AccountId: 011433970860
ContactId: accb6bb0-2222-4ddc-97d3-cc58e6694a2a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240059 ms
Total Talk Time (AGENT): 114777 ms
Total Talk Time (CUSTOMER): 79327 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/accb6bb0-2222-4ddc-97d3-cc58e6694a2a_20250428T15:18_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Uh, yes, I need to um check status and see if you received a claim because we were, we submitted one and we never got a response.
[AGENT][POSITIVE] OK, I will be glad to help you. Go ahead and give me your name and the member's policy number.
[CUSTOMER][NEUTRAL] Uh-huh. My name is [PII] and policy number is 021-75808.
[AGENT][POSITIVE] Alrighty, [PII], thank you so much for that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright [PII], thank you for all that information. Now your patience, name and date of birth that please, ma'am.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Alright, looks like [PII] is a dependent on this medical supplemental plan. Now, you did say you want to check status of a claim. Is that correct, [PII]?
[CUSTOMER][NEGATIVE] Um, yes, I, I have a claim that was submitted to UHC Primary and crossed over to APL and no response.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, what's that data service, [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] And where is that bill gonna be from?
[CUSTOMER][NEUTRAL] Uh, the University of Kansas Hospital.
[AGENT][NEUTRAL] Alright, so the facility bill, OK, let me do some checking. Let's see what I can find.
[AGENT][NEUTRAL] How much is your bill for?
[CUSTOMER][NEUTRAL] Uh, let's see, total charges are, um.
[CUSTOMER][NEUTRAL] $41,062.43.
[AGENT][NEUTRAL] Oh, I think I see that. Let me pull it up. Let's see if I can get my computer to move, so bear with me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, it looks like patient had already met the max prior to your claim being processed, so they've already met that, um, that maximum benefit payable, but you should have gotten an EOB that tells you that you want me to fax you one over, [PII]?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] Alright, give me a good fax number, [PII].
[CUSTOMER][NEUTRAL] OK, that fax number is um [PII].
[AGENT][NEUTRAL] Uh, you let me repeat that fax number back for that AOB that's area code [PII]. Was that your correct fax number?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] Alrighty, I'm gonna fax you over that EOB just so you'll have that information.
[AGENT][NEUTRAL] Um, so you can uh put that in your file, but yes ma'am, they've already maxed out their benefit here at APL.
[CUSTOMER][NEUTRAL] OK and um do you have a reference call number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, we don't give reference numbers, [PII], but you can use my name in today's date if you need to do so. And my name is [PII] spelled [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Oh [PII], OK, OK, um, alright, well thanks a lot for your information.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Well, yes, ma'am, and thank you then, [PII]. Uh, that's all I can help you with today?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alrighty, well, thanks so much for calling APO [PII]. You have a great rest of your day.
[CUSTOMER][POSITIVE] You too. Thanks a lot, bye.
[AGENT][POSITIVE] Thank you, ma'am. Bye bye.