AccountId: 011433970860
ContactId: abc64541-916d-4553-8c74-0beaa9fbf78f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 600239 ms
Total Talk Time (AGENT): 288849 ms
Total Talk Time (CUSTOMER): 234188 ms
Interruptions: 6
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/abc64541-916d-4553-8c74-0beaa9fbf78f_20250618T14:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], I was just following up on some of the claims I submitted.
[AGENT][NEUTRAL] OK, I can check on those claims for you uh what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Um [PII]
[AGENT][NEUTRAL] OK, and then, uh, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Um, let me, let me go up here to my.
[CUSTOMER][NEUTRAL] And here let me go to here.
[CUSTOMER][NEUTRAL] Dashboard
[CUSTOMER][NEUTRAL] Um da da da.
[CUSTOMER][NEUTRAL] Skip, let me see. dashboard.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Coverage details my policy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm, 207.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 6808.
[AGENT][POSITIVE] OK, got it thank you one moment.
[AGENT][NEUTRAL] OK and then uh just gonna verify some.
[AGENT][NEUTRAL] Information really quick, uh, [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] Yes,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect, uh, last thing I need is the email address we've got on file for you looks like it's a Gmail account.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Awesome OK thank you so much for verifying all of that.
[AGENT][NEUTRAL] OK, so I am showing that we have received claim information for you on [PII] and it is still currently being processed. It can take, um, gosh, I think anywhere between 7 to 14 business days for claim information to complete processing, um, but with it being and you know the [PII], I'd imagine it should be completed soon.
[AGENT][POSITIVE] So of course you are more than welcome to check the status on the portal or just give us a call back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, which claim was that? Because I have 12.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] For I know.
[AGENT][NEUTRAL] Uh, well, for the policy number you gave me, I see two pieces of claim information. Um, they don't currently have claim numbers yet as they're not completed processing, but I do have those confirmation numbers.
[CUSTOMER][NEUTRAL] OK, just a second. I know I got paid on one that was for my mammogram. I did receive that one that was.
[AGENT][NEUTRAL] Oh, did you have a more recent policy?
[AGENT][NEUTRAL] Oh, you do, OK.
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] The policy number you gave me was an older one.
[CUSTOMER][NEUTRAL] Yeah, see, there's different ones because.
[AGENT][NEUTRAL] Yes, I understand, OK.
[CUSTOMER][POSITIVE] Oh OK, I'm sorry.
[AGENT][NEUTRAL] No, no, no, you're perfectly fine. Uh, the one that you gave me, um, I see two that are currently being processed, um, let's take a look at these others. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then there are 2 others.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That were submitted at the same time still currently in line for processing and then let me check this most recent.
[AGENT][NEUTRAL] OK, yes, so I'm showing that as of yesterday.
[AGENT][NEUTRAL] You have quite a few that completed, let's see.
[AGENT][NEUTRAL] Well, there are, there's one that you submitted on the [PII] that completed on the [PII]. I'll take a look at that one first.
[CUSTOMER][NEUTRAL] Yes, was that the $50.01?
[AGENT][NEUTRAL] Yeah, that's the mammogram. Yes, ma'am, that's the mammogram, so we paid that $50.
[CUSTOMER][NEUTRAL] OK, I did receive.
[CUSTOMER][NEUTRAL] Yes, I did receive that.
[AGENT][NEUTRAL] OK and then.
[CUSTOMER][NEUTRAL] And then
[AGENT][NEUTRAL] Got it. So then there was another one that completed yesterday, um, quite a few items on it, but we did pay a bit of, uh, $357.50.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, that should go reach the bank.
[CUSTOMER][NEUTRAL] Because that's the one that's when I was calling so that one hasn't reached the bank yet so.
[AGENT][NEUTRAL] Well I
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yesterday again I would, I usually say it depends on the bank of course um but I would say no more than about 2 to 3 business days but I also keep an eye on your bank to see if you see it in the pending transactions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and the other one.
[CUSTOMER][NEUTRAL] Claim 3481715.
[AGENT][NEUTRAL] Uh, I'm sorry, could you repeat that claim number?
[CUSTOMER][NEUTRAL] 3481715
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me locate that. Give me just a moment.
[CUSTOMER][NEGATIVE] Oh, that one's owed. That one's owed. I'm sorry. I don't know why I didn't receive anything on that one.
[AGENT][NEUTRAL] Oh, that's OK.
[CUSTOMER][NEUTRAL] I'm just reading this. I'm looking at the dates now.
[AGENT][NEUTRAL] Um, I could take a look
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure you're fine let's see.
[CUSTOMER][NEUTRAL] That one wasn't
[CUSTOMER][NEUTRAL] Yeah, I see now.
[CUSTOMER][NEUTRAL] OK, this is the other one pending. OK, I got the other one pending. I'm sorry.
[AGENT][MIXED] No, no, no, you are perfectly fine. It's very confusing and I know what the website changing it made it a bit more confusing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah and there's like I don't have a claim number on this one it says it's pending but I know I submitted two mammograms.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I believe a colonoscopy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, those are still pending 123.
[AGENT][NEUTRAL] Yes, I saw a total of 4, and of course you know I don't know they might be on the same part of the same claim, but it's 4 separate submissions that I saw that we're still like currently being processed.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, that's, I was just following up because I went, well, I need to call and check because I didn't get other ones, you know, and I could go back as long as I had this policy and when I talk to that girl, oh yeah, there's no deadline. So I said well I'm just gonna start submitting them because I had normal mammograms, normal colonoscopy, things I didn't know I could claim on. I went, well.
[AGENT][POSITIVE] Oh sure, absolutely.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Yes, and there's timely filing limit, so yeah, probably I usually try letting people know that.
[CUSTOMER][NEUTRAL] So that's, I think I've talked to you before. Your voice sounds.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was just checking, so, OK, I'll just make sure there's nothing else that y'all needed.
[AGENT][POSITIVE] Absolutely, yeah, and I'd imagine it should be completed shortly um so I would definitely keep an eye on that or give us a call back in the next couple of days.
[CUSTOMER][NEUTRAL] OK, and on the colonostomies, what, what is the pay on that? Is it $50 too?
[AGENT][NEUTRAL] Yes, yes, that's considered of those, uh, preventative, um, diagnostic benefits.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK, all right. I think I just submitted, um, um, uh, that one. I can't remember. I was doing so many as I was trying to write them down, but anyway, OK, well thank you for your help. I was just.
[AGENT][POSITIVE] Oh, I understand it'll be easier once they're all processed and you'll be able to actually see all of it.
[CUSTOMER][NEUTRAL] And if y'all need additional information.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK, um, so if y'all need additional information you'll contact me correct?
[AGENT][NEUTRAL] Well you should be able to see it of course on the portal but if you need clarification because sometimes it's you know a little bit confusing as to what might be missing um definitely give a call and we'll let you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah this portal is kind of.
[CUSTOMER][NEUTRAL] OK, well thank you so much. I was trying to figure this portal out and I'm finally sending claims, so I went, OK, OK, but I, I think I got trying to get this portal figured out now.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] I will send.
[AGENT][POSITIVE] No worries and I will say too, um, from personal experience I have seen it where I.
[AGENT][MIXED] Now and I'm sure they're working on it to get it better but if you go to your claims and you see where it's like the little rotating circles next.
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Let it sit on that page for I mean gosh uh maybe a good 5 minutes or so um because it's it's downloading that information um so and you know the more claims it's gonna take a while so it is thinking but I promise if you just let it sit it will, it will be done eventually.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, yeah, that's yeah it is that's what it's telling me it's um.
[CUSTOMER][NEUTRAL] Well, this one says claim pending says.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, insured on.
[CUSTOMER][NEUTRAL] Identified identified.
[CUSTOMER][NEUTRAL] Hm, what does that mean?
[AGENT][NEUTRAL] Are those the ones that are in progress?
[CUSTOMER][NEUTRAL] Yeah, yeah, OK, that mean, OK, they're still in progress pending, pending lists to see it? OK.
[AGENT][MIXED] It's just that, yeah, I know again that very confusing, a bit misleading, yeah, yeah, don't worry about that just yet. Once it's completed, you'll be able to view it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][POSITIVE] You are very welcome was there anything else I can help you with?
[CUSTOMER][POSITIVE] You have a good day.
[CUSTOMER][NEUTRAL] No that's it's all I need.
[AGENT][POSITIVE] Alright, thanks, Ms. [PII]. You too.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.