AccountId: 011433970860
ContactId: c21fa720-e15a-4c3d-a92a-04a99a8d2fad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371619 ms
Total Talk Time (AGENT): 153543 ms
Total Talk Time (CUSTOMER): 120340 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/c21fa720-e15a-4c3d-a92a-04a99a8d2fad_20250407T17:20_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] on the care team. Um, I'm wondering if you could assist this member with her claims. Um, she's got two different policy numbers, but I'm having a hard time following what's transpired, so.
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] OK. And what was the policy number? What was she calling in regards to just on the claim question or?
[CUSTOMER][NEGATIVE] Yeah, she she said she submitted the claims over a week ago and she got a letter confirming that we received them and then she said they were there this morning and now they've all disappeared when she looks at the portal so I'm not sure what I don't I can't tell what's going on so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Can you give me one of the policy numbers?
[CUSTOMER][NEUTRAL] Yeah, uh, the old one is 2384924.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she said she had.
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Yeah, and I verified her information. Um, she said she submitted some dates from [PII] that were for follow ups, and she said she submitted this is what the additional information she submitted a week ago stating they were for follow ups and then she also had some dates from [PII].
[CUSTOMER][NEUTRAL] But I can't follow what's um going on on the claims.
[AGENT][NEUTRAL] So did she say they were a follow up? OK, let's see what else here because I do see that.
[AGENT][NEUTRAL] Mail was moved, let me look under this other policy.
[CUSTOMER][NEUTRAL] Yeah, one references the other policy number and then when I pull it up on the other one, it references the other policy number so I'm not sure what I can't decipher what happened.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me see if I can see what's going on. Let's see, give me a moment, let me take a look here.
[AGENT][NEUTRAL] Oh my. I see what you're talking about.
[AGENT][NEUTRAL] That's, they, that's done on under all the policies.
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Yeah, let me see.
[AGENT][NEUTRAL] If I can find the mail itself and see if they maybe put a note on the mail.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Wonder who
[AGENT][NEGATIVE] I can't even find the mail. Let's see here.
[AGENT][NEUTRAL] Oh wait, OK, it looks like it's been sent back to indexing. OK, let's see here, see if they put a note on here to see what is going on.
[AGENT][NEUTRAL] Hmm. And you said she sent in for several different dates of service for [PII]?
[CUSTOMER][NEUTRAL] Yeah she said she had some for [PII] um she I, she didn't specify how many and then some for [PII] she's just concerned because she said she saw it on the portal and now it disappears.
[AGENT][NEUTRAL] Mm, cause this piece of mail here that I see that it was put under the policy 2384924, it's only one page. It looks like it's only just a referral for, it looks like a date of
[AGENT][NEUTRAL] [PII] and that's it. That's the only page. Let me look at something else. Let me see.
[AGENT][NEUTRAL] Yeah, that's the only thing that I see that was sent under that policy, the 2384924 on that document.
[CUSTOMER][NEUTRAL] It looks like we had uh 1114 23 on the 2528619, but then it says see policy 2384924.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] So I don't know what happened.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, I'll have to look further on this one. I'll have to get with the examiner that DM this mall to see exactly what's going on.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Because I'm not able to determine why come this mall has been DM2 under both of these policies and it isn't noted on the noted anywhere as to what's going on with this. I will have to reach out to the examiner to check on this.
[CUSTOMER][NEUTRAL] OK, do you wanna talk to the member? Do you want me to just tell her somebody will research and call her back or?
[AGENT][POSITIVE] Yes, yes, you can get, get her um information and we can give her a call back.
[CUSTOMER][NEUTRAL] OK, do you need anything else from me?
[AGENT][NEUTRAL] No, I don't.
[CUSTOMER][NEUTRAL] You'll look, OK, OK, do you want me to like, um, send a chat?
[AGENT][NEUTRAL] And what is her callback number?
[CUSTOMER][NEUTRAL] Uh, call back is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yeah, I'll take, I'll um I'll have, I took her number [PII] and I'll have the examiner reach back out to her cause I'm, I have to check with her to see what's going on with these documents cause I'm not able to see what's going on while they're getting DM2d.
[CUSTOMER][NEUTRAL] OK all right I'll let her know somebody will be reaching back out.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Oh thank you, bye.
[AGENT][NEUTRAL] Bye bye.