AccountId: 011433970860
ContactId: b7d1c42e-d731-44b8-9908-032a8aa2223c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403799 ms
Total Talk Time (AGENT): 131330 ms
Total Talk Time (CUSTOMER): 184716 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/b7d1c42e-d731-44b8-9908-032a8aa2223c_20250204T15:26_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling Ael [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII]. How are you?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] I have the insured on the phone. Um, let me know when you're ready for the policy number.
[AGENT][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] It's 247.
[CUSTOMER][NEUTRAL] 552 3.
[CUSTOMER][NEUTRAL] That should be for [PII].
[AGENT][NEUTRAL] OK, and you have a callback number?
[CUSTOMER][NEUTRAL] Uh, that number is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he's calling about, it looks like we're still waiting on medical records.
[CUSTOMER][NEGATIVE] Um, and I, you know, read the notes on [PII] to she reached out. He's, he's, he's irritated.
[CUSTOMER][NEUTRAL] Um, and that's pretty much what I told him, but he's holding the line. It's like, no, no, no, no, no, I want some further answers than that. So then it looks like we received the medical records under claim 353-4973, so I'm not for sure what's going on here.
[AGENT][NEUTRAL] OK, you can go and send them through and I'll just have to ask this.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] No, I'm saying you can send it through. I just have to ask to show you what the status of it is.
[CUSTOMER][POSITIVE] OK, OK, alright, here he comes, thanks.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Good morning. Thanks for calling AP's [PII]. Am I speaking with Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, yeah.
[AGENT][NEUTRAL] Um, the rep stated that you had a question about um the claim that's pending.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Just checking on the status.
[AGENT][NEUTRAL] OK, if you can give me one moment, I'm, I'm gonna look into this.
[CUSTOMER][NEUTRAL] On the phone.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's
[CUSTOMER][NEUTRAL] People still sent me my invoices.
[AGENT][NEUTRAL] OK, so, um,
[AGENT][NEUTRAL] The claim is still pending because we have not received the medical records. We reached out to the doctor's office, um, and this was last week, um, the same one you called last week and we haven't received that, those records to be able to process your claim.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Have y'all talked to him since last week?
[CUSTOMER][NEUTRAL] Like, have y'all gotten in contact with them to be able to get and they just haven't sent them to y'all yet or?
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Or y'all just haven't gotten in touch with him yet.
[AGENT][NEUTRAL] So it looks like, hold on one second, I'm still reading the notes. Hold on 1 2nd.
[CUSTOMER][NEGATIVE] I mean, this is getting ridiculous.
[CUSTOMER][NEUTRAL] And I've been waiting on the medical records for over almost a month now.
[AGENT][NEUTRAL] Yes, I mean, we can't, I mean, we can't press, like I said, um, some, um, doctor's office, they take, I mean, long, but like I said, that's the only thing that we're waiting on. So we do follow up weekly um to check the status and like I said, they still haven't sent it, so I mean, um, if you want to contact them to have them to, um, send over the information cause like I said, that is what we're waiting on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, let me ask you that when I call them, what exactly it is y'all y'all need?
[CUSTOMER][NEGATIVE] From them, so when I call them and tell them what they need to send, I know what to what to tell them and maybe even give them a freaking number to tell them to send it to or how are they gonna do that?
[AGENT][NEUTRAL] Let me go to
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] Like what exactly is it that y'all need?
[CUSTOMER][NEUTRAL] Uh I I know I, I faxed you all my medical records.
[AGENT][NEUTRAL] Well, it has to come from the doctor. So we sent them a letter. I'm just reading a letter. Hold on one second to see what dates we're needing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] I know last I talk I talked to, uh, well, I had an appointment.
[CUSTOMER][NEUTRAL] Uh, last month in January with my doctor, and I think this was like [PII], and I talked to him.
[CUSTOMER][NEUTRAL] And I said, hey, look, I got this metal, this, this insurance claim I'm trying to get, and they want me to do uh uh uh a spinal tap to prove that I have MS. And he was like, yeah, yeah, we talked to this my doctor was telling me that. He said, yeah, we spoke with him and I told him that uh.
[CUSTOMER][NEGATIVE] That they were that that that was an invasive procedure that didn't need to be done and we would get them the right paperwork so I just assumed he's already sent it to y'all but I guess not. So I'm gonna call him and be like hey man, look, they're still waiting on this, this, you know, medical records. I can't get my money until I get it.
[CUSTOMER][NEUTRAL] So when I call them, you know, I'd like to know exactly what.
[CUSTOMER][NEUTRAL] They need to send and
[CUSTOMER][NEUTRAL] Where to send it?
[AGENT][NEUTRAL] So, um, looking at the letter, I said the only thing they need to send is we need the medical records, um.
[AGENT][NEUTRAL] For the, um, hold on one second.
[AGENT][NEUTRAL] So when you ask for the medical records, they're gonna um for um.
[AGENT][NEUTRAL] They're gonna send a medical records that they have on file for you. So that's the only thing you would just need to tell them. Just let them know that we did send them a letter on [PII] stating that we are needing records, medical records to determine if we can pay your claim. So that's the only thing you would need to tell them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All y'all need
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] So all y'all just tell them that they need to send my whatever medical records I have, they have me on file to send it to y'all.
[AGENT][NEUTRAL] That is correct and they um can fax that over to us or mail it to us.
[CUSTOMER][NEUTRAL] OK, what
[CUSTOMER][NEUTRAL] OK, how, what's the fax number?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Wait [PII].
[CUSTOMER][NEUTRAL] 9423 you said?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And what did, what did they put like attention who?
[AGENT][NEUTRAL] This attention claims.
[CUSTOMER][NEUTRAL] Like who's this?
[CUSTOMER][NEUTRAL] Flames
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and it just needs to be my medical records, nothing else.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] All right I'll call him right now appreciate it.
[AGENT][POSITIVE] No problem, [PII]. Was there anything else that I can help you with today?
[CUSTOMER][POSITIVE] That's it thank you.
[AGENT][POSITIVE] No problem, thanks for calling Apo. You have a wonderful day.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Thank you.