AccountId: 011433970860
ContactId: c35f3ae6-7784-45d5-81a1-4a59089f3b61
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447579 ms
Total Talk Time (AGENT): 232146 ms
Total Talk Time (CUSTOMER): 139765 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/c35f3ae6-7784-45d5-81a1-4a59089f3b61_20250122T22:17_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Um, hi, [PII]. Uh, I had a question. I had my, um,
[CUSTOMER][NEUTRAL] Uh, health insurance person or APL person helped me with filing some claims, and they sent me the proof that they filed them, but for whatever reason they're not showing in my portal.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, all right.
[CUSTOMER][NEGATIVE] And so I'm very confused.
[AGENT][POSITIVE] Yes ma'am I can help you with that. Can you please give me uh your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII], and it's [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII].
[CUSTOMER][NEGATIVE] And do you want my policy number? Oh, you know what's so funny? They just started showing up.
[AGENT][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Oh when did you know it?
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEGATIVE] That's so crazy though because he filed them on [PII] and they're just starting to show up in the system.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] You know, it does take 7 to 10 business days once we receive the claim to get it completed. So,
[CUSTOMER][NEGATIVE] That's so weird.
[AGENT][NEUTRAL] It may be that they're just now getting the 18th.
[AGENT][NEUTRAL] They usually get them within the 1st 3 days is when they start processing them, so I bet they just got it to start processing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then can you look at it because it's weird because like one of them says process but has no money, no confirmation number, no nothing.
[AGENT][NEUTRAL] OK, yes, I'll look at them. What is your policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] 218-047-7
[AGENT][NEUTRAL] OK, let me pull that in real quick.
[CUSTOMER][NEUTRAL] And how far can you go back and file?
[AGENT][NEUTRAL] Is uh there's no timely filing limit as long as you're covered on the.
[AGENT][NEUTRAL] Date of service for the claim, you can submit it at any time.
[CUSTOMER][NEUTRAL] OK, because.
[CUSTOMER][NEUTRAL] And how do I see all of like when's the last time I filed a claim?
[AGENT][NEUTRAL] Uh, it should be on the.
[CUSTOMER][NEGATIVE] Because it only shows like the last 24 months, but I haven't filed. I don't even think I filed in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We just filed for 23 and 25.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I can look at that also, um, Ms. [PII], can you verify your date of birth for me please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then for security reasons, I'll need for you to verify your address, phone number, and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Um, [PII] email maybe S O [PII].
[AGENT][NEGATIVE] It's [PII]?
[CUSTOMER][NEUTRAL] Oh, that's my work email, [PII].
[AGENT][NEUTRAL] OK thank you and then the phone number that you gave me to call you back on.
[AGENT][NEUTRAL] That's your cell phone number?
[CUSTOMER][NEUTRAL] [PII] yep.
[AGENT][POSITIVE] OK, thank you so much I appreciate it. Alright, I'm looking at the clients.
[AGENT][NEUTRAL] So it looks like the first claim you ever filed with us was on [PII].
[AGENT][NEUTRAL] You filed
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Yeah, you filed um.
[CUSTOMER][NEUTRAL] 2022.
[AGENT][NEUTRAL] That was the first one for yourself and then the second one was on [PII].
[AGENT][NEUTRAL] And then we received your third claim on [PII].
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] That's the one that you got confirmation on today?
[CUSTOMER][NEUTRAL] Yes, I think.
[AGENT][NEUTRAL] OK, let me look at that. OK.
[CUSTOMER][NEUTRAL] Yeah I see that one.
[CUSTOMER][NEUTRAL] But on my screen I only show 43 in progress and 1 process.
[AGENT][NEUTRAL] OK and then um there's another one reported on [PII] that's um.
[AGENT][NEUTRAL] Let's see what that one says.
[AGENT][NEUTRAL] The last one, the one for [PII].
[AGENT][NEUTRAL] It's gonna be your claim number 3554326?
[AGENT][NEUTRAL] 3554326. That claim is for.
[CUSTOMER][NEUTRAL] Yeah, that's the one that says 0 and has.
[AGENT][NEUTRAL] Right, that's for [PII].
[AGENT][NEUTRAL] Um, that was the provider is [PII].
[CUSTOMER][NEUTRAL] No, it's not.
[CUSTOMER][NEUTRAL] Oh, the provider
[AGENT][NEUTRAL] The physician?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, the physician is [PII], and looking at the remarks on this one, it says the insurance primary insurance provided full benefits there are no benefits payable, so your primary insurance provided full benefits is what it says.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Um, I guess, I don't know, I'll have to show my insurance guy that cause he put
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], I don't know, it doesn't say he said.
[CUSTOMER][NEUTRAL] I don't know he just sent me like where it showed that I paid out of pocket.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that one is showing that the insurance company provided full benefits and there are no benefits payable, and that's on the one for [PII], the one that you sent in on [PII], the 355-42229. Let me look at that one. That one looks like it's been paid to you.
[AGENT][NEUTRAL] I'm pulling it up now $325.40.
[CUSTOMER][NEUTRAL] And where would that be going to I guess.
[AGENT][NEUTRAL] I'm gonna get um.
[AGENT][NEUTRAL] Let me see if I can find the check number on that one.
[AGENT][NEGATIVE] It's not giving me the check number because it was just done.
[AGENT][NEUTRAL] Um, so I have to process overnight for the check number to show up.
[CUSTOMER][NEUTRAL] Oh, OK, so it's probably all stuff I'll see.
[AGENT][NEUTRAL] Yes ma'am, it has to process overnight, but it's $325.40 payable to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I think that's good as long as everything's going so then.
[AGENT][NEUTRAL] Yeah, it's going, it's moving.
[CUSTOMER][NEUTRAL] OK, so I'll just give it some time and watch it and see what happens, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate your help. Thank you so much.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] You're welcome, Miss [PII] Thank you for calling APL. You have a great afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] All right.