AccountId: 011433970860
ContactId: baff4dff-279d-4f1d-9244-e64d417b6316
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 560619 ms
Total Talk Time (AGENT): 181256 ms
Total Talk Time (CUSTOMER): 293089 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/baff4dff-279d-4f1d-9244-e64d417b6316_20250410T15:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. My name is [PII], and I was calling um.
[CUSTOMER][NEUTRAL] I guess you're tired of me calling too, but um, I'm calling my husband, we, I sent in a claim for him and he's getting a little bit antsy about his claim because um he said he don't think he's not sure if the information I uploaded, the requested information is being tied to the actual claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because it doesn't have a claim number on it, the additional information, so he's just worried that they're not processing his claim because they may still be waiting on that information that he already sent in.
[AGENT][NEUTRAL] OK, we, we can take a look. Do you have his policy number?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] What's great.
[CUSTOMER][NEUTRAL] Yes, it's 1415882.
[AGENT][NEUTRAL] OK, let me pull that.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And then if I could just get your date of birth and address, please?
[CUSTOMER][NEUTRAL] My date of birth is [PII] and the address is [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Have you uploaded. OK, I see something on 41.
[CUSTOMER][NEUTRAL] OK, yes, so 41 was the additional information that they asked for the original claim, I think was um done on um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So when we filed that claim for his cancer, we also filed along with that, we sent in on his wellness checkup for the last few years because we didn't know that.
[CUSTOMER][POSITIVE] We had that benefit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the wellness part was paid, but not the cancer policy.
[CUSTOMER][NEUTRAL] And um because they wanted a physician stay, so that's what was sent in on [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] But he's just concerned because when
[CUSTOMER][NEUTRAL] You look at it online, it's not the claim, there's no claim number tying it to the actual claim.
[AGENT][NEUTRAL] Right, it's just showing still in progress.
[CUSTOMER][NEUTRAL] So I don't know if I was supposed to just send everything in all over again or just uploaded the requested information.
[AGENT][NEUTRAL] OK, so because the claim submitted on the [PII], that claim number shows a benefit payment for this for $300.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Did you guys get any of that?
[CUSTOMER][NEUTRAL] Right, and that was.
[CUSTOMER][NEUTRAL] Yeah, that was for the wellness ones all the wellness claims that um was submitted.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For the how many years we had to, we went back [PII], I believe.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] He just don't want to, and not see it and then he have to start the process all over and the wait time all over and.
[CUSTOMER][NEUTRAL] Because his bills is rolling in and he, he wanna get them paid.
[AGENT][NEUTRAL] Right, yeah, let me see.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] No, sometimes.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I'm just gonna double check the upload and see if there's.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And because we're just now at 7 days and so
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see if I think.
[AGENT][NEUTRAL] Don't think
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And so under the.
[CUSTOMER][NEUTRAL] Original claim, the upload for the pathology report is under there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and then the one for [PII] is the physician statement that they wanted.
[CUSTOMER][NEUTRAL] The upload for [PII].
[AGENT][NEUTRAL] I see that. OK.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I didn't know how to tie those things together, so they know that, you know.
[CUSTOMER][NEUTRAL] This is the information you requested for that claim.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right, right, right, well, and you're not alone on that, so I see exactly what you guys submitted and um that is correct. People do that um all the time honestly um they you know have to upload additional documents and um there's not a way to attach it to the original claim so the examiner does know to like hey what is this? Oh, that's maybe you know in reference to the previous claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I'm happy to go in and just notate our conversation. Um, they do check notes on policies and things like that. Um, I don't think you guys have anything to worry about.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Generally, claims can take up to 10 days, sometimes longer, depending on the type of claim. So, um, yeah, just tell them, unfortunately, give it a little bit more time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK, I guess he was like, he said, well the other claims paid really fast so, and I, and when he look then he don't see like a claim number or you know, uh.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, service from date or something, whatever it is, then he gets a little bit worried like.
[AGENT][NEUTRAL] Right, right.
[AGENT][POSITIVE] Yeah, I do.
[CUSTOMER][NEUTRAL] Do they know that this belonged to this?
[AGENT][NEUTRAL] I do know that we did have a meeting last week and I do know that claims is kind of backed up so they have been taking a little longer unfortunately and some of the um bigger claims can take a little longer so yeah just um give give it a little bit more time it's not asking for anything it's just showing still in progress so.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Alright, well if you could just document that that you know that those things do go together.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] Yes, ma'am, absolutely. I will put in the notes the claim number and then it's attached to that, OK?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK and um whenever they do process it, do they like email you and let you know that it's processed or you just have to keep checking the system?
[AGENT][POSITIVE] No, no, no, yeah, you should get um like an email notification or a text, yeah, like some sort of notification that it's been processed, absolutely.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, alright, because I know the last claim we didn't know. I, he just happened to call to check on them they told him the amounts that were paid, so and that's how we found out to look, yeah, so that's what I was wondering, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Alright, well hopefully not too much longer. No, that would be it. Alright.
[AGENT][POSITIVE] All right. Well, you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.