AccountId: 011433970860
ContactId: b55f82b7-368c-428b-959e-312029ed9fc6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423630 ms
Total Talk Time (AGENT): 148250 ms
Total Talk Time (CUSTOMER): 143303 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/b55f82b7-368c-428b-959e-312029ed9fc6_20250618T20:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII].
[CUSTOMER][NEUTRAL] And I'm calling from office. The call is regarding a client information.
[AGENT][NEUTRAL] OK, I could check an account for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] Uh [PII]
[AGENT][NEUTRAL] OK, and then, uh, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh yeah, it's gonna be D as in David, 459-06904.
[AGENT][NEUTRAL] OK, so [PII], that's not one of our policy numbers, but it's through, uh, they're called 90 degree benefits. If you'd like, I can give you their information and transfer you to them, uh, or if you have the member's social, I can see if they have a policy with us.
[CUSTOMER][NEUTRAL] Um, let me check that one as well. Just give me a sec.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I don't have the social. I do have a client number here. Um, can you able to verify with that one?
[AGENT][NEUTRAL] Uh, yeah, you can give that to me. I can see if it's one of ours. Sure, I can let you know if it's ours.
[CUSTOMER][NEUTRAL] Um, yeah, let's see.
[CUSTOMER][NEUTRAL] Uh yeah, the client number is 356-407-0.
[AGENT][NEUTRAL] 4070. OK. That does sound like one of ours. Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What was the uh name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] Uh, yeah, patient's name was [PII], and date of birth is [PII].
[AGENT][NEUTRAL] OK. Uh, thank you for verifying that. Um, did you want me to go ahead and give you that correct policy number, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yes please, yeah.
[AGENT][NEUTRAL] Sure that is uh 02.
[AGENT][NEUTRAL] 57
[AGENT][NEUTRAL] 1692.
[CUSTOMER][POSITIVE] OK, got that. Thank you so much for that.
[AGENT][NEUTRAL] OK, of course, uh we we just needing clarification regarding the denial reason?
[CUSTOMER][NEUTRAL] Uh, yes, I need the information on this one.
[AGENT][NEUTRAL] OK, give me just a moment, let me check that for you.
[AGENT][NEUTRAL] OK, so it looks like there was a bit of a hiccup with this claim and so it's going to be uh reprocessed. I do apologize for any of that confusion we were awaiting information regarding their employer um or from their employer but as soon as we have that information then we'll be able to get the reprocessed.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Uh, you're still in waiting for that information from the patient?
[AGENT][NEUTRAL] Correct, uh, from the patient's employer.
[CUSTOMER][NEUTRAL] Pass employer.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so the client um is still pending, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, what, what exactly information you need from that?
[AGENT][NEUTRAL] It's eligibility information from their employer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is there any specific question on this one,
[AGENT][NEUTRAL] Uh, any particular one? I'm sorry.
[CUSTOMER][NEUTRAL] It is not
[CUSTOMER][NEUTRAL] Uh, is it, it is not regarding an accident detail information, right?
[AGENT][NEUTRAL] Regarding what? I'm sorry?
[CUSTOMER][NEUTRAL] Uh, because the note stating in here is the premium for this doss was not received and that's the entire description I do have here. So that's what I'm looking for is this, uh.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, so we're just waiting for that information from their employer and once we have that information then we'll be able to continue getting it processed.
[CUSTOMER][NEUTRAL] OK, couldn't, couldn't you be able to uh check the patient's eligibility dates on the data service now?
[AGENT][NEUTRAL] And at this time we're waiting for that information from their employer.
[CUSTOMER][NEUTRAL] Oh, OK, I got that. You don't have this information, uh.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yeah, sorry for all the confusion.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, no problem. Yes, I just got that clear and thank you so much for that. And nothing much issue. Yeah, can I get a callerence number for conversation on this phone?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Sure, that would just be my first name, last initial and today's date. Uh so my name is spelled [PII] Was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Uh, nothing much in here, and thank you so much for that. And I just wanna confirm that did you send any letters to the letters to to the the patient's employer regarding this one?
[AGENT][POSITIVE] Oh yes, to the employer, yes, absolutely that information has been sent to them.
[CUSTOMER][NEUTRAL] On which rate?
[CUSTOMER][NEUTRAL] Uh, on which date?
[AGENT][NEUTRAL] Um, let, mm, give me just a moment, let me check that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does look like last that was sent was um.
[AGENT][NEUTRAL] Well, give me just a moment. I'm going to look at the actual notes bear with me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, I'm unable to view that at the moment, [PII]. I apologize.
[CUSTOMER][NEUTRAL] OK, no problem. Uh, could you ini initiate another one, regarding this information to the
[CUSTOMER][NEUTRAL] Patient
[AGENT][NEUTRAL] Say, say that again, I'm sorry.
[CUSTOMER][NEUTRAL] Uh, could you initiate one more letter to the patient today?
[AGENT][NEGATIVE] We were, no, we're not going to be able to reach out to the patient regarding this.
[CUSTOMER][NEUTRAL] As a reminder
[CUSTOMER][NEUTRAL] Uh, uh, the patient employee, right, uh.
[AGENT][NEUTRAL] The patient can file, yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, let me, uh, get this information from the patient and uh we'll call you back and.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yeah, uh, nothing much and thank you so much, uh, uh, I'm sorry. Have a wonderful day.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] You're fine. You too. Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.