.
[AGENT][NEUTRAL] And you said that you're calling on behalf of the provider's office?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm not showing any claims received from the provider.
[AGENT][NEUTRAL] These were all submitted by the policy.
[CUSTOMER][NEUTRAL] Uh, not the provider's office, sorry, these are.
[CUSTOMER][NEUTRAL] I'm the broker for the for the agent's office sorry I thought you meant like our agent's office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, no, no, no, the dental, the medical provider. OK, making sense.
[CUSTOMER][NEUTRAL] Yeah, no, I'm the I'm from the agent's office, sorry, yeah, I'm the broker at the agent's office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes, and then the it's the claim is on 12025 for [PII].
[AGENT][NEUTRAL] OK, so I do show that one for [PII]. Um, it made a payment of $50 of course that's going to the policyholder and that one was processed on the [PII] just yesterday.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alrighty this one was resubmitted so that's the only reason I'm calling actually.
[AGENT][NEUTRAL] Yeah, we received it twice. I see that.
[AGENT][NEUTRAL] OK, so let me go back to [PII].
[CUSTOMER][POSITIVE] Alrighty perfect.
[AGENT][NEUTRAL] So the claim number for [PII] is 3558674.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] I don't show one for [PII], but I show one for.
[AGENT][NEUTRAL] Let's see, no, [PII], it's not a dependent.
[AGENT][NEUTRAL] Yeah, the other one that I showed for date of service [PII] is for [PII].
[CUSTOMER][POSITIVE] Yeah, that one should have paid by now I think I'm pretty sure I called OK I think I called a couple of days ago on that one and it did pay alrighty.
[AGENT][NEUTRAL] It did.
[AGENT][NEUTRAL] It did.
[AGENT][NEUTRAL] OK, but I'm not showing anything for [PII].
[AGENT][NEUTRAL] Not a 25 claim for medicine.
[CUSTOMER][NEUTRAL] Um, nope, I think.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, yep, neither am I. OK, we're good.
[CUSTOMER][POSITIVE] Alrighty, I think we're right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So was it just for [PII]?
[CUSTOMER][NEUTRAL] Uh, yes, just for I just wanted to know the status of [PII]'s because like I said I had to resubmit this one because apparently it wasn't showing in your guys' system.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All [PII]. Well, did you have any other questions, [PII]?
[CUSTOMER][POSITIVE] Uh, nope, I think that is all. Thank you for your help today. Sorry for convenience you using so much.
[AGENT][POSITIVE] All righty. That's OK. You're welcome. Thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.