AccountId: 011433970860
ContactId: b247e2d3-2314-4125-a0c5-e8eec550cfea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 670429 ms
Total Talk Time (AGENT): 156586 ms
Total Talk Time (CUSTOMER): 269969 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/b247e2d3-2314-4125-a0c5-e8eec550cfea_20250423T16:42_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm trying to, I sent you a claim.
[CUSTOMER][NEUTRAL] Uh, claim number 3584407 on [PII].
[CUSTOMER][NEUTRAL] Do you need my account?
[AGENT][POSITIVE] Um, yes, please, and if I can get, um, first, if I can get a good callback number for you please.
[CUSTOMER][NEUTRAL] Outpatient.
[CUSTOMER][NEUTRAL] Yes, please. [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And [PII], if I can get um your policy number?
[CUSTOMER][NEUTRAL] Sure, it's I'm giving you the outpatient, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 022.
[CUSTOMER][NEUTRAL] 654.
[CUSTOMER][NEUTRAL] 83.
[CUSTOMER][NEUTRAL] M as in Mary. L as in Linda. H.
[AGENT][NEUTRAL] OK, and if you can please verify your date of birth and email address for me.
[CUSTOMER][NEUTRAL] Sure, it's [PII] and my email address is, I think you have the work address, right? It's [PII].
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] Thank you for that information. OK, and what was that claim number?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, the claim number was on.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII], I, I give you the claim, the claim number, OK, it's 3584407.
[AGENT][NEUTRAL] OK, and that's where we asked for the urgent care visit and we asked for the diagnosis and the EOB?
[CUSTOMER][NEUTRAL] Exactly, exactly. So I'm trying to load the papers, the diagnosis and the EOB, but I, I, it doesn't seem to go through. I don't understand why.
[AGENT][NEUTRAL] Um, I'm showing we just.
[CUSTOMER][NEUTRAL] So how do I do it?
[AGENT][NEUTRAL] You just uploaded something. I see.
[CUSTOMER][NEUTRAL] What do you have?
[AGENT][NEUTRAL] Uh, let me look at it.
[CUSTOMER][NEGATIVE] It doesn't show on my end.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, one moment please.
[CUSTOMER][NEUTRAL] Did that OK fine thank you.
[CUSTOMER][NEGATIVE] Right, I, I try to, but it doesn't show on my end that I that I downloaded it uploaded anything.
[AGENT][NEUTRAL] I'm showing we got 11 pages.
[AGENT][NEUTRAL] Well, 10, including the, well 10 including the the first page that the system generates.
[CUSTOMER][NEUTRAL] 11 pages?
[AGENT][NEUTRAL] So that's 12.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What does it say? Does it have a title?
[AGENT][NEUTRAL] Um, it looks like you sent an EOB.
[CUSTOMER][NEUTRAL] You'll be for the same incident for [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, good. From doctor from from Cigna right from my insurance.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, perfect. And then.
[AGENT][NEUTRAL] I'm scrolling. I'm still scrolling. I'm still scrolling.
[CUSTOMER][NEUTRAL] This is the only thing I sent you?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that's it. You sent this EOB from Cigna and then you uploaded the EOB that we sent you, but I don't see the diagnosis code, so that'll be the only thing that we need now is the diagnosis for that visit.
[CUSTOMER][NEUTRAL] OK, so how am I going to, uh, how am I going to upload it again? OK, so after I go to the green button.
[AGENT][NEUTRAL] The same way you uploaded that.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] The same way you uploaded this information that I'm looking at right now.
[CUSTOMER][NEUTRAL] So that's I don't know how it went on because I don't really know how did I I was successful in one and I wasn't successful in the other so let's help me trace my my uh my my steps back. I mean I'm going to upload files.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, is that where I go, OK, and then I say [PII], and it says one second, I'm sorry, and it says [PII] applicant, right? Should I press this?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, perfect. And then I go next.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or click here if claimant or coverage type not listing no OK so next.
[CUSTOMER][NEUTRAL] And then I go upload files, right? And I'm going to select files and I'm going to Doctor G urgent care. I'm going to open.
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And submit, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so that's what I did before. I don't know why it, it didn't go through. Let's see if it's going through now.
[CUSTOMER][NEUTRAL] And then it says claim uploaded successfully I made OK one second.
[CUSTOMER][NEUTRAL] OK, now how can I go into my documents to see that I actually.
[CUSTOMER][NEUTRAL] OK, it doesn't show me that it's, it went on OK.
[CUSTOMER][NEGATIVE] It doesn't show me at my end.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][POSITIVE] OK, we got it.
[AGENT][NEUTRAL] I can see it on my end.
[CUSTOMER][NEUTRAL] You got what
[AGENT][NEUTRAL] What you just uploaded.
[CUSTOMER][NEUTRAL] Oh great. OK, so because I don't see it on, OK, that's, that's interesting because I don't see it in my end. That's why I'm, I was confused. OK, so basically speaking, you got everything that you wanted from me regarding this claim. You got the, the EOB, the explanation of the.
[AGENT][NEUTRAL] Let me look at what you just sent.
[AGENT][NEUTRAL] Let me look at what you just sent.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Let me look at what you just sent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem. Thank you. I appreciate your time and effort.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like it's just the same EOB I don't see.
[AGENT][NEUTRAL] Were you sent anything different? It's the same thing that you sent previously.
[CUSTOMER][NEUTRAL] What? Really?
[CUSTOMER][NEUTRAL] It's the same thing as you will be.
[AGENT][NEUTRAL] I don't see the diagnosis code. The information that I'm seeing is the same thing that
[AGENT][NEUTRAL] You just sent. It's, it's the same thing.
[AGENT][NEUTRAL] I don't see anything different.
[CUSTOMER][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] Give me a second please, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] I, I don't understand why you don't see it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me, let me send it again, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't, OK.
[CUSTOMER][NEUTRAL] So let me go back here and I'm going to upload files. Let's try it again and I'm going to go the claimant [PII], OK.
[CUSTOMER][NEUTRAL] Then I'm going to go.
[CUSTOMER][NEUTRAL] Mixed
[CUSTOMER][NEUTRAL] And I'm going to go to upload files.
[CUSTOMER][NEUTRAL] I'm going to give this again open.
[CUSTOMER][NEUTRAL] And subnet.
[CUSTOMER][POSITIVE] OK, successfully. Let's see now.
[CUSTOMER][POSITIVE] It's amazing that on my end, I don't see all the papers that I'm submitting.
[AGENT][NEUTRAL] Um, but it is telling you that it was submitted successfully, so you may not be able to see it until we open the claim and process it.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, would you like to just to check to see if you got it?
[AGENT][NEUTRAL] One moment. I have to give it at least a minute to.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you. OK.
[CUSTOMER][POSITIVE] I truly appreciate your time thank you.
[AGENT][POSITIVE] It's my pleasure.
[CUSTOMER][NEUTRAL] Is there possible a way that I can review the document I sent?
[CUSTOMER][NEUTRAL] Or there is no way I can review them.
[AGENT][NEUTRAL] If you're not able to see it, I'm not sure if you can't see it because we haven't opened the claim yet.
[AGENT][NEUTRAL] And it hasn't been processed yet. I, I don't know why you, you won't be able to see it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] But I do know once we open the claim and start processing it and we finish processing it you can see um I don't see I'm I'm looking through the.
[AGENT][NEUTRAL] The urgent care information now for the code. One moment, please. I see it right here. Allergic reaction is the diagnosis. OK, so we have what we need. Um, if you can just allow 7 to 10 business days to get that processed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. Thank you so very much. I appreciate it. Thank you.
[AGENT][NEUTRAL] OK, anything else I can assist with today?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Uh, no, thanks [PII], and I truly appreciate your help. Thank you.
[AGENT][POSITIVE] Thank you for calling APL you have a good day.
[CUSTOMER][POSITIVE] Thank you. The same to you, darling. Bye.
[AGENT][NEUTRAL] All right, bye bye.