AccountId: 011433970860
ContactId: b6be9bf3-1155-41c6-a4bd-a8dcd67dc01c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 436950 ms
Total Talk Time (AGENT): 150092 ms
Total Talk Time (CUSTOMER): 167860 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/b6be9bf3-1155-41c6-a4bd-a8dcd67dc01c_20241230T19:53_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from March Mayer Concrete, and I'm calling, um, see like I'm getting up in status update on a.
[CUSTOMER][NEUTRAL] And claims that I submitted from one of my
[CUSTOMER][NEUTRAL] Employees
[AGENT][POSITIVE] OK, sure, I can assist you with claims with Barra. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I have um also the claim numbers, OK? You need that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, I'm gonna need the policy number if you have it.
[CUSTOMER][POSITIVE] Oh, the policy, yes, uh, I'm right on his.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] It's, it's for two of them. I wanna.
[CUSTOMER][NEUTRAL] Wanna check on the short term disability first, so she's 224.
[CUSTOMER][NEUTRAL] 4733.
[AGENT][NEUTRAL] What's the name and date of birth?
[CUSTOMER][NEUTRAL] The name is [PII].
[CUSTOMER][NEUTRAL] And date of birth is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And I need to verify some information from you. Um, I need your email address.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's the name of the group?
[CUSTOMER][NEGATIVE] Much smaller concrete.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, let me check the status of the claim, one moment.
[CUSTOMER][NEUTRAL] Yeah, because I still needed it like, um, I think it was like [PII] or [PII].
[CUSTOMER][NEUTRAL] It's in um English I know.
[AGENT][NEUTRAL] OK, so that it was incomplete. We need the physician to complete the physician portion.
[CUSTOMER][NEUTRAL] Decision. So let me double check this, but it was submitted in the same file. I know I have some image issues because
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He doesn't have uh access to, you know, like a car or anything, so he sent us.
[CUSTOMER][NEUTRAL] Pictures, so we try to do our best and we put it on our PDF file and it's still there for some reason you guys cannot read it. It's uh it's legible or something because it'sn't there.
[AGENT][NEUTRAL] Mm, that's not
[AGENT][NEUTRAL] Yeah, that's not the reason that it was saying that it's not there. Let me go ahead and see if I'm able to view the image. One moment.
[CUSTOMER][NEUTRAL] Yeah, cause
[AGENT][NEGATIVE] Yeah, if it's not legible, they will let us know that it's not legible, but they're saying that it's just missing. Mm mm, no. Let me see.
[CUSTOMER][NEUTRAL] So, that's not it? OK. I don't know. It's in there, it has, let me see, is it employer.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Employee and physician, so I don't know.
[AGENT][NEUTRAL] OK, I'm waiting on the documents to upload.
[AGENT][NEUTRAL] Let's deal with.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, here it is. Let's go to the pages.
[AGENT][NEUTRAL] No no.
[AGENT][NEUTRAL] I deposit.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh
[AGENT][NEGATIVE] The physician's form is incomplete.
[AGENT][NEUTRAL] Um, so the top part doesn't have the information of the insured, so it's like they send in.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Information of the doctor, but it doesn't have the member's information.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Oh, I see. Oh my God, I see the patient name and the social. Oh my God, I see.
[AGENT][NEUTRAL] Uh-huh, yeah.
[AGENT][NEGATIVE] Yes, and then, yeah, and then the bottom part was like blurry. It has like a big stain, like black stain. I'm not sure if it's because of the printer or something, so, so that one, yeah, it's, that part is not legible, but yeah, it's missing the top part as well too. Mhm.
[CUSTOMER][NEUTRAL] Yeah, I don't know.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK, I do, I do see that now, of course, like, oh my [PII], really? OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] All right
[CUSTOMER][POSITIVE] Excellent. Well, did you, can you check on the, we submit another 10 no, I closed it. Um for the critical illness, I believe. Do you see that one?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, let me get back and I closed the drink.
[CUSTOMER][NEUTRAL] If you the
[CUSTOMER][NEGATIVE] Sorry my computer is so slow.
[AGENT][NEUTRAL] Mhm, um.
[CUSTOMER][NEGATIVE] My computer's just like me, doesn't wanna work anymore. What.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Uh, let's see, let me see why this, this one it looks like it is also pending. Let me see why.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Like.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't realize he only had to send me one for the hospital stay too. He stayed there for 2 days.
[AGENT][NEUTRAL] OK, so it looks like um let's see, let's see.
[AGENT][NEUTRAL] We need um itemized bill or medical records for the claim.
[CUSTOMER][NEUTRAL] That you might still on that one? OK.
[AGENT][NEUTRAL] Mhm. Yes.
[CUSTOMER][NEUTRAL] OK, I can get that OK.
[CUSTOMER][POSITIVE] OK. I think you have been wonderful and very helpful.
[AGENT][POSITIVE] Mhm. You're welcome.
[CUSTOMER][POSITIVE] Um, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today? Any other questions or concerns, Miss [PII]?
[CUSTOMER][NEUTRAL] I'm gonna call her right now.
[CUSTOMER][POSITIVE] No, that will be all. Thank you very much and you have a happy new year.
[AGENT][NEUTRAL] Mhm. OK.
[AGENT][POSITIVE] Happy New Year. Thank you for calling APL. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. You too.