AccountId: 011433970860
ContactId: b2da31a1-a4dd-4169-b754-7af477a26912
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233619 ms
Total Talk Time (AGENT): 60159 ms
Total Talk Time (CUSTOMER): 84940 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/b2da31a1-a4dd-4169-b754-7af477a26912_20250429T14:31_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Calling APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Yes, hi, good morning, [PII]. I am calling just to get some clarification on a recent claim that was completed.
[AGENT][POSITIVE] I'd be happy to assist with the claim today. May I have a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number is, bear with me one moment because I
[CUSTOMER][NEUTRAL] Jumped out. Um.
[CUSTOMER][NEUTRAL] 2556453
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] The the the subscribers [PII], who's my husband.
[AGENT][NEUTRAL] Alright, and what's the date of service?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] And this is a claim for yourself or a dependent?
[CUSTOMER][NEUTRAL] Myself.
[AGENT][NEUTRAL] [PII]. Looks like we made a $70 payment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] OK, if you look at the paperwork and I called with spoke with somebody earlier but they didn't really clarify very well and she was like, oh, if you're due any money they're, they'll re-review it but I just wanna make sure that we're on the same page. Um, the [PII] date of service is for the balance of 47,270, and I think they put the wrong date of service they put [PII].
[AGENT][NEUTRAL] OK, let me pull up the paperwork that was submitted one moment.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] OK, so they, I see what you're saying they should have paid.
[AGENT][NEUTRAL] Let me see 36. I only see one line. Oh, so I see, so for 36 they didn't see the deductible side they only pay the copay. Oh, so she has that highlighted.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um, it looks like she highlighted that at [PII] central, so that means she sent it back to the, um, examiner to be reprocessed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect. I just wanted to make sure because she was like, oh, I don't know. And then I'm like, oh well, how long should it take? Oh, I'm not sure. So I just felt a little.
[CUSTOMER][NEUTRAL] Concerned and I just said let me call back.
[AGENT][NEUTRAL] Oh well, our processing time, the normal processing time is 7 to 10 business days, um, so it'll be, it should be reprocessed within 10 business days.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] Sounds good. I appreciate it so much and have a great day.
[AGENT][POSITIVE] Oh, thank you for calling APO. You have a great day as well.
[CUSTOMER][NEUTRAL] Bye bye