AccountId: 011433970860
ContactId: af41ea09-1702-47ed-b2eb-47f6c32bcc38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 530099 ms
Total Talk Time (AGENT): 184088 ms
Total Talk Time (CUSTOMER): 205582 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/af41ea09-1702-47ed-b2eb-47f6c32bcc38_20250131T16:19_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] I like your hair like that.
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII]. I am calling from the broker associated Financial Consultants regarding one of our groups.
[AGENT][NEUTRAL] OK, [PII], you're um you're calling from a broker's office regarding a group, is that correct?
[CUSTOMER][NEUTRAL] Yes, well, one of the employees for one of our groups, yes, um, regarding some claims that were denied.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] I could give you the group number or employee name.
[AGENT][NEUTRAL] Well, first off, uh, first off, what is your last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and your call back number please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the group, uh, well, the member's policy number?
[CUSTOMER][NEUTRAL] Um, policy number 02455568.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so thank you. Give me just a moment to get the member's information pulled up now I will need to verify several things with you first, um, [PII].
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, so just one moment.
[AGENT][NEUTRAL] OK, and what is the name of this group?
[CUSTOMER][NEUTRAL] This is for um on [PII].
[AGENT][NEUTRAL] OK, and the agent's name and email?
[CUSTOMER][NEUTRAL] I drew a blank for a second.
[CUSTOMER][NEUTRAL] The agent's name and email? I don't know what that means.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Who's the agent for this group?
[CUSTOMER][NEUTRAL] Um, hm, hold on one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then your email address please.
[CUSTOMER][NEUTRAL] My email is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so now that
[AGENT][NEUTRAL] Can I place you on a brief hold because that information is not matching what we have on file for the agent email.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Well, that's my email. His email, [PII]'s email is because you asked me for my email, so it's if you need [PII]'s email, it is [PII].
[AGENT][NEUTRAL] I did, but the agent, mhm. Sure.
[AGENT][NEUTRAL] OK, and even that email address for him is not what we have on file.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Maybe [PII].
[CUSTOMER][NEUTRAL] If not then no.
[AGENT][POSITIVE] Perfect
[AGENT][NEUTRAL] OK, can you hold on for me please? because the email that we have on file, have you ever had another email other than the one you gave me?
[CUSTOMER][NEUTRAL] I mean we all have like we don't use the other email but we all have so I also have [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you spell your first name with an [PII] or [PII]?
[CUSTOMER][NEUTRAL] No, there's two of us. There's [PII] and then me [PII]
[AGENT][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] I know a little confusing, I know.
[AGENT][NEUTRAL] Yes, OK, so.
[AGENT][POSITIVE] Thank you and
[CUSTOMER][NEUTRAL] I know [PII] called in this morning to you guys actually.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the member's name, I mean, date of birth?
[CUSTOMER][NEUTRAL] job
[CUSTOMER][NEUTRAL] So the member's date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you and what is the data service that you're calling about?
[CUSTOMER][NEUTRAL] So that's the problem basically his son [PII] has claims that were denied um pending EOBs.
[AGENT][NEUTRAL] And what is the son's name and yeah.
[CUSTOMER][NEUTRAL] I could give you [PII]'s information, yeah, uh, let me give it to you.
[AGENT][NEUTRAL] Yeah, I need
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So why is my computer frozen?
[CUSTOMER][NEUTRAL] Here we go [PII].
[CUSTOMER][NEUTRAL] Scarfo date of birth [PII].
[AGENT][NEUTRAL] OK, and so the claims are all for [PII] that we're.
[AGENT][NEUTRAL] Discussing.
[CUSTOMER][POSITIVE] Correct, correct.
[AGENT][NEUTRAL] And what's, because they have had multiple policies, I need to verify that I'm looking at the correct policy for the data service.
[CUSTOMER][NEUTRAL] Um, so basically what I'm calling is I just need for the claims that were denied, um, and that are pending EOBs, which there might be a few I need those dates of service so that I can reach out to the carrier.
[CUSTOMER][NEUTRAL] And provide it to them to get the EOBs.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Like literally going in circles.
[AGENT][NEUTRAL] OK, again, I need, uh, they've had 12345. They've had 6 policies with APL.
[AGENT][NEGATIVE] The policy number that you gave me is no longer active. It was active from [PII].
[AGENT][NEUTRAL] So is that
[CUSTOMER][NEUTRAL] Well, the claims that are in question are from [PII].
[AGENT][NEUTRAL] OK, all right, so one moment.
[CUSTOMER][NEUTRAL] Um, in February, like pretty much the month of [PII].
[AGENT][NEUTRAL] OK, so I don't.
[CUSTOMER][NEUTRAL] I don't have the dates it's just at home.
[AGENT][NEUTRAL] OK, so for locus, I don't have anything denied for an EOB.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] But you have
[CUSTOMER][NEGATIVE] Claims denied.
[AGENT][NEUTRAL] Uh, the most recently processed claim for him, if the insured's a primary insurance provided full benefits, so there were no benefits payable on this policy.
[AGENT][NEUTRAL] The last two claims were both.
[CUSTOMER][NEUTRAL] So the last two claims that were denied, let me write that down.
[AGENT][NEUTRAL] And the primary insurance paid everything in full. There was nothing for this policy to cover.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I don't know. I have all the information I got to call, so I guess I'll have to dig around more on my end and then call back.
[AGENT][NEUTRAL] Yeah, because I don't show that there's anything denied for primary EOB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But do you show any claims denied that are still pending from [PII]?
[AGENT][NEUTRAL] What is the date of service in February?
[CUSTOMER][NEUTRAL] We don't know. I don't know the day. They have so many dates. There's like 17 dates.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, yeah.
[AGENT][NEUTRAL] No, I don't show anything at this point.
[CUSTOMER][POSITIVE] OK perfect let me um.
[AGENT][NEUTRAL] Pending
[CUSTOMER][POSITIVE] Yeah, let me just see what more I could find out and then give you a call back if needed.
[AGENT][NEUTRAL] OK. So, um, but yes, as of now, no ma'am, there's nothing.
[AGENT][NEUTRAL] That hasn't been processed for him.
[CUSTOMER][POSITIVE] OK perfect thank you so much for your help I appreciate it.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. So if that's all then [PII] that I can help you with, thank you again for calling APL and I hope you have a great weekend.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][NEUTRAL] Yes ma'am. Bye bye.